A celiac plexus block is an image-guided injection that interrupts pain signals from the upper abdominal organs, offering relief for people with severe pancreatic or other upper-abdominal cancer pain when oral medications fall short.
OVERVIEW
What a celiac plexus block is and how it works
The celiac plexus is a dense network of nerves located deep in the upper abdomen, in front of the spine near where the aorta passes through the diaphragm. These nerves relay pain sensations from organs such as the pancreas, liver, gallbladder, stomach, and upper intestines toward the brain. When disease in this region produces severe, hard-to-control pain, blocking the celiac plexus can quiet those signals before they reach the spinal cord.
During the procedure, an interventional pain physician at Columbia Pain & Spine Institute uses imaging to guide a thin needle toward the celiac plexus and deposits medication around the nerves. A diagnostic block uses local anesthetic to confirm that the celiac plexus is the source of the pain. A therapeutic, longer-lasting block, often called neurolysis, uses an agent such as alcohol or phenol to interrupt the nerves for more durable relief, an approach commonly used in pancreatic and other upper-abdominal cancers.
CONDITIONS
What a celiac plexus block commonly treats
A celiac plexus block is most often used for visceral pain arising from the upper abdomen, particularly cancer-related pain that is no longer well controlled by oral medication.
Commonly treats
YOUR VISIT
What to expect
Before
You will review your medications with our team, including blood thinners, which may need to be paused beforehand. Because the procedure can temporarily lower your blood pressure, you will be asked to arrange a ride home and to follow any fasting instructions you are given.
During
You typically rest on your stomach while the skin is numbed. Using image guidance such as fluoroscopy or CT, your physician advances a thin needle toward the celiac plexus, confirms placement with contrast dye, and injects the medication. The procedure usually takes about 30 to 60 minutes, and sedation may be offered for comfort.
After
You are monitored for a short time, in part to check your blood pressure as the block takes effect. Mild soreness at the injection site or a temporary change in bowel habits, such as loose stools, can occur. Many patients return to light activity within a day or two, and your care team will explain how to track your pain relief.
QUESTIONS
Frequently asked questions
How long does relief from a celiac plexus block last?
It varies. A diagnostic block with local anesthetic provides shorter-term relief, while a neurolytic block is intended to last longer, sometimes weeks to months. Because nerves can regenerate, a neurolytic block may need to be repeated. Your physician will discuss what is realistic for your situation, since individual results differ and no specific outcome can be guaranteed.
Is the celiac plexus block the same as other plexus blocks?
No. Each block targets a different nerve network. The celiac plexus serves the upper abdomen, while the superior hypogastric plexus block addresses lower pelvic pain and the stellate ganglion block targets the head, neck, and upper limb. You can compare related options on our plexus and ganglion blocks hub.
Will I be awake during the procedure?
It depends on your needs and your physician’s plan. The skin is numbed with local anesthetic, and sedation is often available to keep you comfortable. Our team will review sedation options with you in advance so you know what to expect.
NEXT STEPS
Talk with our Gresham & Portland pain specialists
The fellowship-trained physicians at Columbia Pain & Spine Institute perform celiac plexus blocks for patients across Gresham, Portland, and the greater Portland metro area. If upper-abdominal or pancreatic cancer pain is limiting your daily life, we can help you understand whether this procedure is appropriate for you. Explore our full range of interventional pain services or related options such as the intercostal nerve block and sympathetic nerve block.