A Comprehensive Review of the Celiac Plexus Block for the Management of Chronic Abdominal Pain

Curr Pain Headache Rep. 2020 Jun 11;24(8):42. doi: 10.1007/s11916-020-00878-4.


Purpose of review: Chronic abdominal pain (CAP) is a significant health problem that can dramatically affect quality of life and survival. Pancreatic cancer is recognized as one of the most painful malignancies with 70-80% suffering from substantial pain, often unresponsive to typical medical management. Celiac plexus neurolysis and celiac plexus block (CPB) can be performed to mitigate pain through direct destruction or blockade of visceral afferent nerves. The objective of this manuscript is to provide a comprehensive review of the CPB as it pertains to CAP with a focus on the associated anatomy, indications, techniques, neurolysis/blocking agents, and complications observed in patients who undergo CPB for the treatment of CAP.

Recent findings: The CAP is difficult to manage due to lack of precision in diagnosis and limited evidence from available treatments. CAP can arise from both benign and malignant causes. Treatment options include pharmacologic, interventional, and biopsychosocial treatments. Opioid therapy is typically utilized for the treatment of CAP; however, opioid therapy is associated with multiple complications. CPB has successfully been used to treat a variety of conditions resulting in CAP. The majority of the literature specifically related to CPB is surrounding chronic pain associated with pancreatic cancer. The literature shows emerging evidence in managing CAP with CPB, specifically in pancreatic cancer. This review provides multiple aspects of CAP and CPB, including anatomy, medical necessity, indications, technical considerations, available evidence, and finally complications related to the management.

Keywords: Celiac plexus block; Chronic abdominal pain; Neurolytic agents; Neurolytic blocks; Pancreatic cancer.

Publication types

  • Review

MeSH terms

  • Abdominal Pain / etiology
  • Abdominal Pain / therapy*
  • Celiac Plexus*
  • Chronic Pain / etiology
  • Chronic Pain / therapy*
  • Ethanol / therapeutic use
  • Glucocorticoids / therapeutic use
  • Humans
  • Nerve Block / methods*
  • Pancreatic Neoplasms / complications
  • Pancreatitis, Chronic / complications
  • Phenol / therapeutic use
  • Triamcinolone / therapeutic use
  • Visceral Pain / etiology
  • Visceral Pain / therapy*


  • Glucocorticoids
  • Triamcinolone
  • Phenol
  • Ethanol