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Celiac plexus blockade in children using a three-dimensional fluoroscopic reconstruction technique: case reports.
Kenneth R Goldschneider1, John M Racadio, Norbert J Weidner
1Division of Pain Management, Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA. Kenneth.goldschneider@cchmc.org
Regional Anesthesia and Pain Medicine
|November 24, 2007
Summary
Three-dimensional rotational angiography successfully guided celiac plexus blocks for abdominal pain relief. This technique enhances understanding of medication spread for improved procedural success.
Area of Science:
- Interventional Radiology
- Pain Management
- Medical Imaging
Background:
- Celiac plexus blockade is used for intractable upper abdominal pain.
- Cases included chronic pancreatitis, abdominal pain with gastrointestinal dysmotility, and adrenocortical carcinoma.
- Facilitating retrocrural celiac plexus blockade can be challenging.
Observation:
- A novel application of 3-dimensional rotational angiography was employed.
- This technique visualizes the spread of injected medication in three dimensions.
- The technology is adapted from 3-dimensional rotational angiography.
Findings:
- Three-dimensional rotational angiography was applied to three cases.
- The technique was used to facilitate retrocrural celiac plexus blockade.
- Clinical success was achieved in all three cases.
Implications:
- 3D rotational angiography offers promise for visualizing injectate spread during celiac plexus blocks.
- It may help explain block failures due to anatomical distortions.
- This technique could improve the success rate of celiac plexus interventions.