[Diagnostic and therapeutic blockade of the celiac ganglia]

Neurolytic celiac plexus block is the therapy of choice for visceral upper abdominal pain that is resistant to therapy. In order to ensure that the treatment is indicated a temporary block for diagnostic purposes (application of a local anesthetic) has to be carried out. A diagnostic block can be performed as a blind puncture according to anatomic criteria if new computed tomograms are available providing the necessary information on the patient's anatomy. In 18 patients who underwent a diagnostic block by this procedure no side effects could be observed. If neurolytic substances (e.g. ethanol 96%) are used, a contrast medium should be added to make roentgen control and documentation possible. Computed tomography is a very suitable procedure for these purposes. The location, angle and depth of the puncture can be calculated by the computer tomograph. Of 14 patients in whom we performed a CT-guided block of the celiac ganglion, 10 were free from pain afterwards or showed considerably reduced pain symptoms. The side effects that could be observed were but slight and passed after a few days.