Contribution to the variability in the coeliac plexus structure and formation.

Area of Science:

• Anatomy
• Pain Management
• Surgical Procedures

Background:

• The coeliac plexus is a key target for managing intractable abdominal pain from pancreatic and neighboring organ pathologies.
• Variations in coeliac plexus anatomy are a known cause of procedural failure in pain management interventions.
• Accurate anatomical knowledge is essential for successful coeliac plexus interventions.

Purpose of the Study:

• To investigate the anatomical variations of the coeliac plexus in human cadavers.
• To provide detailed anatomical data to improve the success rates of coeliac plexus blocks and sympathectomy.
• To highlight anatomical factors influencing the efficacy of pain management strategies for abdominal malignancies.

Main Methods:

• Dissection of 20 human cadavers (17 male, 3 female; age 30-86 years) in a supine position.
• Systematic examination of the abdominal autonomic nervous system, including the coeliac plexus.
• Identification and measurement of coeliac ganglia and their connections to surrounding nerves.

Main Results:

• Coeliac ganglia size varied significantly (5-45 mm), with notable right-left asymmetry (largest 45 mm right, 25 mm left).
• Ganglia number ranged from 2 to 12, exhibiting diffuse or concentric organization.
• The coeliac plexus typically receives branches from the greater splanchnic and vagus nerves, with occasional contributions from lesser splanchnic, phrenic, and accessory phrenic nerves.

Conclusions:

• Anatomical variability of the coeliac plexus must be considered in procedures like sympathectomy and coeliac blocks.
• Awareness of these variations can help optimize pain relief strategies for patients with pancreatic cancer.
• Further anatomical studies are needed to refine interventional pain management techniques targeting the coeliac plexus.