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What Is a Celiac Plexus Block?

A celiac plexus block is an interventional pain procedure that injects medication around the celiac plexus, a network of sympathetic nerves in the upper abdomen. These nerves carry visceral pain signals from organs including the pancreas, stomach, liver, gallbladder, spleen, and parts of the intestines. Local anesthetic can temporarily interrupt pain transmission and can also help predict whether longer-lasting neurolysis is likely to help. Celiac plexus neurolysis is related but uses a destructive agent such as alcohol to produce a longer-lasting interruption of nerve signaling.

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What Is a Celiac Plexus Block?

A celiac plexus block is an interventional pain procedure that injects medication around the celiac plexus, a network of sympathetic nerves in the upper abdomen. These nerves carry visceral pain signals from organs including the pancreas, stomach, liver, gallbladder, spleen, and parts of the intestines. Local anesthetic can temporarily interrupt pain transmission and can also help predict whether longer-lasting neurolysis is likely to help. Celiac plexus neurolysis is related but uses a destructive agent such as alcohol to produce a longer-lasting interruption of nerve signaling.

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Why Is a Celiac Plexus Block Performed?

The procedure is used for selected patients with severe upper abdominal visceral pain that remains difficult to control with less invasive treatments. Pancreatic cancer is one of the most common malignant indications, and chronic pancreatitis or other upper abdominal disorders can also produce pain that is considered for blockade. The goal is to reduce pain and sometimes reduce reliance on opioid medication and its side effects. Patient selection considers pain pattern, diagnosis, bleeding risk, infection, anatomy, previous surgery, and response to other pain treatments.

How Is a Celiac Plexus Block Performed?

The patient is positioned according to the chosen approach, and computed tomography, fluoroscopy, ultrasound, or endoscopic ultrasound can be used to guide needle placement. The needle is advanced near the celiac plexus around the origin of the celiac artery and the front of the aorta while nearby organs and vessels are avoided. Contrast can be used with radiographic techniques to confirm spread before local anesthetic is injected. Neurolysis, when specifically planned, uses a neurolytic agent rather than a standard temporary local-anesthetic block.

What Is Recovery Like After a Celiac Plexus Block?

Patients are observed after the procedure because temporary low blood pressure, diarrhea, back soreness, or abdominal discomfort can occur as sympathetic nerve activity decreases. Hydration and blood-pressure monitoring are commonly used during the early recovery period. Pain relief can begin quickly after local anesthetic injection but varies in intensity and duration among patients. Follow-up determines whether the block provided useful relief and whether repeat block, neurolysis, medication adjustment, or another pain treatment is appropriate.

What Are the Risks and Complications?

Possible complications include temporary hypotension, diarrhea, bleeding, infection, bruising, and pain at the needle site. Accidental injury to nearby vessels, kidneys, bowel, nerves, or other structures can occur despite image guidance. Rare serious complications include pneumothorax, local-anesthetic toxicity, spinal or epidural injection, neurologic injury, and paralysis. Anticoagulation, low blood pressure, infection, and altered anatomy require careful review before the procedure.

Frequently Asked Questions About Celiac Plexus Block

What pain does a celiac plexus block treat?

It targets visceral pain from upper abdominal organs and is commonly used for selected patients with pancreatic cancer pain or chronic pancreatitis pain.

Is a celiac plexus block the same as celiac plexus neurolysis?

No. A standard block commonly uses local anesthetic for temporary interruption, while neurolysis uses an agent such as alcohol to produce a longer-lasting destructive effect on nerve transmission.

How is the celiac plexus located during the procedure?

Imaging such as computed tomography, fluoroscopy, ultrasound, or endoscopic ultrasound is used to guide the needle toward the plexus while avoiding nearby structures.

Why can diarrhea occur after a celiac plexus block?

Blocking sympathetic nerves can temporarily increase intestinal activity because parasympathetic influence becomes relatively unopposed, which can lead to diarrhea.

References

Celiac Plexus Block: What It Is, Side Effects & Benefits. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/16853-celiac-plexus-block. Date Accessed September 11, 2026.

Celiac Plexus Block. StatPearls (NCBI Bookshelf). https://www.ncbi.nlm.nih.gov/books/NBK531469/. Date Accessed September 11, 2026.

About Your Celiac Plexus Block Procedure. Memorial Sloan Kettering Cancer Center. https://www.mskcc.org/cancer-care/patient-education/celiac-plexus-block. Date Accessed September 11, 2026.

Pain Management - Pancreatic Cancer. Johns Hopkins Pathology. https://pathology.jhu.edu/pancreas/treatment/pain-management. Date Accessed September 11, 2026.

Celiac Plexus Block and Neurolysis: A Review. PubMed. https://pubmed.ncbi.nlm.nih.gov/30241645/. Date Accessed September 11, 2026.