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Celiac Plexus Blockade in Children Using a Three-Dimensional Fluoroscopic Reconstruction Technique: Case Reports
  1. Kenneth R. Goldschneider, M.D.,
  2. John M. Racadio, M.D. and
  3. Norbert J. Weidner, M.D.
  1. Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
  2. Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
  1. Reprint requests: Kenneth R. Goldschneider, M.D., Division of Pain Management, Department of Anesthesia, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3039. E-mail: Kenneth.goldschneider{at}cchmc.org

Abstract

Background and Objectives: We present three cases wherein a new radiologic technique was used to facilitate performance of retrocrural celiac plexus blockade. Three patients presented to our institution for performance of celiac plexus block for relief of intractable upper abdominal pain. One carried the diagnosis of chronic pancreatitis, one abdominal pain and gastrointestinal dysmotility, the other adrenocortical carcinoma.

Methods: We applied the technology used in 3-dimensional rotational angiography to determine spread of the injected medication in three dimensions, and facilitate the blocks.

Results: Three-dimensional rotational angiography was used with clinical success.

Conclusions: Three-dimensional rotational angiography shows promise for understanding the spread of medication necessary to accomplish a successful block, and may help explain failures in cases where anatomic distortion may interfere with proper injectate flow.

  • Abdominal pain
  • Celiac plexus block
  • Children
  • Rotational angiography

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