Celiac plexus blockade in children using a three-dimensional fluoroscopic reconstruction technique: case reports.
OBJECTIVE
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.
Goldschneider
Kenneth R
KR
Division of Pain Management, Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA. Kenneth.goldschneider@cchmc.org
Racadio
John M
JM
Weidner
Norbert J
NJ
D000306:Adrenal Cortex Neoplasms / Q000150:complications; D000328:Adult; D002277:Carcinoma / Q000150:complications; D002447:Celiac Plexus / Q000033:anatomy & histology; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications; D017809:Fatal Outcome; D005769:Gastrointestinal Motility / Q000187:drug effects; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D028361:Mitochondrial Diseases / Q000150:complications; D009407:Nerve Block; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D010166:Palliative Care; D010195:Pancreatitis / Q000150:complications