title: Classic transcrural celiac plexus block simulated on 100 computed tomography images.
abstract: OBJECTIVE
  To evaluate intra-abdominal needle trajectories of the classic transcrural celiac plexus block (tCPB) with a simulation technique.
  
  
  METHODS
  Classic tCPB technique cited from 10 latest authoritative textbooks were simulated on abdominal computed tomography images retrospectively.
  
  
  METHODS
  University-affiliated community hospital.
  
  
  METHODS
  One hundred axial computed tomography images across the celiac trunk were retrieved. Three lines simulating classic tCPB were executed on each image. The organs traversed by each line were noted and analyzed. The frequencies of organ traverse were compared with the incidences described in the literature.
  
  
  RESULTS
  All 3 lines traversed various organs with different frequencies. The right side line frequently traversed the right kidney (36%). The left side line always traversed the aorta (100%). The modified line on the right side frequently traversed the inferior vena cava (32%). The highest kidney traverse percentage on both sides and the highest aorta traverse percentage on the right side were observed in pancreatic cancer patients.
  
  
  CONCLUSIONS
  Despite uncommon clinical complications, classic tCPB needle placement frequently traversed through several key organs in this simulation series. Organ penetrations could be avoided by needle trajectory adjustment.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, NY 10457, USA. Electronic address: iyangmd@gmail.com.
authors.forename: Ian Y
authors.initials: IY
authors.lastname: Yang
authors.affiliation: Department of Anesthesiology and Pain Medicine, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, NY 10457, USA.
authors.forename: Saeed
authors.initials: S
authors.lastname: Oraee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, NY 10457, USA.
authors.forename: Carlos
authors.initials: C
authors.lastname: Viejo
authors.affiliation: Department of Radiology, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, NY 10457, USA.
authors.forename: Harvey
authors.initials: H
authors.lastname: Stern
mesh_terms: D000328:Adult; D000368:Aged; D066008:Cervical Plexus Block / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D010190:Pancreatic Neoplasms / Q000473:pathology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Classic technique; Image simulation; Transcrural celiac plexus block