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The Celiac Ganglia in Man

Normal Anatomic Variations

Ellen M. Ward, MD^*, Duane K. Rorie, MD, PhD, Lee A. Nauss, MD, and Robert C. Bahn, MD, PhD

*Resident in Internal Medicine, Mayo Graduate School of Medicine, Departments of Internal Medicine, Mayo Cinic and Mayo Foundation, Rochester, Minnesota 55901. Assistant Professor of Anesthesiology and Associate Professor of Anatomy, Mayo Medical School. Department of anesthesiology, Mayo Cinic and Mayo Foundation, Rochester, Minnesota 55901. Assistant Professor of Anesthesiology, Mayo Medical School. Department of anesthesiology, Mayo Cinic and Mayo Foundation, Rochester, Minnesota 55901. Professor of Pathology, Mayo Medical School. Department of Pathology, Mayo Cinic and Mayo Foundation, Rochester, Minnesota 55901.

Abstract

The celiac ganglia and plexus were examined during autopsy in 20 adult bodies. The size of the ganglia and their relationships to the celiac artery were determined by direct measurement; their relationships to the anterior vertebral column and to different vertebral levels were determined by roentgenography after markers outlining the ganglia had been applied. The celiac ganglia were found to vary in diameter from 0.5 to 4.5 cm, in number from 1 to 5, and in location from the middle of the second lumbar vertebra to the intervertebral disk between the T-12 and L-1 vertebrae. The average distances of the ganglia below the celiac artery on the right and left sides were 0.6 and 0.9 cm, respectively. Most frequently, the ganglia were less than 1.5 cm in front of the anterior vertebral margin, as determined by lateral roentgenographic views. These findings indicate that celiac plexus block is most likely to be successful if the needle on the left side is placed so that the tip is at the level of the junction of the middle and lower thirds of the first lumbar vertebra and if the needle on the right side is placed approximately 1 cm higher. The needle tips should be placed from 1 to 1.5 cm anterior to the anterior vertebral margin. Use of computed tomography for locating the celiac artery and ganglia before blocks gave inconsistent results.

Key Words: ANATOMY: celiac plexus; • ANESTHETIC TECHNIQUES, Regional: celiac plexus.

This article has been cited by other articles:

				X. M. Zhang, Q. H. Zhao, N. L. Zeng, C. P. Cai, X. G. Xie, C. J. Li, J. Liu, and J. Y. Zhou The celiac ganglia: anatomic study using MRI in cadavers. Am. J. Roentgenol., June 1, 2006; 186(6): 1520 - 1523. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999