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Results for “CELIAC PLEXUS”

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At least 595 records · Page 33Linked to original sources

PubMed1983

Unilateral computerised tomography guided coeliac plexus block: a technique for pain relief.

Twelve patients have undergone unilateral coeliac plexus block using needle localisation by computed tomography and the technique is described. Computed tomography has the advantage that the needle route to the coeliac axis can be accurately planned, avoiding damage to other organs. In this study nine out of twelve patients had significant pain relief. Most success was achieved in patients with carcinoma of the pancreas.

Abdominal Neoplasms↗

PubMed2001

Sympathetic blockade for the relief of chronic pain.

The sympathetic blocks are useful in many ways for relief of chronic pain. The sympathetic block can be caused at pre- and paravertebral sympathetic ganglia eg, stellate ganglia, coeliac plexus and lumbar sympathetic ganglia. Indications for sympathetic blockade are: Complex regional pain syndrome, phantom limb pain, central pain, acute pancreatitis, pancreatic cancer and cancer pain from upper abdominal viscera. Stellate ganglion blockade is required for the diagnosis, prognosis and therapy for painful and other conditions associated with sympathetic dysfunctions of head, neck and upper extremity. Coeliac plexus block is indicated in pain due to intra-abdominal cancer, stemming from organs innervated by coeliac plexus. Lumbar sympathetic block is indicated for diagnosis, prognosis and therapy for painful and other conditions associated with sympathetic dysfunctions like complex regional pain syndrome I and II, herpes zoster, amputation stump pain and inoperable peripheral vascular vasospastic diseases of the lower limb. Indications for superior hypogastric block are the prognostic and therapeutic purposes of cancer pelvic organs--uterus, cervix, bladder, prostate, urethra, testes and ovaries.

Anesthetics, Local↗

PubMed1997

Nitric oxide synthase distribution in the enteric nervous system of children with cardiac achalasia.

OBJECTIVE: To study the distribution of nitric oxide synthase (NOS) in the enteric nervous system of children with cardiac achalasia. METHODS: Biopsy specimens of the lower esophagus, cardia, gastric fundus and pylorus from 13 patients with cardiac achalasia and 6 controls were obtained and studied histochemically with nicotinamide adenine dinucleotide phosphate diaphorase (NADPH-d) and immunohistochemically with a specific polyclonal antiserum. RESULTS: NOS was abundant in the myenteric plexus and the nerve fibers of musculatures in the esophagus, cardia and gastric fundus in control group, while it was nearly absent in the patient group. The distribution of NOS in the pylorus was similar in the two groups. CONCLUSION: These findings suggest that a lack of NOS in the lower esophagus, cardia and gastric fundus is involved in the pathophysiology of cardiac achalasia in children.

Adolescent↗

PubMedDate not supplied

New insights into the organization of a gastroduodenal inhibitory reflex by the coeliac plexus.

The mechanisms involved at the prevertebral ganglionic level in a gastroduodenal inhibitory reflex were investigated in the rabbit on an in vitro preparation of the coeliac plexus connected to the stomach and duodenum. Intraluminal gastric and duodenal pressures were measured using water-filled balloons. Gastric distension inhibited duodenal motility via a nerve reflex which was abolished by section of the nerves connecting the coeliac plexus to the viscera. Superfusion of the coeliac plexus with a low Ca(2+)-high Mg2+ solution abolished the gastroduodenal inhibitory reflex, indicating a synaptic link at the ganglion level. The reflex was unaffected by superfusion of the coeliac plexus with hexamethonium and tubocurarine, ruling out a nicotinic mechanism. The reflex persisted when the coeliac plexus was superfused with tetrodotoxin or when the nerves connecting the coeliac plexus to the viscera were superfused with a Na(+)-free solution; these results indicate that the reflex does not involve sodium-dependent action potentials. Moreover, superfusion of the nerves connecting the coeliac plexus to the viscera with a calcium blocker or with a Ca(2+)-free solution also failed to abolish the reflex, suggesting that calcium-dependent action potentials are not involved. Our study demonstrates that a gastrointestinal inhibitory reflex via the coeliac ganglion is not based on fast synaptic inputs or action potentials. These results provide new insights concerning the physiology of the sympathetic prevertebral ganglia.

Animals↗

PubMed1984

[Experimental studies of the localization of neural centers in the ovaries and fallopian tubes in cows].

For the studies 4 sexually mature cows were used, in which ovaria and oviducts were cut out bilaterally or unilaterally. The fourth cow was the control of the experiment. The operated animals were kept alive for 21 days and then slaughtered. For studies were taken: the brain stem, spinal cord from the segments Th9 - Th13 and L1 - S4, bilateral spinal ganglions, bilaterally the sympathetic chain from the segment Th10 - S4, and also ganglions and visceral-plexi, anterior mesenteric, intermesenteric, posterior mesenteric, hypogastric and pelvic. The material was fixed in alcohol, embedded in paraffin and cut into 15 micron sections. The sections were stained by Nissel's method. For examinations subsequent sections were taken. Due to the operations performed degeneration changes occurred in nervous cells in the central and peripheral nervous system. They were the basis for determination of the localization of the nervous centres for ovarium and oviduct. The source of preganglionic sympathetic visceromotor fibres for these organs is nucleus intermediolateralis in the segment L2 - L3. The sympathetic postganglionic fibres originate from cells of the sympathetic chain from L1 to L3 and from the posterior mesenteric ganglion and hypogastric plexus. The source of parasympathetic fibres for ovarium and oviduct are cells of nucleus parasympathicus nervi vagi in the segment located somewhat posteriorly from obex. The source of viscerosensory fibres for the discussed parts of the sexual organs in the cow are cells of the spinal ganglions in the segment Th9 - Th13 and cells of nucleus tractus spinocerebellaris dorsalis localized in neuromers L2 and L3.

Animals↗

PubMed2006

Neurogenic insulin resistance in guinea-pigs with cisplatin-induced neuropathy.

The aim of the present work was to study whether neurotoxicity produced by cisplatin modified tissue insulin sensitivity in guinea-pigs. One week after selective sensory denervation of the anterior hepatic plexus by means of perineurial 2% capsaicin treatment, hyperinsulinaemic euglycaemic glucose clamp were performed to estimate insulin sensitivity in male guinea-pigs. The guinea-pigs underwent regional sensory denervation of the anterior hepatic plexus exhibited insulin resistance, whereas systemic capsaicin desensitization increased insulin sensitivity. Intraportal administration of L-nitro-arginine methyl ester (L-NAME decreased, whereas capsaicin increased insulin sensitivity. Neither atropine nor acetylcholine produced any significant effect. In animals with preceding regional capsaicin desensitization, none of the pharmacological maneuvers modified the resulting insulin resistant state. Cisplatin pretreatment induced sensory neuropathy and decreased insulin sensitivity. Insulin sensitivity did not change after either regional or systemic capsaicin desensitization in the cisplatin-treated animals. CGRP(8-37), a nonselective calcitonin gene-related peptide (CGRP) antagonist (50 microg/kg i.v.), significantly increased insulin sensitivity in normal animals but only a tendency to insulin sensitization was seen after cisplatin treatment. Cisplatin treatment, similar to regional capsaicin desensitization of the anterior hepatic plexus, produced a significant decrease in insulin-stimulated uptake of 2-deoxy-D [L-14C] glucose in cardiac and gastrocnemius muscle with no effect on percentage suppression of endogenous glucose production by hyperinsulinaemia. We conclude that the majority of cisplatin-induced insulin resistance is related to functional deterioration of the hepatic insulin sensitizing substance (HISS) mechanism.

Acetylcholine↗

PubMed1977

Coeliac plexus block with alcohol for relief of upper abdominal pain due to cancer.

One hundred cases of coeliac plexus block in which absolute alcohol was used as a sclerosing agent, performed over a period of 10 years between 1963 and 1973, are analysed. A success rate of 91% in relieving the pain of advanced intra-abdominal malignant disease is claimed and reasons for failures are advanced. The technique described is relatively simple and a 3-day hospital stay is all that is required. It is recommended that this procedure be carried out before the invalid is subjected to repeated injections of narcotic drugs or any form of surgery for pain relief.

Abdominal Neoplasms↗

PubMed1989

Percutaneous anterior approach to the coeliac plexus using ultrasound.

A new approach is described to the neurolytic block of the coeliac plexus through the anterior abdominal wall using ultrasonic guidance. In nine patients, ultrasound was used for needle placement and examination of the spread of injection. Total pain relief was obtained in seven of the patients after 2 weeks and in five patients after 6 months. No serious complications were observed. The anterior approach is simple and useful in those patients with chronic pancreatic pain undergoing biopsy of the pancreas, and in those terminally ill or heavily sedated patients who have difficulty in tolerating the prone flexed position.

Adult↗

PubMed1988

Splanchnic circulation following coeliac plexus block.

Both the capacitance vessels and the resistance vessels of the splanchnic area are innervated by the sympathetic nerve fibers. We investigated the effect of abdominal visceral sympathectomy on splanchnic circulation, and the effect of altered splanchnic circulation on systemic circulation in ten mongrel dogs. Abdominal visceral sympathectomy was induced by coeliac plexus block with 1 ml/kg (body weight) of 1% lidocaine infiltrated around the coeliac artery. Comparison was made with infiltration of physiologic saline of the same volume. The saline infiltration caused no significant changes in the hemodynamic parameters of systemic and splanchnic circulation. Mean arterial pressure decreased significantly from 18.2 +/- 2.0 to 14.4 +/- 1.9 kPa following the coeliac plexus block, with a concomitant decrease in the cardiac index from 2.63 +/- 0.46 to 2.30 +/- 0.54 l X min-1 X m-2, while systemic vascular resistance was unchanged. Portal vein blood flow, hepatic artery blood flow and, therefore, splanchnic blood flow decreased by 8 to 17%. Portal vascular and hepatic artery resistances were not affected by abdominal sympathectomy. It was concluded that the capacitance vessels in splanchnic circulation are dilated during abdominal sympathetic denervation, causing a blood shift from systemic to splanchnic circulation. On the other hand, the resistance vessels in splanchnic circulation are affected little by abdominal visceral sympathectomy.

Animals↗

PubMed1993

Paraplegia following coeliac plexus block.

Coeliac plexus block (CPB) is one of the few neurolytic procedures that is still considered very useful in managing chronic cancer pain. We describe what we believe to be the fifth case in the literature of paraplegia following coeliac plexus block with ethyl alcohol. Clinical and neurophysiological examination confirmed the hypothesis of an acute myelopathy probably caused by ischemia due to involvement of Adamkievicz's artery. The seriousness of this neurological complication led us to review the different pain-relieving strategies in pancreatic cancer. Several medical and surgical procedures are available for advanced pancreatic cancer, yet none of them alone can be considered the therapy of choice for all cases. Hence, only a multidisciplinary approach to pancreatic cancer pain can help in making the most appropriate choice for each patient.

Adenocarcinoma↗

PubMed1982

Structural studies on the connectivity of the inferior mesenteric ganglion of the guinea pig.

After injection of horseradish peroxidase (HRP) into the inferior mesenteric ganglion (IMG) of the guinea pig, labeled cell bodies were found in the solar plexus ganglia, the ganglia of the pelvic plexus and in the nodose ganglia as well as in the spinal cord and dorsal root ganglia at the T13-L4 levels. By using the fluorescent tracer True blue, labeled cell bodies could also be detected in the myenteric and submucosa ganglia of the distal colon. Application and uptake of HRP by the colonic nerves resulted in labeling of cell bodies in the dorsal root ganglia, the IMG and in the solar plexus ganglion complex indicating that the latter neurons send their axons in the intermesenteric nerve through the IMG to continue in the colonic nerves to the distal colon. When HRP was applied and diffused into the hypogastric nerves labeled cell bodies were seen in the IMG, the dorsal root ganglia and in the preganglionic nuclei of the lumbar spinal cord with 50% of the labeled neurons located dorsal and dorsolateral to the central canal. The finding of such a diversity in the nerve supply to the IMG, supports the view that the ganglion plays an important role in the integration of visceral reflexes.

Animals↗

PubMed1975

[A morphofunctional analysis of the exocrine division of the pancreas subjected to disrupted innervation].

The functional state of the pancreas of the cat was studied light and electron microscopically 14 days after a removal of the solar plexus at different periods after feeding. It was established that disturbed innervation retained the capacity of the gland to respond to a food stimulus, but resulted in development of certain neurodystrophical changes in the organ which could be divided into two categories: 1) disorders observed permanently at both microscopic and submicroscopic levels and having degenerative character and involving an inconsiderable part of the organ. 2) Ultrastructural lesions involving more expansive zones of the organ parenchyma and developing in pancreacytes during their functioning. These processes did not result in death of the gland cell but disturbed its normal secretory activity. Possible mechanisms of the found changes are discussed.

Alkaline Phosphatase↗

PubMedDate not supplied

Coeliac plexus block for upper abdominal cancer pain.

The use of coeliac plexus block (CPB) to relieve intractable pain owing to upper abdominal malignancy is well established. Significant relief of pain is reported in 70-90% of patients, allowing a reduction in opioid use and in the occurrence of opioid-related side effects (Eisenberg et al, 1995; Prasanna, 1996). Duration of relief varies, but the majority of patients experience relatively pain-free deaths (Patt, 1993). CPB is a relatively safe procedure, and although it is associated with common adverse effects such as diarrhoea, hypotension and local pain, these are mostly transient. However, severe complications, including paraplegia, have been reported. When CPB is performed, nurses should be aware of these potential complications and their management.

Abdominal Neoplasms↗

PubMed1988

[Ultrastructural changes in the jejunal mucosa of the dog after dissection of the cranial mesenteric plexus].

Ultrastructural change was investigated in the small intestinal mucosa of dogs after experimental dissection of the cranial mesenteric plexus and/or obstruction of the lymphatics. In group with a combination of dissection of the plexus and obstruction of the lymphatics (Group A): Marked mucosal edema and dilatation of intercellular spaces of epithelial cell were observed after the 6th postoperative hours (POH), and numerous pinocytotic vesicles appeared after 24th POH. After the 5th postoperative days, rough glycocalyx and irregular microvilli were recognized in epithelial cells. As a characteristic change, pinocytotic vesicles fused together and formed a complex. However, no lipid droplet were accumulated in epithelial cells. In group with obstruction of lymphatics (Group B): Epithelial cells were full in lipid droplets. Based on these evidences, it was suggested that diarrhea and nutritional disorder were mainly caused by the disturbance of absorption and water transport in epithelial cells, involving severe pathological changes in their ultrastructure.

Animals↗

PubMed1992

The cellular network of interstitial cells associated with the deep muscular plexus of the guinea pig small intestine.

Systematic examination using electron microscopic montages and serial sections has demonstrated that three types of interstitial cell, namely gap junction-rich cells, glycogen-rich cells and fibroblast-like cells, are densely located along the whole extent of the deep muscular plexus of the guinea pig small intestine. They tend to be distributed in an alternating fashion in the cellular network, connected with muscle cells of the outer, circular layer by means of gap junctions. These three types of interstitial cell show close relations to two types of nerve varicosity: one type is characterized by clear round vesicles with diameters of about 50 nm, and the other by flattened vesicles measuring about 35 nm by 70 nm. Electron-dense patches have been observed at the cytoplasmic side of the axonal membranes. Muscle cells of both inner and outer circular layers also show close relations to these two types of nerve varicosity. These morphological features are discussed with the implication that they may have some regulatory role in intestinal movement.

Animals↗

PubMed1982

[Infiltration block of the coeliac plexus using a plastic catheter].

Nine patients suffered from intractable pain that was not relieved by analgesic medication. All had cancer of the stomach or pancreas. The coeliac plexus was approached from the back, two long Teflon catheters being directed onto the appropriate ganglia under x-ray control. When the catheters were correctly positioned, under continuous aspiration we administered via each catheter 25 ml of Xylocaine 0.5-0.8%. The successful and uneventful trial was followed with injection of an equal volume of 25 ml 50% alcohol through each catheter on the next day. In eight patients pain ceased completely while the ninth presented a 50% improvement. In the last five patients alcohol was injected 2 to 3 hours after the injection of the local anesthetic. We had a postspinal headache from accidental puncture of the dura mater, and a mild toxic reaction to Xylocaine. Also three patients presented hypotension after the Xylocaine was administered.

Catheterization↗

PubMed2005

[Aspiration biopsy, puncture and neurolysis of coeliac plexus with guided linear endoscopic ultrasonography--personal experience].

Endoscopic ultrasonography, as relatively new diagnostic procedure, has made a significant progress in detection and presentation of small lesions of digestive tract, as well as in other organs. By introducing linear ultrasonography in clinical practice, the possibilities of this procedure became even more apparent, anabling even more precise diagnosis and various therapeutic procedures. With endoscopic ultrasound (EUS) guided aspiration biopsy it is possible to obtain samples in specific, well defined layer of gastrointestinal tract wall, and also from different parts of other organs and formations, which finaly enables establishing definite patohystologic diagnosis. First linear EUS procedure in this part of south-east Europe, was performed in University Clinical Center "Bezanijska Kosa" (N. Milinic, M. Petrovic) in 1999, and first EUS guided aspiration biopsy was performed on July 4th 2000 (N. Milinic--biopsy of pancreas). Using "Pentax" FG-36UX linear echo-endoscope, until now, 40 pancreas biopsies, 34 stomach biopsies, 9 biopsies of mediastinal lymph nodes, cysts and tumors, 22 biopsies of masses in retroperitoneal region, 7 biopsies of papilla Vateri, 4 biopsies of left suprarenal gland, 2 punctures of renal cysts, 14 biopsies of focal liver lesions, 2 punctures of liver cysts, and 5 neurolyses of coeliac plexus was performed. From 134 EUS guided biopsy samples, 114 was, according to pathologist, adequate for patohystologic evaluation, and in 96 cases obtained samples was essential for obtaining definite diagnosis. The major problem in this issue was a lack of well trained and expirienced cytologist, as also is the current problem in Western countires with more expirience and practice in this field. EUS guided aspiration biopsy, as the procedure itself, was successful in all cases. There were no major complications during the procedures, mainly because of using Colour-Doppler technique in defferentiating vascular from other structures. Results so far are showing that linear endoscopic ultrasonography is extremely precise diagnostic method, and should be used in establishing definite diagnosis in many well defined indications, and also is showing the consecutive need for specialy trained and expirienced citologists.

Biopsy, Needle↗

PubMed1993

Proportions of renal and splenic postganglionic sympathetic populations containing galanin and dopamine beta hydroxylase.

Galanin is a 29-amino acid neuropeptide found in rat spinal cord, autonomic ganglia and gastrointestinal tract, as well as in other areas of the nervous system in rats and other species. As part of an overall objective to determine if peptides contribute to target-specific control of visceral function, this study was designed to determine the percentages of populations of renal and splenic postganglionic neurons that contain galanin, and to determine if these neurons were likely to be adrenergic. Retrogradely transported fluorescent dyes were placed on renal and splenic nerves in male Wistar rats anaesthetized with sodium pento-barbital. Four days post-operatively, rats were perfused transcardially with fixative, and T12-L1 thoracolumbar chain ganglia, splanchnic ganglia and the solar plexus were removed. Immunocytochemical methods were then used to determine the proportions of the retrogradely labelled renal and splenic neurons containing galanin-like immunoreactivity and dopamine beta hydroxylase-like immunoreactivity. In seven rats, 24 +/- 3% of 2838 renal neurons were found to contain galanin-like immunoreactivity; in six rats, 32 +/- 5% of 5102 splenic neurons were found to contain galanin-like immunoreactivity. These proportions of the two populations were not significantly different from one another. In three rats, 94 +/- 2% of 684 renal neurons were found to contain dopamine beta hydroxylase-like immunoreactivity, and 95 +/- 2% of 2597 splenic neurons in three rats also showed dopamine beta hydroxylase-like immunoreactivity. These experiments indicate that subpopulations of both renal and splenic postganglionic sympathetic neurons contain the neuropeptide galanin and that these neurons are likely to be adrenergic in function. These findings suggest a role for galanin in control of the kidney and the spleen by the sympathetic nervous system.

Adrenergic Fibers↗