Celiac Plexus/Solar Plexus

The celiac plexus is the large collection of nerve fibers directly under the aortic hiatus of the diaphragm along with ganglia connected with the roots of the celiac trunk and superior mesenteric artery. Ganglia related to the celiac plexus consist of two celiac ganglia, a single superior mesenteric ganglion, and two aorti-corenal ganglia.

The celiac plexus is generally described as giving rise to plexuses that expand out along the several sections of the celiac like trunk the superior mesenteric plexus, the renal plexus, and other plexuses.

The celiac plexus is the biggest sympathetic plexus of the body. The other large plexuses are the cardiac plexus and the hypogastric plexus.

Celiac Plexus

Structure

• Its Diameter is around 50 mm.
• It covers the beginnings of the celiac artery as well as superior mesenteric artery.
• Boundaries
  • Laterally – adrenal glands
  • Above – aortic opening of the diaphragm
  • Below – root of the renal artery
• It is located at the level of the first lumbar vertebra, on the first portion of the abdominal aorta, anterior towards the crura of the diaphragm.

Connections

• It gets its primary innervation through the preganglionic thoracic splanchnic nerves that are greater splanchnic nerve T5-T9, lesser splanchnic nerve T10-11 along with lowest splanchnic nerve T12.
• Postganglionic fibers innervate the majority of the abdominal organs and right after synapsing within the celiac ganglion travel towards the connected plexuses.
• Other essential roots of the celiac plexus are:
  • The abdominal sections of the vagus nerves.
  • Divisions of the last thoracic ganglion.
  • 1st and 2nd lumbar ganglia.
• Cranially, the celiac plexus is attached to the thoracic aortic plexus and also caudally it proceeds within the abdominal aortic plexus.

Coeliac Ganglion

A paired celiac ganglion is located inside the celiac plexus. The left ganglion is located closer to the midline and partially on the aorta and the right ganglion is located on the right crus of the diaphragm.

Coeliac Ganglion

In some cases both ganglia fuse together and develop a ring shape, which is also called the solar ganglion or solar plexus.

The smaller superior mesenteric ganglion and aorticorenal ganglion are connected with the celiac ganglion.

Clinical Significance

Celiac Plexus Block

• This method might be done (often bilaterally) for pain relief in situations regarding cancer of the stomach or pancreas.
• A thin long spinal needle is injected under the lower edge of the 12th rib, 7 cm lateral towards the midline.
• The needle is pressed medially on an angle of 45 ° in order to touch the body of L., vertebra.
• The needle is then made to move anteriorly past the body as well as connect with simply alongside abdominal aorta or inferior venacava.
• This is the place for injection of the neurolytic solution within the celiac plexus.
• A celiac plexus block through fluoroscopically assisted injection is often utilized in order to cure tenacious pain from cancers like pancreatic cancer.
• Often, celiac plexus block is carried out by pain management professionals and radiologists, with CT scans for assistance. Intractable pain surrounding chronic pancreatitis is a crucial sign for celiac plexus ablation.