GI Endoscopy · 1 min read
Vascular Topography of the Celiac Plexus
Explore the crucial role of celiac trunk branches in abdominal anatomy, their vital functions, and their impact on gastrointestinal health.
Clinical Bottom Line
| Major Branch | Anatomical Target | Endoscopic Relevance |
|---|---|---|
| Left Gastric Artery | Lesser curvature of the stomach; distal esophagus. | Origin of massive hemorrhage in Dieulafoy's lesions near the cardia. |
| Common Hepatic Artery | Liver, pylorus, and proximal duodenum (via the GDA). | The GDA sits directly beneath the duodenal bulb, exposing it to massive erosion from posterior peptic ulcers. |
| Splenic Artery | Spleen and body/tail of the pancreas. | Highly tortuous; frequently visualized during EUS evaluation of pancreatic body cysts. |
The Trunk of the Foregut
The celiac trunk represents the primary arterial supply to the embryonic foregut. Springing immediately anteriorly from the abdominal aorta directly below the aortic hiatus, it trifurcates within centimeters into the left gastric, common hepatic, and splenic arteries. For the advanced endoscopist, a deep spatial understanding of these branches is non-negotiable, particularly during transluminal interventions.
EUS-Guided Celiac Plexus Block
The dense network of sympathetic ganglia (the celiac plexus) physically engulfs the base of the celiac trunk. For patients suffering from intractable pain secondary to unresectable pancreatic cancer or severe chronic pancreatitis, the endoscopist utilizes a linear echoendoscope in the upper stomach. By identifying the pulsating root of the celiac trunk via Doppler, the physician physically drives a 22g needle immediately adjacent to the artery, injecting absolute alcohol to definitively ablate the surrounding nerve plexus, effectively severing the pain signals from the upper abdominal viscera to the brain.
Clinical guidelines summarized by the Gastroscholar Research Team. Last updated: 2026. This article is intended for physicians.
For your teaching file
Save this article as a PDF
Drop your email and we'll open a print-ready version you can save as a PDF — and you'll start getting our weekly GI endoscopy newsletter.