Endoscopic ultrasonography: An inside view

Control of chronic abdominal pain with first-line medications in patients with chronic pancreatitis or intra-abdominal malignancy may be inadequate or fraught with adverse effects. One alternative is endoscopic ultrasonography-guided fine-needle (EUS) celiac plexus block, performed under echoendoscopic guidance with passage of an injection needle. This procedure has been shown to be safe, is technically easy to perform, and is a safe alternative to percutaneous block guided by computed tomography. The arrow shows the EUS-guided placement of the needle.