Which is the primary cause of retroperitoneal hemorrhage during celiac plexus block?

The primary cause of retroperitoneal hemorrhage during a celiac plexus block is the puncture of the aorta. During this procedure, the injection is often performed near major blood vessels, including the aorta, which runs along the posterior abdominal wall in close proximity to the celiac plexus. If the needle inadvertently punctures the aorta, it can lead to significant bleeding into the retroperitoneal space due to the high pressure within the aorta and the volume of blood contained within it.

Recognizing the anatomy and the potential complications of any procedure is crucial. The possibility of puncturing other structures, like the vena cava, pleura, or the kidneys, may occur in various contexts, but they are not the primary concern for retroperitoneal hemorrhage specifically during a celiac plexus block. The aorta’s position and size make it the most likely candidate for causing a retroperitoneal hemorrhage in this scenario.