splanchnic nerves


Summary: The major nerves supplying sympathetic innervation to the abdomen. The greater, lesser, and lowest (or smallest) splanchnic nerves are formed by preganglionic fibers from the spinal cord which pass through the paravertebral ganglia and then to the celiac ganglia and plexuses. The lumbar splanchnic nerves carry fibers which pass through the lumbar paravertebral ganglia to the mesenteric and hypogastric ganglia.

Top Publications

  1. Loukas M, Klaassen Z, Merbs W, Tubbs R, Gielecki J, Zurada A. A review of the thoracic splanchnic nerves and celiac ganglia. Clin Anat. 2010;23:512-22 pubmed publisher
    Anatomical variation of the thoracic splanchnic nerves is as diverse as any structure in the body...
  2. Buscher H, Jansen J, van Dongen R, Bleichrodt R, van Goor H. Long-term results of bilateral thoracoscopic splanchnicectomy in patients with chronic pancreatitis. Br J Surg. 2002;89:158-62 pubmed
    ..Bilateral thoracoscopic splanchnicectomy alleviated pain in patients with chronic pancreatitis. It was associated with a low morbidity rate and no deaths. Pain eventually recurred in approximately 50 per cent. ..
  3. Maher J, Johlin F, Heitshusen D. Long-term follow-up of thoracoscopic splanchnicectomy for chronic pancreatitis pain. Surg Endosc. 2001;15:706-9 pubmed
    ..Similarly, there are short-term improvements in degree of disability, mood, and freedom from narcotic use that are not sustained in the long-term. Nevertheless, two-thirds of patients stated that they would have the surgery again. ..
  4. Cuschieri A, Shimi S, Crosthwaite G, Joypaul V. Bilateral endoscopic splanchnicectomy through a posterior thoracoscopic approach. J R Coll Surg Edinb. 1994;39:44-7 pubmed
    ..Bilateral thoracoscopic total splanchnicectomy merits further evaluation in patients with pancreatic pain. No complications including hypotension have been encountered. ..
  5. Nakamura T, Bhatt S, Sapru H. Cardiovascular responses to hypothalamic arcuate nucleus stimulation in the rat: role of sympathetic and vagal efferents. Hypertension. 2009;54:1369-75 pubmed publisher
  6. Howard T, Swofford J, Wagner D, Sherman S, Lehman G. Quality of life after bilateral thoracoscopic splanchnicectomy: long-term evaluation in patients with chronic pancreatitis. J Gastrointest Surg. 2002;6:845-52; discussion 853-4 pubmed
    ..Bilateral thoracoscopic splanchnicectomy appears to work best in patients who have had no prior operative or endoscopic interventions. ..
  7. Leksowski K. Thoracoscopic splanchnicectomy for the relief of pain due to chronic pancreatitis. Surg Endosc. 2001;15:592-6 pubmed
    ..Thoracoscopic splanchnicectomy is a simple, minimally invasive, save procedure that appears to offer relief from pain, allow recovery of daily activities and improve the adequacy of the analgesic management. ..
  8. Baghdadi S, Abbas M, Albouz F, Ammori B. Systematic review of the role of thoracoscopic splanchnicectomy in palliating the pain of patients with chronic pancreatitis. Surg Endosc. 2008;22:580-8 pubmed
    ..Patient selection determines success rates, but the early good results achieved decline with time elapsed after thoracoscopic splanchnicectomy. ..
  9. Kawabe T, Chitravanshi V, Kawabe K, Sapru H. Cardiovascular function of a glutamatergic projection from the hypothalamic paraventricular nucleus to the nucleus tractus solitarius in the rat. Neuroscience. 2008;153:605-17 pubmed publisher

More Information


  1. Engeland W. Functional innervation of the adrenal cortex by the splanchnic nerve. Horm Metab Res. 1998;30:311-4 pubmed
  2. Johnson C, Berry D, Harris S, Pickering R, Davis C, George S, et al. An open randomized comparison of clinical effectiveness of protocol-driven opioid analgesia, celiac plexus block or thoracoscopic splanchnicectomy for pain management in patients with pancreatic and other abdominal malignancies. Pancreatology. 2009;9:755-63 pubmed publisher
    ..Previous randomized studies have shown small differences in pain scores, but no difference in opioid consumption and quality of life. The absence of any benefit from interventions in the present study questions their value. ..
  3. Buscher H, Schipper E, Wilder Smith O, Jansen J, van Goor H. Limited effect of thoracoscopic splanchnicectomy in the treatment of severe chronic pancreatitis pain: a prospective long-term analysis of 75 cases. Surgery. 2008;143:715-22 pubmed publisher
    ..07). Splanchnicectomy offers prolonged (>4 years) benefit in 1 of 4 patients with severe chronic pancreatitis pain. Prior opioid use may adversely impact pain relief after splanchnicectomy. ..
  4. Martin A, Mathieu M, Guerineau N. Evidence for long-lasting cholinergic control of gap junctional communication between adrenal chromaffin cells. J Neurosci. 2003;23:3669-78 pubmed
    ..These results strongly suggest that gap junctional communication between chromaffin cells is under tonic inhibitory control exerted by cholinergic synaptic inputs. ..
  5. Hammond B, Vitale G, Rangnekar N, Vitale E, Binford J. Bilateral thoracoscopic splanchnicectomy for pain control in chronic pancreatitis. Am Surg. 2004;70:546-9 pubmed
    ..The decrease in hospital admissions represents further quality of life improvement in this difficult to treat group of patients. ..
  6. Huber D, Schreihofer A. Attenuated baroreflex control of sympathetic nerve activity in obese Zucker rats by central mechanisms. J Physiol. 2010;588:1515-25 pubmed publisher
    ..Furthermore, central deficits in the regulation of SNA in OZRs extend to other sympathoinhibitory reflexes initiated by vagal afferent nerves...
  7. Marra V, Debernardi F, Frigerio A, Menna S, Musso L, Di Virgilio M. [Neurolytic block of the celiac plexus and splanchnic nerves with computed tomography. The experience in 150 cases and an optimization of the technic]. Radiol Med. 1999;98:183-8 pubmed
    ..The sites of alcohol injection (celiac plexus, splanchnic nerves or both) are chosen after evaluation of anatomy by preliminary CT scans, or during the procedure, depending ..
  8. Ulrich Lai Y, Engeland W. Adrenal splanchnic innervation modulates adrenal cortical responses to dehydration stress in rats. Neuroendocrinology. 2002;76:79-92 pubmed
    ..These data support the hypothesis that the splanchnic innervation of the adrenal gland represents an additional physiological mechanism to control stress-induced adrenal cortical responses in vivo. ..
  9. Basinski A, Stefaniak T, Vingerhoets A, Makarewicz W, Kaska L, Stanek A, et al. Effect of NCPB and VSPL on pain and quality of life in chronic pancreatitis patients. World J Gastroenterol. 2005;11:5010-4 pubmed
    ..Both invasive pain treatment methods are effective in CP patients with chronic pain. ..
  10. Naidoo N, Partab P, Pather N, Moodley J, Singh B, Satyapal K. Thoracic splanchnic nerves: implications for splanchnic denervation. J Anat. 2001;199:585-90 pubmed
    ..that the inconsistent results of splanchnicectomies may be due to anatomical variations in the pattern of splanchnic nerves. The advent of minimally invasive and video-assisted surgery has rekindled interest in the frequency of ..
  11. Ulrich Lai Y, Arnhold M, Engeland W. Adrenal splanchnic innervation contributes to the diurnal rhythm of plasma corticosterone in rats by modulating adrenal sensitivity to ACTH. Am J Physiol Regul Integr Comp Physiol. 2006;290:R1128-35 pubmed
  12. Warashina A, Ogura T. Modeling of stimulation-secretion coupling in a chromaffin cell. Pflugers Arch. 2004;448:161-74 pubmed
    ..The results suggest that the presented model provides a useful tool for analyzing and predicting quantitative relations in various events occurring in stimulation-secretion coupling in chromaffin cells. ..
  13. Lamb K, Kang Y, Gebhart G, Bielefeldt K. Gastric inflammation triggers hypersensitivity to acid in awake rats. Gastroenterology. 2003;125:1410-8 pubmed
    ..Nonhuman models have previously focused on responses to mechanical stimulation. We studied the response to acid stimulation in the normal and inflamed stomach in rats...
  14. Hopkins M, Schnettler W. Anatomic identification and functional outcomes of the nerve sparing Okabayashi radical hysterectomy. Gynecol Oncol. 2007;107:2-3 pubmed
  15. Nakazato Y, Sekine H, Isogaya M, Ito S, Ohga A. Atropine- and hexamethonium-resistant motor response to greater splanchnic nerve stimulation in the dog stomach. J Auton Nerv Syst. 1987;20:35-42 pubmed
    ..A possible involvement of SP in the long lasting contraction was discussed...
  16. Nathan H. Osteophytes of the spine compressing the sympathetic trunk and splanchnic nerves in the thorax. Spine (Phila Pa 1976). 1987;12:527-32 pubmed
    ..It is proposed that these observations are useful in understanding certain observed clinical conditions and act an anatomic baseline for research in the future. ..
  17. Costello A, Brooks M, Cole O. Anatomical studies of the neurovascular bundle and cavernosal nerves. BJU Int. 2004;94:1071-6 pubmed
    ..The anatomy of the cavernosal nerves is such that accurate graft anastomosis to proximal and distal cavernosal nerve segments is extremely difficult. The current anatomical description of the cavernosal nerve and NVB is inaccurate. ..
  18. de Diego A, Gandia L, Garcia A. A physiological view of the central and peripheral mechanisms that regulate the release of catecholamines at the adrenal medulla. Acta Physiol (Oxf). 2008;192:287-301 pubmed
    ..Different firing patterns of splanchnic nerves and nicotinic or muscarinic receptors cause the selective release of noradrenaline or adrenaline, to adapt ..
  19. Vayssettes Courchay C, Bouysset F, Verbeuren T, Laubie M, Schmitt H. Quipazine-induced hypertension in anaesthetized cats is mediated by central and peripheral 5-HT2 receptors: role of the ventrolateral pressor area. Eur J Pharmacol. 1991;192:389-95 pubmed
    ..These results indicate that the cardiovascular changes induced by quipazine in anaesthetized cats are mediated by central 5-HT2 receptors located in the ventrolateral pressor area and by peripheral vascular 5-HT2 receptors. ..
  20. Bailey S, Hendricks Munoz K, Wells J, Mally P. Packed red blood cell transfusion increases regional cerebral and splanchnic tissue oxygen saturation in anemic symptomatic preterm infants. Am J Perinatol. 2010;27:445-53 pubmed publisher
    ..NIRS identified increases in CrSO(2) and SrSO(2) in preterm neonates after PRBC transfusions and has the potential to become incorporated into neonatal transfusion management paradigms. ..
  21. Ho C, Chiang C, Lee C, Fan Y, Su C. Glutamatergic activities in neonatal rat spinal cord heterogeneously regulate single-fiber splanchnic nerve discharge. Auton Neurosci. 2013;177:175-80 pubmed publisher
    ..Fine-tuning of ionotropic glutamate receptor activities in the spinal cord may serve as a simple way for heterogeneous regulation of various sympathetic-targeting tissues. ..
  22. Evrard S. Surgical lesioning of splanchnic nerves using wet needle radiofrequency thermoablation. J Surg Oncol. 2002;80:171-2 pubmed
  23. Olesen S, Frøkjær J, Lelic D, Valeriani M, Drewes A. Pain-associated adaptive cortical reorganisation in chronic pancreatitis. Pancreatology. 2010;10:742-51 pubmed publisher
    ..05). The findings indicate that sustained pain in CP leads to functional reorganisation of the insular cortex. We suggest its physiological correlate to be an adaptive response to chronic pain. and IAP. ..
  24. Anderson R, Jobling P, Matthew S, Gibbins I. Development of convergent synaptic inputs to subpopulations of autonomic neurons. J Comp Neurol. 2002;447:218-33 pubmed
    ..It seems likely that synaptogenesis occurs independently of the neurochemical differentiation of the target neurons but is closely related to the pathway-specific dendritic development of those neurons. ..
  25. Wotus C, Lilley T, Neal A, Suleiman N, Schmuck S, Smarr B, et al. Forced desynchrony reveals independent contributions of suprachiasmatic oscillators to the daily plasma corticosterone rhythm in male rats. PLoS ONE. 2013;8:e68793 pubmed publisher
  26. Wright S, Washington M, Garcia C, Sayegh A. Gastrin releasing peptide-29 requires vagal and splanchnic neurons to evoke satiation and satiety. Peptides. 2012;33:125-31 pubmed publisher
    ..Therefore, reduction of MS and prolongation of IMI by GRP-29 require vagal and splanchnic nerves, and the duodenum is the major conduit that communicates prolongation of IMI by GRP-29 with the brain.
  27. Casadevall N, Valla D. [Any splanchnic vein thrombosis must make look for a forme fruste of myeloproliferative disorder]. Rev Prat. 2005;55:1669-70 pubmed
  28. McMullan S, Goodchild A, Pilowsky P. Circulating angiotensin II attenuates the sympathetic baroreflex by reducing the barosensitivity of medullary cardiovascular neurones in the rat. J Physiol. 2007;582:711-22 pubmed
    ..We suggest that this results from activation by Ang II of a central pathway originating at the circumventricular organs. ..
  29. Stefaniak T, Vingerhoets A, Makarewicz W, Kaska L, Kobiela J, Kwiecińska B, et al. Opioid use determines success of videothoracoscopic splanchnicectomy in chronic pancreatic pain patients. Langenbecks Arch Surg. 2008;393:213-8 pubmed
  30. Yokotani K, Okada S, Murakami Y, Nakamura K. Nicotinic receptors involved in gastric noradrenaline release evoked by electrical stimulation of the splanchnic nerve in rats. Eur J Pharmacol. 2001;423:149-55 pubmed
    ..However, the functional nicotinic receptor activated by electrical stimulation of the splanchnic nerve seems to be different in character from that activated by (-)-nicotine. ..
  31. Yokotani K, Okuma Y, Osumi Y. Release of endogenous noradrenaline from the vascularly perfused rat stomach in vitro: modulation by pre- and postsynaptic adrenoceptors. J Pharmacol Exp Ther. 1992;260:728-33 pubmed
    ..abstract truncated at 250 words) ..
  32. Galewski D, Schwille P, Rumenapf G, Scheele J, Kissler H, Steinlein R. Proximal gastric vagotomy: effects of two surgical modifications on oral and intravenous glucose tolerance in the conscious rat. Physiol Behav. 1995;57:813-9 pubmed
  33. Miyawaki T, Goodchild A, Pilowsky P. Evidence for a tonic GABA-ergic inhibition of excitatory respiratory-related afferents to presympathetic neurons in the rostral ventrolateral medulla. Brain Res. 2002;924:56-62 pubmed
    ..Inputs from post-inspiratory neurons appear to be an especially potent excitatory synaptic drive to the presympathetic neurons in the absence of the GABAergic inhibition. ..
  34. Kang C, Lee H, Yang H, Jang H, Gil Y, Kim K, et al. Bilateral thoracoscopic splanchnicectomy with sympathectomy for managing abdominal pain in cancer patients. Am J Surg. 2007;194:23-9 pubmed
    ..No mortality and morbidity were found in this study. This bilateral thoracoscopic splanchnicectomy with sympathectomy is safe, easy, and effective method in managing cancer-derived visceral abdominal pain. ..
  35. Süleyman Ozyalçin N, Talu G, Camlica H, Erdine S. Efficacy of coeliac plexus and splanchnic nerve blockades in body and tail located pancreatic cancer pain. Eur J Pain. 2004;8:539-45 pubmed
    ..pain relieving efficacy, side effects and effects on QOL of neurolytic coeliac plexus blockade (NCPB) and splanchnic nerves neurolytic blockade (SNB) in body and tail located pancreatic cancer...
  36. Makeham J, Goodchild A, Costin N, Pilowsky P. Hypercapnia selectively attenuates the somato-sympathetic reflex. Respir Physiol Neurobiol. 2004;140:133-43 pubmed
    ..Hypercapnia significantly affects phrenic nerve activity (PNA), sSNA and selectively inhibits the somato-sympathetic reflex with little effect on the sSNA baroreflex. ..
  37. Li P, Tjen A Looi S, Guo Z, Fu L, Longhurst J. Long-loop pathways in cardiovascular electroacupuncture responses. J Appl Physiol (1985). 2009;106:620-30 pubmed publisher
    ..Direct projections from the ARC to the rVLM, which serve as an important source of beta-endorphin, appear also to exist. ..
  38. Landoni F. Nerve sparing surgery in cervical cancer. Gynecol Oncol. 2005;99:S150-1 pubmed
  39. Ulrich Lai Y, Marek D, Engeland W. Capsaicin-sensitive adrenal sensory fibers participate in compensatory adrenal growth in rats. Am J Physiol Regul Integr Comp Physiol. 2002;283:R877-84 pubmed
    ..The splanchnic nerves of anesthetized male rats were treated with capsaicin or vehicle...
  40. Zogovic B, Pilowsky P. Intrathecal bombesin is sympathoexcitatory and pressor in rat. Am J Physiol Regul Integr Comp Physiol. 2011;301:R1486-94 pubmed publisher
    ..01). We conclude that bombesin is sympathoexcitatory at thoracic spinal segments. The effect on phrenic nerve activity may the result of spinobulbar pathways and activation of local motoneuronal pools. ..
  41. Chitravanshi V, Sapru H. Cardiovascular responses elicited by a new endogenous angiotensin in the nucleus tractus solitarius of the rat. Am J Physiol Heart Circ Physiol. 2011;300:H230-40 pubmed publisher
  42. Holst J, Ehrhart Bornstein M, Messell T, Poulsen S, Harling H. Release of galanin from isolated perfused porcine adrenal glands: role of splanchnic nerves. Am J Physiol. 1991;261:E31-40 pubmed
    ..It is concluded that galanin, coreleased with catecholamines from the adrenal glands, may have endocrine functions but that galanin may also have local regulatory functions in the adrenals. ..
  43. Peng S, Ho C, Ho S, Tsai S, Su C. The role of intraspinal adenosine A1 receptors in sympathetic regulation. Eur J Pharmacol. 2004;492:49-55 pubmed
    ..We conclude that intraspinal adenosine A1 receptors may down-regulate sympathetic outflow and serve as a part of the scheme for neuroprotection. ..
  44. Gangi A, Buy X, Garnon J, Tsoumakidou G, Moser T, Bierry G, et al. [Pain management in oncology]. J Radiol. 2011;92:801-13 pubmed publisher
    ..Several indications have previously been validated, including thermal ablation of bone metastases with results superior to conventional therapies. Additional applications should be validated over the next few years. ..
  45. Buscher H, van Goor H, Wilder Smith O. Effect of thoracoscopic splanchnic denervation on pain processing in chronic pancreatitis patients. Eur J Pain. 2007;11:437-43 pubmed
    ..Although patients benefiting from TSD consume less opioids preoperatively, we were unable to clearly link treatment success with specific perioperative patterns of neuroplasticity such as the presence or absence of hyperalgesia. ..
  46. Martin A, Alonso G, Guerineau N. [An unexpected role for agrin on cell-to-cell coupling during synaptogenesis]. Med Sci (Paris). 2005;21:913-5 pubmed
  47. Grundy D. Neuroanatomy of visceral nociception: vagal and splanchnic afferent. Gut. 2002;51 Suppl 1:i2-5 pubmed
    ..Because of the different response profiles following activation of these pathways, it is likely that vagal and splanchnic afferents play different roles in mediating sensation. ..
  48. Breslow M, Tobin J, Bredt D, Ferris C, Snyder S, Traystman R. Nitric oxide as a regulator of adrenal blood flow. Am J Physiol. 1993;264:H464-9 pubmed
    ..These data suggest independent neural control of medullary Q and catecholamine secretion, the former by NO and the latter by acetylcholine. ..
  49. Michelena P, De la Fuente M, Vega T, Lara B, Lopez M, Gandia L, et al. Drastic facilitation by alpha-latrotoxin of bovine chromaffin cell exocytosis without measurable enhancement of Ca2+ entry or [Ca2+]i. J Physiol. 1997;502 ( Pt 3):481-96 pubmed
    ..This situation might be physiologically reproduced during ACh stimulation of chromaffin cells, which is followed by the firing of Na(+)-dependent action potentials. ..
  50. Ginda W, Nussdorfer G, Malendowicz L. Effects of bilateral splanchnic-nerve section and chemical sympathectomy on PACAP38 content in the rat adrenals. Horm Metab Res. 1999;31:483-5 pubmed
    ..In contrast, chemical sympathectomy, obtained by administering newborn rats with 6-hydroxydopamine, was ineffective. Our findings support the view that splanchnic nerves play an important role in the control of rat adrenal function.
  51. Sobotka P, Osborn J, Paton J. Restoring autonomic balance: future therapeutic targets. EuroIntervention. 2013;9 Suppl R:R140-8 pubmed publisher
    ..Harnessing endogenous homeostatic control systems looks promising as a means to correct autonomic balance. The challenge will be in deciding which interventional approach should be selected...
  52. Reddy S, Burton A. Re: video-assisted thoracoscopic sympathectomy-splanchnicectomy. J Pain Symptom Manage. 2002;23:177; author reply 178 pubmed
  53. Bagdy G, Szemeredi K, Hill J, Murphy D. The serotonin agonist, M-chlorophenylpiperazine, markedly increases levels of plasma catecholamines in the conscious rat. Neuropharmacology. 1988;27:975-80 pubmed