Right greater splanchnic nerve (RGSN)

The right greater splanchnic nerve is an anatomical structure of the peripheral nervous system that carries preganglionic sympathetic fibers from the thoracic sympathetic chain to the abdominal viscera [StatPearls: Anatomy, Thorax, Splanchnic Nerves]. It typically originates from the fifth through ninth (T5-T9) thoracic ganglia and traverses the diaphragm to synapse in the celiac ganglion, playing a pivotal role in the autonomic regulation of the upper gastrointestinal tract and abdominal blood flow [PubMed: PMC5021935]. While not a molecular target like a receptor or enzyme, it is a significant interventional target for treating chronic abdominal pain, particularly in patients with advanced pancreatic cancer or chronic pancreatitis, through techniques such as splanchnic nerve blocks or chemical neurolysis [StatPearls: Splanchnic Nerve Block]. Recently, the nerve has emerged as a therapeutic target for heart failure with preserved ejection fraction (HFpEF), where surgical or catheter-based denervation is used to modulate the splanchnic vascular bed, increase venous capacitance, and reduce cardiac filling pressures [PubMed: 32331570]. Pharmacological agents interacting with this nerve are primarily those used for regional anesthesia and chemical neurolysis, such as lidocaine and ethanol, which inhibit nerve conduction or cause localized tissue destruction rather than binding to specific molecular ligands [NCBI: Bookshelf NBK539700]. Therapeutic challenges include the risk of orthostatic hypotension due to the loss of compensatory sympathetic vasoconstriction and potential procedural complications such as pneumothorax.

Other names

Greater splanchnic nerveNervus splanchnicus majorThoracic splanchnic nerve

Nerve conduction blockade or neurolytic denervation