Clin Endosc.  2015 Jul;48(4):345-347. 10.5946/ce.2015.48.4.345.

Could Transgastric Endoscopic Ultrasound-Guided Aspiration Alone Be Effective for the Treatment of Pancreatic Abscesses?

• Jo HG
• Amarbat B
• Jeong JW
• Song HY
• Song SR
• Kim TH

• KMID: 1964281
• DOI: http://doi.org/10.5946/ce.2015.48.4.345

Abstract

Drainage of pancreatic abscesses is required for effective control of sepsis. Endoscopic ultrasound (EUS)-guided endoscopic drainage is less invasive than surgery and prevents local complications related to percutaneous drainage. Endoscopic drainage with stent placement in the uncinate process of the pancreas is a technically difficult procedure. We report a case of pancreatic abscess treated by repeated EUS-guided aspiration and intravenous antibiotics without an indwelling drainage catheter or surgical intervention.

Keyword

Endoscopic drainage; Endoscopic ultrasound-guided fine needle aspiration; Pancreatic abscess

MeSH Terms

Abscess*
Anti-Bacterial Agents
Catheters
Drainage
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Pancreas
Sepsis
Stents
Ultrasonography
Anti-Bacterial Agents

Figure

• 

  Fig. 1 Contrast-enhanced computed tomography. A gas-containing cystic lesion (arrow) suggestive of an abscess is visible in the pancreatic head portion (uncinate portion).

• 

  Fig. 2 Endoscopic finding. A large, ulcerated crater with exposed vessel is visible in the duodenal bulb.

• 

  Fig. 3 Endoscopic ultrasound (EUS) findings (transgastric view). (A) A low echoic lesion with irregular wall measuring approximately 3.6×2.1 cm is seen in the pancreatic head portion, suggestive of an abscess cavity. (B) A 22-gauge EUS-fine needle aspiration needle entering the cystic cavity for aspiration is visible (arrow).

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