Clin Endosc.  2023 Mar;56(2):252-255. 10.5946/ce.2022.171.

Effective endoscopic band ligation for diverticular perforation with a refractory pelvic abscess

• Soga K
• Majima A

• KMID: 2540744
• DOI: http://doi.org/10.5946/ce.2022.171

Figure

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  Fig. 1. (A) Abdominal computed tomography showing a 112.4×110 mm pelvic abscess caused by a diverticular perforation in the sigmoid colon. (B) On day 5, amidotrizoic acid enema revealed a pelvic abscess (asterisks) connected to a diverticular perforation (arrow) in the sigmoid colon. (C) Computed tomography colonography comprising images after amidotrizoic acid enema showing a pelvic abscess (asterisks) extending from the perforated diverticulum (arrow).

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  Fig. 2. (A) Endoscopy showing adherent pus at the diverticular perforation site. (B) A perforated diverticulum (arrow) was identified and marked with endoclips prior to colonoscope removal. (C) When an endoscopic retrograde cholangiopancreatography cannula was placed close to the perforation and contrast medium was injected, a continuous channel (arrow) from the perforation to the abscess was confirmed. (D) The target diverticulum was suctioned into the band ligator cap, and the elastic band was released to close the perforation site.

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  Fig. 3. Four double-pigtail plastic stents, inserted for endoscopic ultrasound-guided pelvic abscess drainage (A), were endoscopically removed with grasping forceps (B, C).

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