1. Endoscopic drainage for management of infected necrosis following EUS-TA in a patient with pancreatic cancer: A case report.
- Author
-
Kim YJ, Cho E, and Park CH
- Subjects
- Aged, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Biopsy adverse effects, Biopsy methods, Carcinoma, Pancreatic Ductal drug therapy, Carcinoma, Pancreatic Ductal pathology, Drainage instrumentation, Endosonography adverse effects, Endosonography instrumentation, Endosonography methods, Fluorouracil therapeutic use, Humans, Irinotecan therapeutic use, Leucovorin therapeutic use, Male, Oxaliplatin therapeutic use, Pancreas diagnostic imaging, Pancreas pathology, Pancreas surgery, Pancreatic Neoplasms drug therapy, Pancreatic Neoplasms pathology, Pancreatitis, Acute Necrotizing diagnosis, Pancreatitis, Acute Necrotizing etiology, Postoperative Complications diagnosis, Postoperative Complications etiology, Stents, Treatment Outcome, Ultrasonography, Interventional adverse effects, Ultrasonography, Interventional methods, Carcinoma, Pancreatic Ductal diagnosis, Drainage methods, Pancreatic Neoplasms diagnosis, Pancreatitis, Acute Necrotizing surgery, Postoperative Complications surgery
- Abstract
Rationale: Endoscopic ultrasonography-guided tissue acquisition (EUS-TA) has become the norm for the diagnosis of pancreatic solid lesions. EUS-TA is relatively safe, but various complications can occur. Infected pancreatic necrosis (IPN) is a rare but serious complication. The latest guidelines suggest that all invasive interventions in patients with IPN should be delayed until walled-off necrosis appears., Patient Concerns: A 73-year-old man was referred to our hospital with double primary cancers including gallbladder and pancreas. We performed EUS-TA on metastatic pancreatic tail cancer to confirm histologic diagnosis. Six days after the procedure, he developed abdominal pain and fever., Diagnoses: The patient's laboratory findings showed leukocytosis and C-reactive protein elevation. Fluid collection around pancreas tail and stomach was detected in computed tomography (CT) scan, and the patient was diagnosed with IPN., Interventions and Outcomes: EUS-guided endoscopic transmural drainage (EUS-TD) was performed for the treatment of IPN. Two days after the procedure with antibiotics, his CRP level decreased abruptly, and he received chemotherapy for the treatment of pancreatic ductal adenocarcinoma (PDAC) 5 days after the procedure. He was discharged from our hospital without complications 15 days after chemotherapy., Lessons: In selected patients with PDAC, early endoscopic drainage may be recommended as treatment for IPN resulting from complications of EUS-TA., Competing Interests: The authors have no conflicts of interests to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2021
- Full Text
- View/download PDF