Clinical Endoscopy

Could Transgastric Endoscopic Ultrasound-Guided Aspiration Alone Be Effective for the Treatment of Pancreatic Abscesses?: Hoon-Gil Jo, Baatarnum Amarbat, Jin-Woo Jeong, Hyo-Yeop Song, Seung-Ryel Song, Tae-Hyeon Kim; Clin Endosc 2015;48(4):345-347. Published online July 24, 2015; DOI: https://doi.org/10.5946/ce.2015.48.4.345

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.

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Pancreatic abscess: a modern look at an old problem
Fedir Prytkov , Denis Yurkin
The Ukrainian Scientific Medical Youth Journal.2021; 128(1): 42. CrossRef
Infected Pancreatic Necrosis Mimicking Pancreatic Cancer
Jun Heo
Case Reports in Gastroenterology.2020; 14(2): 436. CrossRef

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A Case of a Pancreatic Abscess Complicating Endoscopic Sphincterotomy: Mi Hyun Kim, M.D., Gwang Ha Kim, M.D., Seon Kyeong Kim, M.D., Won Lim, M.D., Jin Sup Park, M.D., Seong Hoon Yoon, M.D., Dong Uk Kim, M.D. and Geun Am Song, M.D.; Korean J Gastrointest Endosc 2009;39(1):55-58. Published online July 30, 2009

Abstract PDF: Endoscopic sphincterotomy (EST) has gained wide acceptance as a valuable tool for the management of disease of the pancreas and biliary tract. Complications associated with an EST include bleeding, perforation, pancreatitis and cholangitis, and the incidence of complications is approximately 5∼10%. A pancreatic abscess can develop rarely after an EST and tends to have a more complicated course, resulting in higher morbidity and mortality. We report a case of a pancreatic abscess that complicated an EST in a 61-year-old woman with a primary common bile duct stone. The patient was successfully cured by treatment with the use of broad-spectrum antibiotics. Although a pancreatic abscess is one of the rare delayed complications that can develop after an EST, it should be considered in the differential diagnosis of patients with a complaint of abdominal pain after an EST because of a high mortality rate and the need for prompt management. (Korean J Gastrointest Endosc 2009;39:55-58)

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Definitive Treatment of Infected Pancreatic Fluid Collection by Endoscopic Transmural Drainage: Jeong Han Kim, M.D., Jong-Jae Park, M.D., Sang Kyun Yu, M.D., Young Kul Jung, M.D., Ji Yeon Lee, M.D., Ik Yoon, M.D., Kyung Oh Kim, M.D., Hyung Joon Yim, M.D., Jin Yong Kim, M.D, Jong Eun Yeon, M.D., Jae Seon Kim, M.D., Kwan Soo Byun, M.D., Young-Tae Bak,; Korean J Gastrointest Endosc 2004;28(1):9-17. Published online January 30, 2004

Abstract PDF: Background
/Aims: Recent experience with endoscopic transmural drainage of pancreatic pseudocysts prompted the use of a similar technique for the primary treatment of infected pancreatic fluid collection (PFC) such as pancreatic abscess and infected pancreatic necrosis (IPN). The aim of this study was to determine the safety and effectiveness of endoscopic transmural drainage for the primary treatment of infected PFC complicating acute pancreatitis. Methods: In 11 patients, a total of 13 infected PFC (11 pancreatic abscesses and 2 IPNs) compressing the stomach, duodenum, or both were drained endoscopically by means of an endoscopic fistulization followed by stent (s) placement alone or additional nasopancreatic catheter insertion. Complete resolution of PFC was defined as the absence of symptoms and no residual collection on the follow-up computed tomography. Results: Complete resolution was achieved in 12 infected PFC (92%) (10 pancreatic abscesses and 2 IPNs) after stent placement for a mean duration of 31 days. For IPN and 2 pancreatic abscess, insertion of a nasopancreatic catheter was required to irrigate thick pus or necrotic debris. There was 1 case of bleeding (8%) but no mortality. Conclusions: Endoscopic transmural drainage is an effective therapy with minimal morbidity for infected pancreatic fluid collection compressing the gut lumen and is a valuable alternative to surgical drainage. (Korean J Gastrointest Endosc 2004;28:9⁣17)

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인터페론에 의한 급성췌장염에 합병된 다발성 췌장농양 1예 ( A Case of Pancreatic Abscesses Complicating Acute Pancreatitis Associated with Interferon Therapy ): Korean J Gastrointest Endosc 2000;20(1):77-82. Published online November 30, 1999

Abstract PDF: A patient experienced a silent gallstone accompanied by acute severe pancreatitis during interferon theraphy for renal cell carcinoma. Although the gallstone was highly suspected to be the cause of the pancreatits, there were no duodenoscopic or endoscopic retrograde cholangiopancreatographic findings suggesting gallstone pancreatitis such as papillitis, impacted papillary and common bile duct stones, and/or a wider cystic or pancreatic duct, respectively. It is believed that the acute pancreatitis in the presenting case was probably caused by interferon because 1) sludge nor biliary crystal was not detected by light microscopic examination, 2) no tumors, anomalies, nor any obstructing ductal lesions in the pancreas were found, 3) this patient had no other potential causes of acute pancreatitis, and 4) there was no use of potential drugs which could be responsible for the acute pancreatitis other than interferon. In addition, trials of endoscopic drainage of complicated pancreatic abscesses were discussed. (Korean J Gastrointest Endosc 2000;20:77~82)

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