EUS-GUIDED TRANSESOPHAGEAL DRAINAGE OF A LIVER ABSCESS WITH A SELF-EXPANDABLE METAL STENT (SEMS) AS RESCUE THERAPY AFTER DOUBLE PIGTAIL STENT (DPS) MISDEPLOYMENT

A Klatskin-IIIB cholangiocarcinoma patient with palliative biliary drainage combining a right ERCP stent and a left EUS-guided hepaticogastrostomy developed a subphrenic abscess. EUS-guided 19-G-needle abscess puncture from the distal esophagus was followed by 4-mm balloon dilatation. A 7Fr-5cm DPS was inserted but misdeployed inside the abscess. A SEMS was deployed and 10-mm balloon dilatated. An ultrathin gastroscope was passed through the SEMS into the abscess. Under endoscopic view the DPS was repositioned using a grasping forceps.

A CT scan was performed two weeks later, confirming abscess resolution with in-situ SEMS and coaxial DPS. One week later both stents were removed.

Publication History

Article published online:
14 April 2022