Ultrasound-Guided Endoscopic Drainage for Pediatric Pancreatic Collections: A Case Report

Introduction:Ultrasound-guided endoscopic drainage is the treatment of choice for managing symptomatic, advanced pancreatic collections in adults. However, data regarding its safety and efficacy in pediatric patients remain limited.

Case Report:A 6-year-old child, with no significant medical history, presented with a large pancreatic collection and secondary splenic thrombosis after 5 weeks of moderate acute pancreatitis. Despite 4 weeks of conservative treatment without improvement, endoscopic drainage was decided. Under controlled anesthesia and fluoroscopy, a transgastric cyst-gastrostomy was performed using a 15x10 mm lumen-apposing metal stent (LAMS). To prevent stent migration, a coaxial 7F-4 cm double pig-tail (DPT) was inserted alongside the LAMS. The patient was discharged uneventfully, but was readmitted two weeks later with bacteremia. A CT scan revealed near-complete resolution of the pancreatic collection and splenoportal thrombophlebitis around the distal end of the DPT. Both stents were removed, and the patient was treated with antibiotics. After 3 months of anticoagulant therapy, complete resolution of the thrombus was achieved.

Conclusion:Ultrasound-guided endoscopic drainage is a viable and safe treatment for pancreatic collections in pediatric patients. The effective management of complications highlights the importance of a multidisciplinary approach in such cases.

Publication History

Article published online:
27 March 2025