Endoscopic management of pancreatic duct leak complicated by retrogastric abscess.
A patient was diagnosed with a large retrogastric abscess associated with a postsurgical pancreatic duct leak refractory to somatostatin (Sandostatin) and external drains. She was managed entirely by endoscopic means consisting of transgastric abscess decompression, irrigation via a nasocystic tube, total parenteral nutrition, and a 7-Fr pancreatic duct stent to facilitate healing of the pancreatic duct leak. Thirty days after placement, the pancreatic duct stent was removed and pancreatogram revealed closure. Fifty-one days after transgastric decompression of the abscess, near complete closure of the cavity was accomplished and the patient returned to a regular diet. One year later, the patient continues to do well.
D018784:Abdominal Abscess / Q000150:complications* / Q000628:therapy; D000368:Aged; D004322:Drainage / Q000379:methods*; D016145:Endoscopy, Digestive System; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D007710:Klebsiella Infections / Q000628:therapy; D007711:Klebsiella pneumoniae; D015282:Octreotide / Q000627:therapeutic use; D010183:Pancreatic Ducts; D010185:Pancreatic Fistula / Q000150:complications / Q000628:therapy*; D010289:Parenteral Nutrition, Total; D011183:Postoperative Complications / Q000628:therapy*; D013203:Staphylococcal Infections / Q000628:therapy; D015607:Stents; D007507:Therapeutic Irrigation
D005765:Gastrointestinal Agents; D015282:Octreotide