title: A case of transgastric gallbladder puncture as a complication during endoscopic ultrasound-guided drainage of a pancreatic pseudocyst.
abstract: A 43-year-old man, a regular drinker, developed a pseudocyst in the pancreatic tail as a result of acutely worsening chronic pancreatitis. Because the pseudocyst, 10 cm in diameter, did not disappear despite conservative treatment, an internal drainage stent was placed transgastrically under endoscopic ultrasound (EUS) guidance. However, cyst infection occurred, and EUS-guided drainage was performed, when the gallbladder was punctured inadvertently. Immediately a nasocystic drain was placed in the gallbladder. Owing to this timely measure, only mild and localized peritonitis developed. Conservative treatment with fasting and an antibiotic was administered, and peritonitis subsided quickly. On the same day, another nasocystic drain was placed for the pancreatic pseudocyst, and it disappeared. As far as we know, this is the first case in which gallbladder puncture was inadvertently performed during EUS-guided drainage of a pancreatic pseudocyst.
authors.affiliation: Department of Endoscopy, Fukushima Medical University Hospital, 960-1295, Japan. takuto@fmu.ac.jp
authors.forename: Takuto
authors.initials: T
authors.lastname: Hikichi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Irisawa
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Takagi
authors.forename: Goro
authors.initials: G
authors.lastname: Shibukawa
authors.forename: Takeru
authors.initials: T
authors.lastname: Wakatsuki
authors.forename: Hidemichi
authors.initials: H
authors.lastname: Imamura
authors.forename: Yuta
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Ai
authors.initials: A
authors.lastname: Sato
authors.forename: Masaki
authors.initials: M
authors.lastname: Sato
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Oyama
authors.forename: Naoto
authors.initials: N
authors.lastname: Sato
authors.forename: Go
authors.initials: G
authors.lastname: Yamamoto
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Mokonuma
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Obara
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Ohira
mesh_terms: D000328:Adult; D004322:Drainage / Q000009:adverse effects* / Q000379:methods; D019160:Endosonography; D005704:Gallbladder / Q000293:injuries*; D006801:Humans; D008297:Male; D010192:Pancreatic Pseudocyst / Q000209:etiology / Q000628:therapy*; D050500:Pancreatitis, Chronic / Q000150:complications