A case of transgastric gallbladder puncture as a complication during endoscopic ultrasound-guided drainage of a pancreatic pseudocyst.
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.
Hikichi
Takuto
T
Department of Endoscopy, Fukushima Medical University Hospital, 960-1295, Japan. takuto@fmu.ac.jp
Irisawa
Atsushi
A
Takagi
Tadayuki
T
Shibukawa
Goro
G
Wakatsuki
Takeru
T
Imamura
Hidemichi
H
Takahashi
Yuta
Y
Sato
Ai
A
Sato
Masaki
M
Oyama
Hitoshi
H
Sato
Naoto
N
Yamamoto
Go
G
Mokonuma
Tatsuyuki
T
Obara
Katsutoshi
K
Ohira
Hiromasa
H
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