title: Endoscopic ultrasonography-guided transmural drainage of an infected hepatic cyst due to Edwardsiella tarda: a case report.
abstract: Infected hepatic cysts are very rare compared to simple liver cysts and abscesses. We treated a 77-year-old man with an infected hepatic cyst in the lateral segment caused by Edwardsiella tarda, which has not been previously reported as a pathogenic organism associated with infected hepatic cysts. Percutaneous drainage was temporarily effective, but infection recurred after the drainage tube was removed. We then inserted two drainage tubes into the cyst using an endoscopic ultrasonography (EUS)-guided technique, which was developed from EUS-guided fine needle aspiration (EUS-FNA). The internal drainage tube was a 7 Fr double pigtail stent, and the external tube was a 6 Fr nasobiliary drainage tube. Lavage through the external drainage tube was carried out for one week. The external drainage tube was discontinued when the patient's condition improved significantly. Sixteen days after tube insertion, he was discharged with the internal tube draining the hepatic cyst into the stomach. Fifteen months after EUS-guided drainage, CT examination showed no recurrence of the hepatic cyst. EUS-guided drainage is an effective treatment for infected hepatic cysts.
authors.affiliation: Department of Digestive and Life-style Related Diseases, Human and Environmental Sciences, Health Research, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Taguchi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Tamai
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Numata
authors.forename: Hitomi
authors.initials: H
authors.lastname: Maeda
authors.forename: Akihiko
authors.initials: A
authors.lastname: Ohshige
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Iwaya
authors.forename: Shinichi
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Shuji
authors.initials: S
authors.lastname: Kanmura
authors.forename: Keita
authors.initials: K
authors.lastname: Funakawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujita
authors.forename: Akio
authors.initials: A
authors.lastname: Ido
authors.forename: Hirohito
authors.initials: H
authors.lastname: Tsubouchi
mesh_terms: D000368:Aged; D003560:Cysts / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D020609:Edwardsiella tarda; D019160:Endosonography; D004756:Enterobacteriaceae Infections / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery*; D008297:Male; D025321:Surgery, Computer-Assisted; D018084:Ultrasonography, Interventional