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Create a Free AccountProcedures - Drainage of pancreatic fluid
Endoscopic management of symptomatic walled-off omental fat necrosis
Omental infarction has been described as a rare adverse event of various abdominal surgeries, including pancreatic resection; it occasionally can lead to a walled-off omental fat necrosis (WOFN) collection. With only 1 case report describing WOFN after pancreatic resection, the incidence and appropriate management are unclear. However, a study of post–distal pancreatectomy patients found the incidence of WOFN to be much higher than previously thought, with reports of 2 presentation patterns: asymptomatic patients with incidental findings on imaging and symptomatic patients presenting with the chief symptom of abdominal pain.EUS-guided duodenojejunostomy by use of a 2-cm lumen-apposing metal stent to treat proximal jejunal stricture in a patient with chronic pancreatitis
EUS-guided gastrojejunostomy has been increasingly used to treat patients with gastric outlet and duodenal obstruction, particularly in patients with many comorbidities prohibiting surgery.1,2 We describe a case of a proximal jejunal stricture treated by EUS-guided duodenojejunostomy with use of a 2-cm lumen-apposing metal stent (LAMS).The evolution of EUS-guided cystogastrostomy for pancreatic fluid collections
Endoscopic drainage of pancreatic fluid collections has conventionally been a tedious procedure. Endoscopic drainage may be performed with or without the use of EUS. Conventionally, EUS-guided cystogastrostomy involved EUS-guided needle puncture, repurposed devices, and multiple exchanges over a guidewire. A simple single-device technique can facilitate the procedure.Endoscopic drainage of pancreatic fluid collections by use of a novel biflanged stent with electrocautery-enhanced delivery system
Endoscopic drainage is currently the preferred modality of drainage for pancreatic fluid collections (PFCs) because of the ease of the procedure, reduced cost, shorter hospital stay, and the reduced morbidity and mortality compared with traditional surgical drainage.1 Plastic stents used for endoscopic drainage may become blocked with the passage of time, leading to adverse events requiring reinterventions, especially in PFCs with significant debris (ie, walled-off necrosis [WON]). Novel large-caliber metal stents (LCMSs) are less prone to spontaneous occlusions and therefore, provide efficient drainage of PFCs.Pancreatic duct rendezvous with pancreatoscopy through the minor papilla
An 18-year-old woman presented to our hospital with diffuse abdominal pain and visible distention. She reported a history of acute pancreatitis 2 months earlier. Physical examination revealed diffuse abdominal tenderness without rebound and an abdominal fluid wave. CT of the abdomen and pelvis (Figs. 1 and 2) showed a large volume of ascites and marked dilation of the pancreatic duct to 16 mm, with a hypodense filling defect within the pancreatic duct near the head of the pancreas.
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