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dergo an endoscopic ultrasound−guided fine−needle aspiration (EUS−FNA) of a le− sion in the posterior region of the rectum. Informed consent was obtained. EUS, per− formed with a linear probe (3830UT, Pen− tax, Hamburg), confirmed a hypoechoic lesion with well−defined margins at 10 cm from the anal sphincter, between the posterior region of the rectum and sa− crum (33 mm). Prophylactic antibiotics were administered (ampicillin 2 g; genta− micin 80 mg intravenously [IV]). Con− scious sedation was initiated with mida− zolam, 2 mg IV. EUS−FNA used a 25 G ul− trasound needle (Wilson−Cook Medical Inc., USA) (l" Figure 1). No complications were encountered. Cytological examina− tion of the lesion revealed amorphous granular material, numerous squamous cells without atypical features, rare stro− mal cells, and few normal glandular ag− gregates; no malignant cells were found (l" Figure 2). Five days following the pro− cedure, the patient complained of pain in the posterior region of the rectum, and experienced fever and spontaneous cuta− neous drainage. EUS showed the lesion to be hypoechoic, with anechoic areas and undefined margins, compatible with pel− vic abscess or hematic extravasation after EUS−FNA. The patient was hospitalized and underwent clinical revalutation. Magnetic resonance imaging revealed features in the presacral−coccyx region consistent with an abscess surrounded by granular tissue. The patient was dis− charged in good clinical condition 10 days later. EUS−FNA has been shown to be a feasible and safe technique to obtain cytological specimens of submucosal, extrinsic gas− trointestinal, pancreatic lesion masses, or pathologic lymph nodes, as well as cystic structures [1 ±3]; the risk of bacteremia is low [4 ±5]. In this clinical case, we used EUS−FNA to better characterize the le− sion; the reported lesion did not show cyst features and therefore the risk asso− ciated with EUS−FNA, as for solid lesions, was negligible. In this case, as in all our cases of transrectal biopsies, prophylaxis with antibiotics was administered. The complication observed after EUS−FNA could be limited by administering anti− biotics in the days following the proce− dure, even though there are no published data on the usefulness of pharmacologic prophylaxis [4].

Complication after endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of rectal lesion