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LATE BLEEDING AFTER EUS‐GUIDED TRANSJEJUNAL DRAINAGE OF A PANCREATIC PSEUDOCYST IN A ROUX‐EN‐Y PATIENT
Author(s) -
ITOI TAKAO,
ITOKAWA FUMIHIDE,
SOFUNI ATSUSHI,
UMEDA JUNKO,
TSUCHIYA TAKAYOSHI
Publication year - 2011
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.2011.01141.x
Subject(s) - medicine , vomiting , abdominal pain , surgery , endoscopic ultrasonography , pancreatic pseudocyst , pancreatic fistula , radiology , nausea , endoscopy , stent , pancreatitis , pancreas , endocrinology
Endoscopic ultrasonography (EUS)‐guided transgastric and transduodenal drainage of a pancreatic pseudocyst (PP) has become a standard and safe procedure for nonsurgical treatment. However, there are only four reports on transjejunal drainage of PP in a patient with or without altered anatomy. Herein, we report a case of EUS‐guided transjejunal PP drainage in a patient with previous Roux‐en‐Y reconstruction. A 58‐year‐old man, who had previously undergone total gastrectomy with Roux‐en‐Y, was admitted to another hospital because of fever, abdominal pain, nausea and vomiting. Computed tomography showed a 22 cm PP. Then, EUS‐guided transjejunal PP drainage was carried out. Twenty‐three days after the procedure and 3 days after the patient started eating, the hematemesis was seen. Emergency endoscopy showed bleeding around a transjejunal fistula. A 6‐Fr nasocystic catheter was placed into the cyst again for lavage and hemostasis as tamponade. After 1 more month, a computed tomography scan showed complete resolution of the PP with the stent still in place.