Year 2022 / Volume 114 / Number 7
Digestive Diseases Image
Endoscopic necrosectomy – when the gastroenterologist faces his greatest nightmare.

422-424

DOI: 10.17235/reed.2021.8403/2021

Raquel Pimentel, Nuno Almeida, Pedro Figueiredo,

Abstract
A 69-year-old woman with severe acute necrotizing pancreatitis underwent a CT-scan, which revealed a peripancreatic collection near the pancreatic body/tail, with heterogeneous content and gas inside, suggestive of an infected walled-off-pancreatic-necrosis (WOPN). The patient was proposed to WOPN transgastric endoscopic drainage. Due to persistence of sepsis, endoscopic necrosectomy was deemed necessary. During the fifth session, the endoscopist noted a large pulsatile vessel at the posterior wall of the collection. Given location and morphologic features, it was assumed that vessel was the splenic artery. The procedure was suspended.
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References
1. van Brunschot S, Fockens P, Bakker OJ, et al. Endoscopic transluminal necrosectomy in necrotising pancreatitis: a systematic review. Surg Endosc. 2014;28:1425-38.
2. Yasuda I, Nakashima M, Iwai T, et al. Japanese multicenter experience of endoscopic necrosectomy for infected walled-off pancreatic necrosis: The JENIPaN study. Endoscopy. 2013;45:627-34.
3. Seewald S, Ang TL, Richter H, et al. Long-term results after endoscopic drainage and necrosectomy of symptomatic pancreatic fluid collections. Dig Endosc. 2012;24:36-41.
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Pimentel R, Almeida N, Figueiredo P. Endoscopic necrosectomy – when the gastroenterologist faces his greatest nightmare.. 8403/2021


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Publication history

Received: 17/10/2021

Accepted: 08/11/2021

Online First: 15/11/2021

Published: 07/07/2022

Article revision time: 14 days

Article Online First time: 29 days

Article editing time: 263 days


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