Skip to main content
Top
Published in: BMC Gastroenterology 1/2013

Open Access 01-12-2013 | Case report

Arterial bleeding during EUS-guided pseudocyst drainage stopped by placement of a covered self-expandable metal stent

Authors: Adrian Săftoiu, Lidia Ciobanu, Andrada Seicean, Marcel Tantău

Published in: BMC Gastroenterology | Issue 1/2013

Login to get access

Abstract

Background

Hemorrhagic complications during EUS-guided pseudocyst drainage can occur, because the vessels on the internal wall of the pseudocyst might be compressed by the fluid and thus not visible on color Doppler or even power Doppler EUS.

Case presentation

We report a case of an immediate internal spurting arterial bleeding precipitated during EUS-guided pseudocyst drainage which stopped instantaneously by placement of a double flanged covered self-expandable metal stent through mechanical hemostasis.

Conclusion

In an unusual situation of bleeding from collateral circulation near the pseudocyst wall during pseudocyst drainage, the placement of an expandable metal stent proved to be useful.
Appendix
Available only for authorised users
Literature
1.
go back to reference Vilmann P, Hancke S, Pless T, Schell-Hincke JD, Henriksen FW: One-step endosonography-guided drainage of a pancreatic pseudocyst: a new technique of stent delivery through the echo endoscope. Endoscopy. 1998, 30: 730-733. 10.1055/s-2007-1001399.CrossRefPubMed Vilmann P, Hancke S, Pless T, Schell-Hincke JD, Henriksen FW: One-step endosonography-guided drainage of a pancreatic pseudocyst: a new technique of stent delivery through the echo endoscope. Endoscopy. 1998, 30: 730-733. 10.1055/s-2007-1001399.CrossRefPubMed
2.
go back to reference Giovannini M, Bernardini D, Seitz JF: Cystogastrotomy entirely performed under endosonography guidance for pancreatic pseudocyst: results in six patients. Gastrointest Endosc. 1998, 48: 200-203. 10.1016/S0016-5107(98)70165-8.CrossRefPubMed Giovannini M, Bernardini D, Seitz JF: Cystogastrotomy entirely performed under endosonography guidance for pancreatic pseudocyst: results in six patients. Gastrointest Endosc. 1998, 48: 200-203. 10.1016/S0016-5107(98)70165-8.CrossRefPubMed
3.
go back to reference Seewald S, Thonke F, Ang TL, Omar S, Seitz U, Groth S, Zhong Y, Yekebas E, Izbicki J, Soehendra N: One-step, simultaneous double-wire technique facilitates pancreatic pseudocyst and abscess drainage (with videos). Gastrointest Endosc. 2006, 64: 805-808. 10.1016/j.gie.2006.07.049.CrossRefPubMed Seewald S, Thonke F, Ang TL, Omar S, Seitz U, Groth S, Zhong Y, Yekebas E, Izbicki J, Soehendra N: One-step, simultaneous double-wire technique facilitates pancreatic pseudocyst and abscess drainage (with videos). Gastrointest Endosc. 2006, 64: 805-808. 10.1016/j.gie.2006.07.049.CrossRefPubMed
4.
go back to reference Lopes CV, Pesenti C, Bories E, Caillol F, Giovannini M: Endoscopic-ultrasound-guided endoscopic transmural drainage of pancreatic pseudocysts and abscesses. Scand J Gastroenterol. 2007, 42: 524-529. 10.1080/00365520601065093.CrossRefPubMed Lopes CV, Pesenti C, Bories E, Caillol F, Giovannini M: Endoscopic-ultrasound-guided endoscopic transmural drainage of pancreatic pseudocysts and abscesses. Scand J Gastroenterol. 2007, 42: 524-529. 10.1080/00365520601065093.CrossRefPubMed
5.
go back to reference Ardengh JC, Coelho DE, Coelho JF, de Lima LF, dos Santos JS, Módena JL: Single-step EUS-guided endoscopic treatment for sterile pancreatic collections: a single-center experience. Dig Dis. 2008, 26: 370-376. 10.1159/000177024.CrossRefPubMed Ardengh JC, Coelho DE, Coelho JF, de Lima LF, dos Santos JS, Módena JL: Single-step EUS-guided endoscopic treatment for sterile pancreatic collections: a single-center experience. Dig Dis. 2008, 26: 370-376. 10.1159/000177024.CrossRefPubMed
6.
go back to reference Ahn JY, Seo DW, Eum J, Song TJ, Moon SH, Park do H, Lee SS, Lee SK, Kim MH: Single-step EUS-Guided transmural drainage of pancreatic pseudocysts: analysis of technical feasibility, efficacy, and safety. Gut Liver. 2010, 4: 524-529. 10.5009/gnl.2010.4.4.524.CrossRefPubMedPubMedCentral Ahn JY, Seo DW, Eum J, Song TJ, Moon SH, Park do H, Lee SS, Lee SK, Kim MH: Single-step EUS-Guided transmural drainage of pancreatic pseudocysts: analysis of technical feasibility, efficacy, and safety. Gut Liver. 2010, 4: 524-529. 10.5009/gnl.2010.4.4.524.CrossRefPubMedPubMedCentral
7.
go back to reference Varadarajulu S, Lopes TL, Wilcox CM, Drelichman ER, Kilgore ML, Christein JD: EUS versus surgical cyst-gastrostomy for management of pancreatic pseudocysts. Gastrointest Endosc. 2008, 68: 649-655. 10.1016/j.gie.2008.02.057.CrossRefPubMed Varadarajulu S, Lopes TL, Wilcox CM, Drelichman ER, Kilgore ML, Christein JD: EUS versus surgical cyst-gastrostomy for management of pancreatic pseudocysts. Gastrointest Endosc. 2008, 68: 649-655. 10.1016/j.gie.2008.02.057.CrossRefPubMed
8.
go back to reference Park DH, Lee SS, Moon SH, Choi SY, Jung SW, Seo DW, Lee SK, Kim MH: Endoscopic ultrasound-guided versus conventional transmural drainage for pancreatic pseudocysts: a prospective randomized trial. Endoscopy. 2009, 41: 842-848. 10.1055/s-0029-1215133.CrossRefPubMed Park DH, Lee SS, Moon SH, Choi SY, Jung SW, Seo DW, Lee SK, Kim MH: Endoscopic ultrasound-guided versus conventional transmural drainage for pancreatic pseudocysts: a prospective randomized trial. Endoscopy. 2009, 41: 842-848. 10.1055/s-0029-1215133.CrossRefPubMed
9.
go back to reference Itoi T, Itokawa F, Sofuni A, Umeda J, Tsuchiya T: Late bleeding after EUS-guided transjejunal drainage of a pancreatic pseudocyst in a Roux-en-Y patient. Dig Endosc. 2011, 23 (Suppl 1): 51-53.CrossRefPubMed Itoi T, Itokawa F, Sofuni A, Umeda J, Tsuchiya T: Late bleeding after EUS-guided transjejunal drainage of a pancreatic pseudocyst in a Roux-en-Y patient. Dig Endosc. 2011, 23 (Suppl 1): 51-53.CrossRefPubMed
10.
go back to reference Varadarajulu S, Christein JD, Wilcox CM: Frequency of complications during EUS-guided drainage of pancreatic fluid collections in 148 consecutive patients. J Gastroenterol Hepatol. 2011, 26: 1504-1508. 10.1111/j.1440-1746.2011.06771.x.CrossRefPubMed Varadarajulu S, Christein JD, Wilcox CM: Frequency of complications during EUS-guided drainage of pancreatic fluid collections in 148 consecutive patients. J Gastroenterol Hepatol. 2011, 26: 1504-1508. 10.1111/j.1440-1746.2011.06771.x.CrossRefPubMed
11.
go back to reference Belle S, Collet P, Post S, Kaehler G: Temporary cystogastrostomy with self-expanding metallic stents for pancreatic necrosis. Endoscopy. 2010, 42: 493-495. 10.1055/s-0029-1244021.CrossRefPubMed Belle S, Collet P, Post S, Kaehler G: Temporary cystogastrostomy with self-expanding metallic stents for pancreatic necrosis. Endoscopy. 2010, 42: 493-495. 10.1055/s-0029-1244021.CrossRefPubMed
12.
go back to reference Tarantino I, Di Pisa M, Barresi L, Curcio G, Granata A, Traina M: Covered self expandable metallic stent with flared plastic one inside for pancreatic pseudocyst avoiding stent dislodgement. World J Gastrointest Endosc. 2012, 4: 148-150. 10.4253/wjge.v4.i4.148.CrossRefPubMedPubMedCentral Tarantino I, Di Pisa M, Barresi L, Curcio G, Granata A, Traina M: Covered self expandable metallic stent with flared plastic one inside for pancreatic pseudocyst avoiding stent dislodgement. World J Gastrointest Endosc. 2012, 4: 148-150. 10.4253/wjge.v4.i4.148.CrossRefPubMedPubMedCentral
13.
go back to reference Pallapothu R, Earle DB, Desilets DJ, Romanelli JR: NOTES(®) stapled cystgastrostomy: a novel approach for surgical management of pancreatic pseudocysts. Surg Endosc. 2011, 25: 883-889. 10.1007/s00464-010-1289-2.CrossRefPubMed Pallapothu R, Earle DB, Desilets DJ, Romanelli JR: NOTES(®) stapled cystgastrostomy: a novel approach for surgical management of pancreatic pseudocysts. Surg Endosc. 2011, 25: 883-889. 10.1007/s00464-010-1289-2.CrossRefPubMed
14.
go back to reference Binmoeller KF, Shah J: A novel lumen-apposing stent for transluminal drainage of nonadherent extraintestinal fluid collections. Endoscopy. 2011, 43: 337-342. 10.1055/s-0030-1256127.CrossRefPubMed Binmoeller KF, Shah J: A novel lumen-apposing stent for transluminal drainage of nonadherent extraintestinal fluid collections. Endoscopy. 2011, 43: 337-342. 10.1055/s-0030-1256127.CrossRefPubMed
15.
go back to reference Itoi T, Binmoeller KF, Shah J, Sofuni A, Itokawa F, Kurihara T, Tsuchiya T, Ishii K, Tsuji S, Ikeuchi N, Moriyasu F: Clinical evaluation of a novel lumen-apposing metal stent for endosonography-guided pancreatic pseudocyst and gallbladder drainage (with videos). Gastrointest Endosc. 2012, 75: 870-876. 10.1016/j.gie.2011.10.020.CrossRefPubMed Itoi T, Binmoeller KF, Shah J, Sofuni A, Itokawa F, Kurihara T, Tsuchiya T, Ishii K, Tsuji S, Ikeuchi N, Moriyasu F: Clinical evaluation of a novel lumen-apposing metal stent for endosonography-guided pancreatic pseudocyst and gallbladder drainage (with videos). Gastrointest Endosc. 2012, 75: 870-876. 10.1016/j.gie.2011.10.020.CrossRefPubMed
16.
go back to reference Escorsell A, Bosch J: Self-expandable metal stents in the treatment of acute esophageal variceal bleeding. Gastroenterol Res Pract Epub. 2011, 910986- Escorsell A, Bosch J: Self-expandable metal stents in the treatment of acute esophageal variceal bleeding. Gastroenterol Res Pract Epub. 2011, 910986-
17.
go back to reference Hubmann R, Bodlaj G, Czompo M, Benkö L, Pichler P, Al-Kathib S, Kiblböck P, Shamyieh A, Biesenbach G: The use of self-expanding metal stents to treat acute esophageal variceal bleeding. Endoscopy. 2006, 38: 896-901. 10.1055/s-2006-944662.CrossRefPubMed Hubmann R, Bodlaj G, Czompo M, Benkö L, Pichler P, Al-Kathib S, Kiblböck P, Shamyieh A, Biesenbach G: The use of self-expanding metal stents to treat acute esophageal variceal bleeding. Endoscopy. 2006, 38: 896-901. 10.1055/s-2006-944662.CrossRefPubMed
18.
go back to reference Shah JN, Marson F, Binmoeller KF: Temporary self-expandable metal stent placement for treatment of post-sphincterotomy bleeding. Gastrointest Endosc. 2010, 72: 1274-1278. 10.1016/j.gie.2010.08.012.CrossRefPubMed Shah JN, Marson F, Binmoeller KF: Temporary self-expandable metal stent placement for treatment of post-sphincterotomy bleeding. Gastrointest Endosc. 2010, 72: 1274-1278. 10.1016/j.gie.2010.08.012.CrossRefPubMed
19.
go back to reference Itoi T, Yasuda I, Doi S, Mukai T, Kurihara T, Sofuni A: Endoscopic hemostasis using covered metallic stent placement for uncontrolled post-endoscopic sphincterotomy bleeding. Endoscopy. 2011, 43: 369-372. 10.1055/s-0030-1256126.CrossRefPubMed Itoi T, Yasuda I, Doi S, Mukai T, Kurihara T, Sofuni A: Endoscopic hemostasis using covered metallic stent placement for uncontrolled post-endoscopic sphincterotomy bleeding. Endoscopy. 2011, 43: 369-372. 10.1055/s-0030-1256126.CrossRefPubMed
20.
go back to reference Hasegawa N, Kato K, Morita K, Kuroiwa M, Shinkai M, Hayashi T, Kamioka T, Otagiri H, Shindo Y, Goto H: Covered expandable metallic stent placement for hemostasis of colonic bleeding caused by invasion of gallbladder carcinoma. Endoscopy. 2003, 35: 178-180. 10.1055/s-2003-37018.CrossRefPubMed Hasegawa N, Kato K, Morita K, Kuroiwa M, Shinkai M, Hayashi T, Kamioka T, Otagiri H, Shindo Y, Goto H: Covered expandable metallic stent placement for hemostasis of colonic bleeding caused by invasion of gallbladder carcinoma. Endoscopy. 2003, 35: 178-180. 10.1055/s-2003-37018.CrossRefPubMed
21.
go back to reference Akbar A, Reddy DN, Baron TH: Placement of fully covered self-expandable metal stents to control entry-related bleeding during transmural drainage of pancreatic fluid collections (with video). Gastrointest Endosc. 2012, 76: 1060-1063. 10.1016/j.gie.2012.07.014.CrossRefPubMed Akbar A, Reddy DN, Baron TH: Placement of fully covered self-expandable metal stents to control entry-related bleeding during transmural drainage of pancreatic fluid collections (with video). Gastrointest Endosc. 2012, 76: 1060-1063. 10.1016/j.gie.2012.07.014.CrossRefPubMed
Metadata
Title
Arterial bleeding during EUS-guided pseudocyst drainage stopped by placement of a covered self-expandable metal stent
Authors
Adrian Săftoiu
Lidia Ciobanu
Andrada Seicean
Marcel Tantău
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2013
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/1471-230X-13-93

Other articles of this Issue 1/2013

BMC Gastroenterology 1/2013 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.