Acute pancreatitis is associated with local and systemic complications. Pancreatic fluid collection (PFC) is the most common local complication. Infected or symptomatic PFCs need drainage. Endoscopic drainage (ED) is the first-line procedure for accessible PFCs adjacent to the stomach and duodenum. ED is performed under endoscopic ultrasound (EUS) guidance. The technical and clinical success rates of EUS-guided ED in well-encapsulated PFCs are high. ED of poorly encapsulated PFCs is associated with complications. Bleeding and perforation are the most common complications. Contrast-enhanced computed tomography is critical in planning ED and early detection and management of complications. With the increasing utilization of ED for PFC, the radiologist must be familiar with the ED techniques, types of stents, and the complications related to ED. In this review, we discuss the technical aspects of the ED as well as the imaging findings of ED-related complications.
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http://dx.doi.org/10.1007/s00261-024-04348-y | DOI Listing |
Gastrointest Endosc
January 2025
Department of Endoscopy and Endoscopic Surgery, The University of Tokyo Hospital, Tokyo, Japan; Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
Background And Aims: Endoscopic ultrasound-guided peripancreatic fluid drainage (EUS-PFD) with on-demand endoscopic necrosectomy, increasingly utilized to manage walled-off necrosis (WON), is associated with substantial morbidity and mortality. This multicenter study aimed to externally validate recently developed quadrant (an abdominal quadrant distribution), necrosis, and infection (QNI) criteria for risk stratification in this setting.
Methods: Of 423 patients with pancreatic fluid collections treated in a large multi-institutional cohort between 2010 and 2020, 212 with available preprocedural computed tomography images were included.
Medicine (Baltimore)
January 2025
Department of General Surgery, Nujiang Prefecture People's Hospital, Yunnan, Nujiang, China.
Rationale: Peritoneal mucinous cystadenoma is rare in the clinic, lacks specific clinical manifestations, tumor markers, and imaging features, and is easily misdiagnosed and missed. Clinical practitioners should maintain a high level of vigilance. Here, we report a case of laparoscopic peritoneal mucinous cystadenoma stripping to improve our understanding of the disease.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
September 2024
Division of Thoracic Surgery, Mayo Clinic, Rochester, Minnesota.
Pleural extension of pseudomyxoma peritonei is rare, and treatment demands multidisciplinary care. Perioperative management during cytoreductive surgery and hyperthermic intrathoracic chemotherapy challenges anesthesiology and surgical teams in unique ways. Hemodynamic, arrhythmogenic, ventilatory, fluid balance, acid-base, and nephroprotection issues are important considerations.
View Article and Find Full Text PDFBMC Gastroenterol
January 2025
Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan.
Background: Endoscopic ultrasound-guided transmural drainage (EUS-TD) is widely performed to treat postoperative peripancreatic fluid collection (POPFC). Recent reports on EUS-TD lack a consensus on stent selection. This study aimed to assess the efficacy of EUS-TD for POPFC using an external drainage-based approach.
View Article and Find Full Text PDFClin J Gastroenterol
January 2025
Department of Gastroenterology, Cleveland Clinic Florida, Weston, FL, 33326, USA.
Pancreatic cancer (PC) manifests as a highly aggressive neoplastic growth, ranking as the fourth major contributor to cancer-related mortality in the United States. Despite sustained efforts, the incidence of PC is projected to rise, and the mortality rate has seen only a marginal reduction over time. A mere 15% of pancreatic cancer cases are deemed resectable upon presentation, explaining the notably low 5-year survival rate associated with this malignancy.
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