Managing acute hemorrhagic pancreatitis

Ji Young Bang, MD, MPH, from the Division of Gastroenterology and Hepatology, Indiana University, in Indianapolis, Indiana, USA presents this video case “Management of acute hemorrhagic pancreatitis after EUS-guided FNA of a pancreatic cyst.”

Our VideoGIE video describes a case of a patient presenting with acute pancreatitis and a hemorrhagic pancreatic fluid collection (PFC) following EUS-FNA of an asymptomatic side-branch IPMN. EUS was performed to evaluate the symptomatic PFC, which revealed extrinsic compression of the distal bile duct and a pancreatic duct leak. The PFC was aspirated under EUS-guidance confirming hemorrhagic fluid, followed by ERCP with pancreatic stent placement to bridge the pancreatic duct leak. The patient also had nasojejunal feeding for 4 weeks, with complete resolution of symptoms and PFC on follow-up CT at 30 days.

It was important to showcase the video to highlight the risks of acute pancreatitis and hemorrhage associated with EUS-FNA of pancreatic cysts, especially in side-branch IPMNs.

The importance of employing a systematic, multidisciplinary approach in the management of adverse events associated with EUS-FNA.

Find more VideoGIE cases online.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.

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