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.

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