Post written by Theodore W. James, MD, from the Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.

We describe our experience rescuing a Jackson-Pratt drain that was inadvertently severed using transduodenal puncture into the peritoneum followed by passage of a linear echoendoscope into the space for withdrawal of the drain.

The ability to think on one’s feet is a necessity when performing therapeutic endoscopy. Many providers in a similar situation would default to a surgical consultation. We aimed to demonstrate that endoscopy offers solutions to problems (in this case, a severed JP drain) that can help patients avoid surgery. Several elements of this case are noteworthy including: transduodenal peritonoscopy, retrieval of a foreign body using EUS, and defect closure using an over-the-scope clip.

Intraperitoneal echoendoscopy may have numerous future applications. This technique should be considered as an active area of research in minimally invasive endoscopic therapy.

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