Tag: walled-off necrosis

Endoscopic management of active arterial bleeding in walled-off necrosis collection

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Post written by Matthew Eganhouse, MD, and Ajaypal Singh, MD, from the Division of Digestive Diseases, Rush University Medical Center, Chicago, Illinois, USA. In our recently published video case, we describe, to our knowledge, the first time endoscopic hemostasis was achieved from active arterial bleeding within a walled-off necrosis (WON) cavity. Our patient, a 45-year-old woman, initially underwent EUS-guided cystgastrostomy …

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Quadrant, necrosis, and infection criteria for the risk stratification of walled-off necrosis: external validation using multi-institutional data

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Post written by Hideyuki Shiomi, MD, PhD, from the Division of Hepatobiliary and Pancreatic Diseases, Department of Gastroenterology, Hyogo Medical University, Hyogo, and Tomotaka Saito, MD, PhD, from the Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan, for the WONDERFUL study group. Our study externally validated the quadrant (an abdominal quadrant distribution), necrosis, and infection (QNI) …

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Necrosectomy and its timing in relation to clinical outcomes of EUS-guided treatment of walled-off pancreatic necrosis: a multicenter study

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Post written Masahiro Tsujimae, MD, PhD, from the Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Hyogo, and Yousuke Nakai, MD, PhD, from the Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan. The aim of our study was to investigate associations of the use of endoscopic necrosectomy (EN) and …

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Diagnosis and treatment of a biliary fistula to walled-off pancreatic necrosis

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Post written by Erica Park, MD, from the Division of Gastroenterology, Hepatology, and Nutrition, Ohio State University Wexner Medical Center, Columbus, Ohio, USA. We describe a case of biliary obstruction from a walled-off pancreatic necrosis, for which the patient underwent EUS-guided cystduodenostomy for biliary decompression. The patient’s liver function tests results subsequently improved, which we initially …

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Large-caliber metal stent controls entry site bleeding during EUS-guided drainage of walled-off necrosis

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Post written by Radhika Chavan, MD, DNB, from the Asian Institute of Gastroenterology, Hyderabad, India. A 35-year-old man, diagnosed with acute necrotizing pancreatitis 7 weeks ago, presented with abdominal pain and fever for 2 weeks. Evaluation showed mild leukocytosis with raised amylase and lipase levels. Endoscopic ultrasound (EUS) showed large walled-off necrosis (WON) with minimal …

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Retrieval and redeployment of migrated LAMS to facilitate endoscopic necrosectomy of walled-off necrosis

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Post written by Shashideep Singhal, MD, FASGE, from the Gastrointestinal Care Consultants, Houston, Texas, USA.                  Walled-off necrosis (WON) develops as a sequel to acute pancreatitis. Approximately 15% of patients with acute pancreatitis can experience WON. EUS-guided transmural drainage of WON has been a safe, efficacious, and widely used therapeutic modality in recent times. The …

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Massive bleeding after EUS-guided walled-off necrosis drainage

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Post written by Lady Katherine Mejia Perez, MD, and Victoria Gómez, MD, from the Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA. We describe a case of a 58-year-old man with necrotizing pancreatitis of biliary origin who underwent endoscopic drainage of a large, 12-cm pancreatic collection consistent with walled-off necrosis. A 15-mm diameter …

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Pulsating pseudoaneurysm in a walled-off necrosis

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Shuntaro Mukai from the Department of Gastroenterology and Hepatology at Tokyo Medical University in Tokyo, Japan describes this VideoGIE case "Pulsating pseudoaneurysm in a walled-off necrosis." Our video case describes a pulsating pseudoaneurysm in the cavity of a walled-off necrosis (WON) diagnosed by endoscopy through a fully-covered biflanged metal stent (BFMS). Subsequently, the pseudoaneurysm was …

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