ASGE Annual Postgraduate Course: Clinical Challenges and Real-Time Decision Making in GI Endoscopy (On-demand) | May 2023-Session 10 - Video Case Discussion 2 - Management of Pancreatic Fluid Collections

Session 10 - Video Case Discussion 2 - Management of Pancreatic Fluid Collections

Video Transcription

Video Summary

During the video, a case of a 48-year-old woman with FAP who had previously undergone a subtotal colectomy and an ampulectomy is discussed. The patient presented with necrotizing pancreatitis and a large peripancreatic collection. Initially, the patient was sent for interventional radiology (IR) drainage, but continued to have fevers and inadequate drainage. The patient was subsequently sent for endoscopic drainage and had endoscopic ultrasound (EUS)-guided placement of luminal opposing metal stents (LAMS) and double pigtail stents to maximize drainage. A necrosectomy was performed using a dedicated necrosectomy tool, and the patient had subsequent complications of splenic artery pseudoaneurysm and bleeding. The pseudoaneurysm was treated with coils, and the patient underwent further necrosectomy. Take-home points include the importance of having a plan of care, considering the underlying cause of pancreatitis, confirming complete resolution on follow-up imaging, and addressing any complications that may arise. No credits were mentioned in the video.

Asset Subtitle

Amrita Sethi

Keywords

FAP

necrotizing pancreatitis

endoscopic drainage

necrosectomy

complications