ASGE DDW Videos from Around the World | 2022-ENDOSCOPIC ULTRASOUND-GUIDED TRANSGASTRIC DRAINAGE OF A HEPATIC ABSCESS WITH A LUMEN-APPOSING METAL STENT: BETTER THROUGH THE STOMACH THAN THE LIVER

ENDOSCOPIC ULTRASOUND-GUIDED TRANSGASTRIC DRAINAGE OF A HEPATIC ABSCESS WITH A LUMEN-APPOSING METAL STENT: BETTER THROUGH THE STOMACH THAN THE LIVER

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Video Transcription

Video Summary

The video summary describes a case of a 71-year-old male with a hepatic abscess in the caudate lobe of the liver, which was not accessible for percutaneous drainage. The patient underwent an endoscopic ultrasound-guided transgastric drainage using a 15 mm luminoposing metal stent. A 19-gauge needle was used to aspirate frank pus from the abscess, and the abscess was drained through the metal stent. Further balloon dilation of the stent was performed to optimize drainage, and extensive irrigation and suction were done to clean the cavity. A double pigtail stent was placed to anchor the metal stent. The patient's condition improved, and follow-up imaging showed complete resolution of the abscess. EUS-guided drainage with a lumen-opposing metal stent is a safe and effective alternative to percutaneous or surgical drainage for inaccessible liver abscesses.

Keywords

hepatic abscess

caudate lobe

endoscopic ultrasound-guided transgastric drainage

luminoposing metal stent

liver abscess