ASGE Endoscopy Live: Pancreatobiliary Cases and Updates (virtual)

Video Transcription

Video Summary

In this video, Dr. Evan Fogel and Dr. Mark Gromski present a case study of a 58-year-old man with a history of alcoholic pancreatitis. The patient had complained of left upper quadrant pain and weight loss, and CT scans revealed a fluid-filled collection in the left upper quadrant and a cystic structure in the head of the pancreas. The patient was referred to the emergency room and diagnosed with acute pancreatitis. A CT scan confirmed the presence of a cystic structure in the head of the pancreas. An endoscopic ultrasound (EOS) was performed, followed by the placement of a luminal opposing metal stent and a double pigtail plastic stent. The patient's symptoms improved, and a follow-up CT scan showed a decrease in size of the left upper quadrant collection. The doctors performed an ERCP and pancreatoscopy to assess the suspected head of pancreas stricture and the fistula from the tail of the pancreas to the fluid collection. Biopsies were taken, and a single double pigtail stent was placed. The doctors discussed the possibility of neoplastic changes in the cystic lesion and the need for surgery. They also discussed the risk of leaving the luminal opposing metal stent in too long and the importance of removing it before the patient undergoes surgery. The video concludes with the doctors performing a trans-papillary double pigtail stent placement to facilitate drainage of the head area.

Asset Subtitle

Evan Fogel, MD

Keywords

alcoholic pancreatitis

case study

CT scans

acute pancreatitis

endoscopic ultrasound

luminal opposing metal stent

double pigtail plastic stent