Interventional Endoscopic Ultrasound (EUS) | October 2026-07 Pancreas Collections

Video Transcription

Video Summary

Dr. Tom Teelman presented a 67-year-old man with a large pancreatic fluid collection after pancreatitis and a later intra-abdominal bleed. Although CT suggested simple fluid possibly arising from the liver, the history and EUS indicated a complex collection; drainage and a high amylase level confirmed its pancreatic origin. Initial necrosectomy revealed substantial necrosis that was difficult to reach because the collection extended around the stomach. Rather than immediately placing a second stent, the team allowed time for drainage and planned reassessment. At follow-up, the cavity had largely emptied, though the cause—hydrogen peroxide, time, or the patient’s heavy Diet Coke intake—was uncertain. Discussion emphasized that CT may not reveal collection contents, treatment should reflect symptoms and necrosis burden, and LAMS should not remain longer than necessary because of bleeding risk. Participants also discussed follow-up timing, conventional plastic-stent drainage, disconnected ducts, and individualized anticoagulation decisions.

Meta Tag

Concept Pancreatic Fluid Collection

Concept Necrotic Collection

Concept EUS-Guided Drainage

Concept Necrosectomy

Concept Pseudocyst

Keywords

pancreatic fluid collection

necrosectomy

lumen-apposing metal stent

EUS drainage

pancreatic necrosis

Pancreatic Fluid Collection

Necrotic Collection

EUS-Guided Drainage

Necrosectomy

Pseudocyst