Successful Treatment of Bilocular Walled-off Necrosis with Transmural Naso-cyst Continuous Irrigation

Mari Matsuyama; Hisanori Matsuzawa; Kazuya Kimura; Yuki Izumiya; Kae Sugawara; Satoko Tsuda; Tsuyotoshi Tuji; Kunio Nakane; Masafumi Komatsu; Katsunori Iijima

doi:10.2169/internalmedicine.3770-24

CASE REPORTS

Successful Treatment of Bilocular Walled-off Necrosis with Transmural Naso-cyst Continuous Irrigation

Mari Matsuyama, Hisanori Matsuzawa, Kazuya Kimura, Yuki Izumiya, Kae Sugawara, Satoko Tsuda, Tsuyotoshi Tuji, Kunio Nakane, Masafumi Komatsu, Katsunori Iijima

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Keywords: walled-off necrosis (WON), transmural naso-cyst continuous irrigation (TNCCI), lumen apposing metal stent (LAMS)

JOURNAL OPEN ACCESS

2025 Volume 64 Issue 2 Pages 195-200

DOI https://doi.org/10.2169/internalmedicine.3770-24

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Abstract

Recently, transmural naso-cyst continuous irrigation (TNCCI) has been reported as an effective and safe treatment for walled-off necrosis (WON). We herein report a case of bilocular WON that was successfully treated with TNCCI. The patient was a 60-year-old man. The patient underwent endoscopic ultrasound-guided cyst drainage of the main cavity and subcavity using a single transluminal gateway transcystic multiple drainage technique, which was ineffective. Subsequently, a lumen-apposing metal stent (LAMS) was placed in the main cavity and TNCCI was successfully performed in the subcavity. TNCCI with LAMS was effective in treating bilocular WON.

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