Abstract
A 66-year-old male patient underwent laparoscopy-assisted distal gastrectomy for cancer of the pyloric antrum. High fever and an increase in the CRP level developed on the 6th postoperative day. Abdominal abscess due to a pancreatic fistula was diagnosed following a CT scanning. Conservative therapy was started which resulted in a temporary relief of inflammatory reaction, but the symptoms recurred on the 17th hospital day. We determined the patient to be a candidate for drainage. However, we could not gain any safe route for percutaneous puncture and then performed endoscopic ultrasonography (EUS)-guided drainage. Thereafter his high fever and increased CRP level rapidly dropped. After an abdominal CT scan confirmed a significant decrease in the retained fluid, the patient was discharged from our hospital on the 47th hospital day.
In instances in which conservative therapy is unsuccessful and percutaneous fine needle drainage is difficult for pancreatic fistula formed after surgery for gastric cancer, EUS-guided drainage can be the treatment of choice.
