A case of underwater endoscopic ultrasound guided abscess drainage

Abstract

A 70-year-old male patient with inoperable cholangiocarcinoma was diagnosed with abdominal abscess. The oral antibiotics therapy did not have much effect on the abscess. Ultrasound findings also showed that percutaneous transhepatic abscess drainage was difficult. We then evaluated the feasibility of performing the endoscopic ultrasound (EUS) guided abscess drainage from the cardia of the stomach. Thus, we decided to perform EUS guided abscess drainage. When we inserted a 19-gauge needle into the EUS scope, the maximum bending angle of the EUS scope got too shallow to puncture the abscess. By filling the stomach with water, we were able to perform underwater EUS abscess drainage.