Splenic Abscess due to a Perforated Duodenal Ulcer Successfully Treated with Endoscopic Ultrasound-Guided Transgastric Drainage
Splenic abscesses are rare, with a reported prevalence of 0.14–0.7% in autopsy studies. The treatment options for splenic abscesses include intravenous antimicrobial therapy, percutaneous drainage, and splenectomy. Although the dissemination of endoscopic ultrasound (EUS) intervention techniques has...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2022-08-01
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| Series: | Case Reports in Gastroenterology |
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| Online Access: | https://www.karger.com/Article/FullText/525571 |
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| author | Taiji Yoshimoto Fumiya Nishimoto Ryuichi Yamamoto Takashi Takenoya Hiroshi Takihara |
| author_facet | Taiji Yoshimoto Fumiya Nishimoto Ryuichi Yamamoto Takashi Takenoya Hiroshi Takihara |
| author_sort | Taiji Yoshimoto |
| collection | DOAJ |
| description | Splenic abscesses are rare, with a reported prevalence of 0.14–0.7% in autopsy studies. The treatment options for splenic abscesses include intravenous antimicrobial therapy, percutaneous drainage, and splenectomy. Although the dissemination of endoscopic ultrasound (EUS) intervention techniques has made it possible to perform puncture and drainage via the transgastrointestinal route for intra-abdominal abscesses where the percutaneous route has been difficult, there have been few reports of EUS-guided drainage of splenic abscesses. A case of a splenic abscess associated with a perforated duodenal ulcer that was successfully treated with EUS-guided transgastric drainage is described. An 89-year-old Asian woman with a perforated duodenal ulcer underwent surgery at another hospital. After surgery, the patient developed a splenic abscess, for which percutaneous treatment was anatomically difficult. Therefore, she was referred to our hospital for treatment of the splenic abscess using EUS-guided drainage. EUS-guided transgastric drainage was performed under sedation using a convex EUS scope. The splenic abscess, measuring approximately 4 × 3 cm2, was punctured using a 19-gauge aspiration needle. A 6-Fr pigtail nasocystic drainage tube was placed in the abscess cavity. The procedure was completed without any complications. After EUS-guided drainage, the abscess cavity decreased in size over time, and the patient had a good clinical course and was subsequently discharged. EUS-guided drainage of splenic abscesses may be a safe and effective therapeutic alternative to percutaneous drainage and surgery; however, large-scale investigations are required to confirm the present findings. |
| first_indexed | 2024-04-12T19:14:50Z |
| format | Article |
| id | doaj.art-8918965a587a48e09b5ef40976ab2d29 |
| institution | Directory Open Access Journal |
| issn | 1662-0631 |
| language | English |
| last_indexed | 2024-04-12T19:14:50Z |
| publishDate | 2022-08-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Gastroenterology |
| spelling | doaj.art-8918965a587a48e09b5ef40976ab2d292022-12-22T03:19:47ZengKarger PublishersCase Reports in Gastroenterology1662-06312022-08-0116245646110.1159/000525571525571Splenic Abscess due to a Perforated Duodenal Ulcer Successfully Treated with Endoscopic Ultrasound-Guided Transgastric DrainageTaiji Yoshimoto0https://orcid.org/0000-0001-5767-9921Fumiya Nishimoto1Ryuichi Yamamoto2Takashi Takenoya3Hiroshi Takihara4Department of Gastroenterology, Musashino Tokushukai Hospital, Tokyo, JapanDepartment of Gastroenterology, Musashino Tokushukai Hospital, Tokyo, JapanDepartment of Gastroenterology, Tokyo-West Tokushukai Hospital, Tokyo, JapanDepartment of Surgery, Ogikubo Hospital, Tokyo, JapanDepartment of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, JapanSplenic abscesses are rare, with a reported prevalence of 0.14–0.7% in autopsy studies. The treatment options for splenic abscesses include intravenous antimicrobial therapy, percutaneous drainage, and splenectomy. Although the dissemination of endoscopic ultrasound (EUS) intervention techniques has made it possible to perform puncture and drainage via the transgastrointestinal route for intra-abdominal abscesses where the percutaneous route has been difficult, there have been few reports of EUS-guided drainage of splenic abscesses. A case of a splenic abscess associated with a perforated duodenal ulcer that was successfully treated with EUS-guided transgastric drainage is described. An 89-year-old Asian woman with a perforated duodenal ulcer underwent surgery at another hospital. After surgery, the patient developed a splenic abscess, for which percutaneous treatment was anatomically difficult. Therefore, she was referred to our hospital for treatment of the splenic abscess using EUS-guided drainage. EUS-guided transgastric drainage was performed under sedation using a convex EUS scope. The splenic abscess, measuring approximately 4 × 3 cm2, was punctured using a 19-gauge aspiration needle. A 6-Fr pigtail nasocystic drainage tube was placed in the abscess cavity. The procedure was completed without any complications. After EUS-guided drainage, the abscess cavity decreased in size over time, and the patient had a good clinical course and was subsequently discharged. EUS-guided drainage of splenic abscesses may be a safe and effective therapeutic alternative to percutaneous drainage and surgery; however, large-scale investigations are required to confirm the present findings.https://www.karger.com/Article/FullText/525571splenic abscessendoscopic ultrasound-guided transmural drainageperforated duodenal ulcer |
| spellingShingle | Taiji Yoshimoto Fumiya Nishimoto Ryuichi Yamamoto Takashi Takenoya Hiroshi Takihara Splenic Abscess due to a Perforated Duodenal Ulcer Successfully Treated with Endoscopic Ultrasound-Guided Transgastric Drainage Case Reports in Gastroenterology splenic abscess endoscopic ultrasound-guided transmural drainage perforated duodenal ulcer |
| title | Splenic Abscess due to a Perforated Duodenal Ulcer Successfully Treated with Endoscopic Ultrasound-Guided Transgastric Drainage |
| title_full | Splenic Abscess due to a Perforated Duodenal Ulcer Successfully Treated with Endoscopic Ultrasound-Guided Transgastric Drainage |
| title_fullStr | Splenic Abscess due to a Perforated Duodenal Ulcer Successfully Treated with Endoscopic Ultrasound-Guided Transgastric Drainage |
| title_full_unstemmed | Splenic Abscess due to a Perforated Duodenal Ulcer Successfully Treated with Endoscopic Ultrasound-Guided Transgastric Drainage |
| title_short | Splenic Abscess due to a Perforated Duodenal Ulcer Successfully Treated with Endoscopic Ultrasound-Guided Transgastric Drainage |
| title_sort | splenic abscess due to a perforated duodenal ulcer successfully treated with endoscopic ultrasound guided transgastric drainage |
| topic | splenic abscess endoscopic ultrasound-guided transmural drainage perforated duodenal ulcer |
| url | https://www.karger.com/Article/FullText/525571 |
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