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Endoscopic management of walled-of pancreatic necrosis
Catarina Gouveia, Catarina Gomes, António Oliveira, Rui Loureiro
Hospital Beatriz Ângelo
We present a case of a 76-year-old woman with history of acute biliary pancreatitis complicated with pancreatic necrosis, who starts vomiting 1 month after. Abdominal CT scan revealed a 16cm walled-off pancreatic necrosis with gastric and duodenal compression. Endoscopic ultrasound showed a collection mainly filled with liquid material, and a cystogastrostomy with placement of two double pigtail plastic stents was made. Patient was discharged uneventfully. Three weeks later she is readmitted with abdominal sepsis. CT scan revealed migration of one plastic stent. A 15mm lumen-apposing metal stent (Hot Axios) was placed and patient underwent four necrosectomy sessions with clinical improvement.
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