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Massive Hemorrhage after Endoscopic Ultrasound Guided Fine Needle Aspiration of a Cephalopancreatic Cystic Lesion
Massive Hemorrhage after Endoscopic Ultrasound Guided Fine Needle Aspiration of a Cephalopancreatic Cystic Lesion
Pedro Costa-Moreira, Pedro Moutinho-Ribeiro, Guilherme Macedo
Centro Hospitalar Universitário de São João
A 68 years old female patient was referred for ultrasonographic study of a cephalopancreatic cystic lesion. Endoscopic ultrasound(EUS) and 22G fine needle aspiration(FNA) of the lesion was performedAfter needle removal, a high-volume hemorrhage was detected. Using the echoendoscope, we performed adrenaline injection and applied two clips, with a partial control. We opted for switching to a gastroscope, complementing the hemostasis with more clips and polidocanol. This case describes a severe adverse event of EUS-FNA. The promptitude of combined hemostasis maneuvers with the device in use, complemented by conventional gastroduodenoscope proved to be crucial in the resolution of the complication.