Fukushima J. Med. Sci.,
Vol. 53, No. 1, 2007

[Case Report]

A CASE OF TRANSGASTRIC GALLBLADDER PUNCTURE AS A
COMPLICATION DURING ENDOSCOPIC
ULTRASOUND-GUIDED DRAINAGE OF A PANCREATIC
PSEUDOCYST

TAKUTO HIKICHI¹⁾, ATSUSHI IRISAWA²⁾, TADAYUKI TAKAGI²⁾,
GORO SHIBUKAWA²⁾, TAKERU WAKATSUKI²⁾, HIDEMICHI IMAMURA²⁾,
YUTA TAKAHASHI²⁾, AI SATO²⁾, MASAKI SATO²⁾, HITOSHI OYAMA²⁾,
NAOTO SATO²⁾, GO YAMAMOTO²⁾, TATSUYUKI MOKONUMA²⁾,
KATSUTOSHI OBARA¹⁾ and HIROMASA OHIRA²⁾

¹⁾Department of Endoscopy, Fukushima Medical University Hospital, 960-1295, Japan
²⁾Department of Internal Medicine II, Fukushima Medical University School of Medicine,
960-1295, Japan

(Received July 18, 2006, accepted November 13, 2006)

Abstract: A 43-year-old man, a regular drinker, developed a pseudocyst in the pancreatic tail as a result of acutely worsening chronic pancreatitis. Because the pseudocyst, 10 cm in diameter, did not disappear despite conservative treatment, an internal drainage stent was placed transgastrically under endoscopic ultrasound (EUS) guidance. However, cyst infection occurred, and EUS-guided drainage was performed, when the gallbladder was punctured inadvertently. Immediately a nasocystic drain was placed in the gallbladder. Owing to this timely measure, only mild and localized peritonitis developed. Conservative treatment with fasting and an antibiotic was administered, and peritonitis subsided quickly. On the same day, another nasocystic drain was placed for the pancreatic pseudocyst, and it disappeared. As far as we know, this is the first case in which gallbladder puncture was inadvertently performed during EUS-guided drainage of a pancreatic pseudocyst.

Key words: gallbladder puncture, pancreatic pseudocyst, EUS-FNA, EUS-guided drainage, complication

引地拓人，入澤篤志，高木忠之，澁川悟朗，若槻　尊，今村秀道，��橋裕太，佐藤　愛，佐藤匡記，大山　仁，佐藤直人，山本　豪，茂古沼達之，小原勝敏，大平弘正

Correspondence to: Takuto Hikichi, Department of Endoscopy, Fukushima Medical University Hospital, Fukushima City 960-1295, Japan.
E-mail: takuto@fmu.ac.jp