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

[Case Report]

TWO CASES OF PANCREATIC ABSCESS ASSOCIATED WITH
PENETRATION TO THE GASTROINTESTINAL TRACT
DURING TREATMENT USING ENDOSCOPIC
ULTRASOUND-GUIDED DRAINAGE

HIDEMICHI IMAMURA¹⁾, ATSUSHI IRISAWA¹⁾, TADAYUKI TAKAGI¹⁾,
GORO SHIBUKAWA¹⁾, TAKERU WAKATSUKI¹⁾, YUTA TAKAHASHI¹⁾,
AI SATO¹⁾, MASAKI SATO¹⁾, TAKUTO HIKICHI²⁾,
KATSUTOSHI OBARA²⁾ and HIROMASA OHIRA¹⁾

¹⁾Department of Internal Medicine 2, Fukushima Medical University School of Medicine
²⁾Department of Endoscopy, Fukushima Medical University Hospital

(Received July 13, 2006, accepted December 20, 2006)

Abstract: Of pancreatic pseudocysts, approximately 30% are complicated by abscess formation, perforation into the abdominal cavity, penetration to the gastrointestinal tract, or bleeding. We report two cases of pancreatic abscess complicating severe acute pancreatitis in which the abscess penetrated to the gastrointestinal tract during the course of treatment with endoscopic ultrasound (EUS)-guided pseudocyst drainage. In these cases, neither aggravation nor recurrence of the pancreatic abscess has been identified since the event occurred. The EUS-guided treatment was effective for improvement of severe inflammation of the pseudocyst as an initial treatment. However, drainage tube placement limitations pertained because the pseudocyst was present with multilocular infection. Penetrations eventually contributed to their resolution because the fistulas were used as wide drainage routes. It is important to understand the courses of these cases for preparation of therapeutic strategies to treat pancreatic pseudocyst/abscess.

Key words: pancreatic pseudocyst, penetration, EUS-guided

今村秀道，入澤篤志，高木忠之，渋川悟朗，若槻　尊，��橋裕太，佐藤　愛，佐藤匡記，引地拓人，小原勝敏，大平弘正

Correspondence to: Atsushi Irisawa, MD, PhD Department of Internal Medicine 2 Fukushima Medical University School of Medicine Hikarigaoka 1, Fukushima City, 960-1295, Japan.
E-mail: irisawa@fmu.ac.jp