Published online Dec 6, 2019. doi: 10.12998/wjcc.v7.i23.4157
Peer-review started: September 5, 2019
First decision: October 24, 2019
Revised: November 1, 2019
Accepted: November 14, 2019
Article in press: November 14, 2019
Published online: December 6, 2019
Endoscopic ultrasound (EUS)-guided drainage is the optimal method for treatment of pancreatic fluid collections (PFCs), and is associated with ease, safety, and efficiency. Bleeding is one of the main procedure-related complications, and often requires surgery or radiologic interventions. Indeed, endoscopic management of this complication is limited.
A 42-year-old man presented for evaluation of abdominal pain and distention for approximately 2 wk. Abdominal computed tomography revealed a pancreatic pseudocyst located in the tail of the pancreas. EUS-guided pancreatic pseudocyst was performed. After stent placement, massive bleeding was noted from the fistula. Finally, hemostasis was successfully achieved using hemostatic forceps within the fistula.
Bleeding vessel grasp and coagulation may represent a successful treatment for a fistula hemorrhage during EUS-guided drainage for a PFC, which may be tried before application of balloon or stent compression.
Core tip: We report the successful management of massive fistula bleeding during endoscopic ultrasound-guided pancreatic pseudocyst drainage using hemostatic forceps within the fistula, which proved the efficiency of this method.