Endoscopic ultrasound-guided drainage of postoperative intra-abdominal abscesses

Figure 1 Case 1. A: Computed tomography (CT) reveals an encapsulated fluid collection in the left subdiaphragmatic area close to the fornix of the stomach; B and C: Fluoroscopy image showing the guidewire inserted into the fluid collection under endoscopic ultrasound (EUS)-guidance and placement of a 6-Fr nasal biliary catheter; D: Six days after EUS-guided drainage, CT reveals that the drain was placed and that the fluid collection decreased.

Figure 2 Case 2. A: Computed tomography (CT) reveals irregular fluid collection around the resection stump of the pancreas at the dorsal side of the stomach; B: Endoscopic ultrasound (EUS) reveals an irregular and cloudy fluid collection close to the gastric wall; C and D: Fluoroscopy image showing the dilation catheter inserted over the guidewire and placement of a 6-Fr nasal biliary catheter; E: Eleven days after EUS-guided drainage, CT reveals that the fluid collection decreased.

Figure 3 Case 3. A: Computed tomography (CT) reveals fluid collection around the resection stump of the pancreas; B: Fluoroscopy image showing the dilation catheter inserted over the guidewire; C: Seven days after endoscopic ultrasound (EUS)-guided internal drainage, CT reveals another fluid collection on the left side of the previously drained abscess; D and E: Fluoroscopy image showing the placement of the 7-Fr double pigtail stent and insertion of the dilation catheter into the new abscess. Moreover, a 6-Fr nasal biliary catheter was placed; F: Seven days after EUS-guided naso-cystic drainage, CT reveals that the fluid collection decreased.

Figure 4 Case 4. A: Computed tomography (CT) reveals fluid collection at the dorsal side of the fornix close to the gastric wall; B: Endoscopic ultrasound (EUS) showing the fluid collection, which was punctured by a 19-gauge needle; C and D: Fluoroscopy image showing placement of the percutaneous drain and insertion of the 6-mm balloon catheter over the guidewire. Both a 7-Fr double pigtail stent and a 6-Fr nasal biliary catheter are placed; E: Ten days after EUS-guided drainage, CT reveals that the fluid collection decreased.