Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2018; 6(11): 459-465
Published online Oct 6, 2018. doi: 10.12998/wjcc.v6.i11.459
Balloon dilator controls massive bleeding during endoscopic ultrasound-guided drainage for pancreatic pseudocyst: A case report and review of literature
Bao-Hua Wang, Li-Ting Xie, Qi-Yu Zhao, Hua-Jie Ying, Tian-An Jiang
Bao-Hua Wang, Li-Ting Xie, Qi-Yu Zhao, Tian-An Jiang, Department of Ultrasound, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Hua-Jie Ying, Department of Nurse, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Author contributions: Wang BH and Jiang TA designed the report; Xie LT, Zhao QY, and Ying HJ collected the patient’s clinical information; Wang BH and Xie LT analyzed the information and wrote the paper; all authors approved the final draft submitted.
Informed consent statement: Consent was obtained from the relatives of the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article, which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Tian-An Jiang, MD, PhD, Professor, Surgeon, Department of Ultrasound, The First Affiliated Hospital, College of Medicine, Zhejiang University, Qingchun Road No. 79, Hangzhou 310003, Zhejiang Province, China. tiananjiang@zju.edu.cn
Telephone: +86-571-87236114
Received: May 13, 2018
Peer-review started: May 13, 2018
First decision: June 5, 2018
Revised: June 16, 2018
Accepted: June 27, 2018
Article in press: June 27, 2018
Published online: October 6, 2018
Abstract

Pancreatic pseudocyst (PPC), a common sequela of acute or chronic pancreatitis, was defined by the revised Atlanta classification as “a collection.” Endoscopic ultrasound (EUS)-guided drainage is often considered a standard first-line therapy for patients with symptomatic PPC. This effective approach exhibits 90%-100% technical success and 85%-98% clinical success. Bleeding is a deadly adverse event associated with EUS-guided drainage procedures, and the bleeding rate ranges from 3% to 14%. Hemostasis involves conservative treatment, endoscopy, interventional radiology-guided embolization and surgery. However, few studies have reported on EUS-guided drainage with massive, multiple hemorrhages related to severe pancreatogenic portal hypertension (PPH). Thus, the aim of this case report was to present a case using a balloon dilator to achieve successful hemostasis for PPH-related massive bleeding in EUS-guided drainage of PPC. To our knowledge, this method has not been previously reported.

Keywords: Endoscopic ultrasound guided, Bleeding, Pancreatic pseudocyst, Balloon compression, Novel hemostasis

Core tip: There has been considerable research in recent years dedicated to the development of endoscopic ultrasound-guided drainage, which is viewed as the first-line therapy for the management of pancreatic pseudocyst due to the minimized invasiveness, lower mortality, better physical and mental condition of patient compared with surgical and percutaneous approaches. Although the procedure is safe and effective, bleeding is one of the deadly adverse events. This is the first report using a balloon dilator to control pancreatogenic portal hypertension-related bleeding in endoscopic ultrasound-guided drainage for pseudocyst.