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
Processing time: 138 Days and 18.8 Hours
ARTICLE HIGHLIGHTS
Case characteristics

A 55-year-old woman was referred to our hospital with abdominal pain and distension resulting from a history of pancreatic pseudocyst.

Clinical diagnosis

Pancreatic pseudocyst.

Differential diagnosis

Walled-off necrosis and pancreatic cystic tumors.

Laboratory diagnosis

No specific laboratory testing contributed to the diagnosis of the pancreatic pseudocyst.

Imaging diagnosis

Abdominal contrast-enhanced computed tomography, magnetic resonance cholangiopancreatography and endoscopic ultrasound examinations showed a pseudocyst in the tail of pancreas.

Pathological diagnosis

Pancreatic pseudocyst.

Treatment

We performed endoscopic ultrasound-guided drainage with massive bleeding and used a balloon dilator to compress the bleeding sites.

Related reports

To our knowledge, using balloon compression to achieve effective hemostasis in EUS-guided drainage for pancreatogenic portal hypertension-related bleeding has not been previously reported.

Term explanation

Endoscopic ultrasound-guided drainage with stenting is recognized as the standard first-line approach for a symptomatic pancreatic pseudocyst.

Experiences and lessons

Balloon compression is a novel and effective form of hemostasis for endoscopic ultrasound-guided drainage with bleeding. Although this method was successful in this case, additional cases are needed to confirm our findings.