Abstract

Acute pancreatitis is a common gastrointestinal complaint that can lead to both acute and chronic symptoms. One such complication is the development of peripancreatic fluid collections that can become symptomatic and thus require drainage. The mainstay of drainage previously was handled mostly by surgical intervention but over the past several years the paradigm for drainage of peripancreatic fluid collections has shifted to favor more minimally invasive techniques, such as Endoscopic Ultrasound (EUS) guided drainage. While EUS-guided drainage of these peripancreatic fluid collections in a trans gastric or trans duodenal manner has been well documented, not all collections are amenable to these lumens. Transesophageal drainage has been described for drainage of superior abdominal and mediastinal fluid collections. More recently the development of a lumen apposing, fully covered, self-expanding metal stent (laSEMS) has been used for drainage of peripancreatic fluid collections with a report of successful use via a transesophageal approach. In our case we present the first successful use of a 15mmx10mm electrocautery enhanced laSEMS to drain a sub-diaphragmatic peripancreatic fluid collection via a transesophageal approach.

Keywords: Pancreatic pseudocyst; Transesophageal; Lumen-apposing fully covered self-expanding metal stent; EUS-guided drainage