VIDEO PLENARY 3: VID-THER-03: Endoscopic ultrasound drainage of pancreatic pseudocyst – a case of bleeding controlled with lumen-apposing metal stent and balloon tamponade

BACKGROUND: Endoscopic ultrasound (EUS) has been widely used as the modality for drainage of pancreatic pseudocyst or walled-off necrosis. We described a case of EUS-guided drainage complicated with bleeding and successfully stopped by lumen-apposing metal stent (LAMS) and balloon tamponade. CASE REPORT: A 49-year-old man presented with acute pancreatitis in April 2015. Follow-up imaging showed a persistent 12 cm pancreatic pseudocyst. EUS-guided drainage of the pseudocyst was performed but complicated with bleeding. LAMS and balloon tamponade were used for drainage and hemostasis. The pseudocyst was successfully drained by EUS-guided LAMS drainage. Reassessment computed tomography scan showed pseudocyst significantly reduced in size. CONCLUSION: EUS-guided drainage with LAMS is an effective means of pancreatic pseudocyst drainage. LAMS and balloon tamponade can be used for hemostasis in case of bleeding after EUS-guided drainage.