• Journal of Veterinary Clinics
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• v.35 no.4
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• pp.146-149
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• 2018

A 7-year-old, castrated, male Maltese dog presented with hyporexia and depression for 3 days. Elevated serum amylase, lipase activities, and liver enzyme values were found upon blood examination. An abdominal mass was seen on radiographs caudal to the gastric body in the left middle abdomen. In the left middle abdomen, abdominal ultrasonography also revealed a massive, irregularly marginated, heterogeneous mass of unknown origin, and in the right cranial abdomen, heterogeneously hypoechoic pancreatic tissue and hyperechoic change of adjacent mesenteric fat were observed. Contrast-enhanced computed tomography showed an irregular contour of the left pancreatic limb as well as heterogeneously enhanced parenchyma. A low-attenuating peripancreatic fluid collection with a thin and irregular wall was also seen. Based on these findings, an atypical pancreatic abscess with necrotizing pancreatitis which manifested as walled-off necrosis was suspected. The mass was excised, and the pancreatic abscess was confirmed by histopathologic examination. No complications were found in the patient after two months of follow-up examination.

• Clinical Endoscopy
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• v.57 no.5
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• pp.588-594
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• 2024

Endoscopic ultrasound (EUS)-guided interventions have evolved rapidly in recent years, with dedicated metal stents playing a crucial role in this process. Specifically, the invention of biflanged short metal-covered stents, including lumen-apposing metal stents (LAMS), and modifications in a variety of tubular self-expandable metal stents (SEMS), have led to innovations in EUS-guided interventions. LAMS or non-LAMS stents are commonly used in the EUS-guided drainage of pancreatic fluid collections, especially in cases of walled-off necrosis. Additionally, LAMS is commonly considered for drainage of the EUS-guided gallbladder or dilated common bile duct and EUS-guided gastroenterostomy. Fully or partially covered tubular SEMS with several new designs are being considered for EUS-guided biliary drainage. This review focuses on advances in SEMS for EUS-guided interventions and discusses related research results.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.3
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• pp.251-262
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• 2022

Purpose: Endoscopic drainage is an established treatment modality for adult patients with pancreatic fluid collections (PFCs). Available data regarding the efficacy and safety of endoscopic drainage in pediatric patients are limited. In this systematic review and meta-analysis, we aimed to analyze the outcomes of endoscopic drainage in children with PFCs. Methods: A literature search was performed in Embase, PubMed, and Google Scholar for studies on the outcomes of endoscopic drainage with or without endoscopic ultrasonography (EUS) guidance in pediatric patients with PFCs from inception to May 2021. The study's primary objective was clinical success, defined as resolution of PFCs. The secondary outcomes included technical success, adverse events, and recurrence rates. Results: Fourteen studies (187 children, 70.3% male) were included in this review. The subtypes of fluid collection included pseudocysts (60.3%) and walled-off necrosis (39.7%). The pooled technical success rates in studies where drainage of PFCs were performed with and without EUS guidance were 95.3% (95% confidence interval [CI], 89.6-98%; I²=0) and 93.9% (95% CI, 82.6-98%; I²=0), respectively. The pooled clinical success after one and two endoscopic interventions were 88.7% (95% CI, 82.7-92.9%; I²=0) and 92.3% (95% CI, 87.4-95.4%; I²=0), respectively. The pooled rate of major adverse events was 6.3% (95% CI, 3.3-11.4%; I²=0). The pooled rate of recurrent PFCs after endoscopic drainage was 10.4% (95% CI, 6.1-17.1%; I²=0). Conclusion: Endoscopic drainage is safe and effective in children with PFCs. However, future studies are required to compare endoscopic and EUS-guided drainage of PFCs in children.