Successful endoscopic transmural drainage of septate walled off necrosis by fracturing the septum under EUS guidance

32  year old male presented with abdominal pain of one week duration. He was diagnosed with alcohol related necrotizing pancreatitis 10 weeks ago. Computed tomography (CT) of abdomen revealed a large, walled off necrosis (WON) compressing the stomach. The WON was divided into two parts by a thin sept um (Fig. 1A; arrows), as demonstrated on endoscopic ultrasound (EUS) also (Fig. 1B; arrows). Under EUS guidance the WON was punctured using a 19 G needle and thereafter the needle was pushed further inwards, piercing the dividing septum of WON also.
Source: Digestive and Liver Disease - Category: Gastroenterology Authors: Tags: Image of the Month Source Type: research