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Endoscopic ultrasonography-guided drainage for tuberculous liver abscess drainage.

Abstract
Traditionally, either surgical or percutaneous drainage is recommended for liver abscess. Recently, several endoscopists have reported the endoscopic ultrasound (EUS)-guided liver abscess drainage. Herein, we report a case of tuberculous liver abscess in which endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) was useful for the diagnosis and therapy. A 78-year-old woman suffered from continuous epigastric pain and fever up. Computed tomography (CT) showed a 70 mm multilocular and multiseptate cystic lesion around the head of pancreas and caudate lobe of the liver. After confirming liver abscess by EUS-FNA, EUS-guided liver abscess drainage was carried out. Finally, a 7 Fr straight stent and a 5 Fr nasocystic catheter were inserted into the cyst. Four weeks later, we found that cultured microorganism obtained using drainage catheter was Mycobacterium tuberculosis. Although he was doing well during 5 days after the procedure, CT showed the size of another abscess increased. Then, additional EUS-guided abscess drainage was carried out at the body of the stomach into the abscess of the left lobe. Two weeks later, CT showed disappearance of abscesses. Then, she discharged with the internal stent still in place.
AuthorsTakao Itoi, Tiing Leong Ang, Stefan Seewald, Shujiro Tsuji, Toshio Kurihara, Reina Tanaka, Fumihide Itokawa
JournalDigestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society (Dig Endosc) Vol. 23 Suppl 1 Pg. 158-61 (May 2011) ISSN: 1443-1661 [Electronic] Australia
PMID21535224 (Publication Type: Case Reports, Journal Article)
Copyright© 2011 The Authors. Digestive Endoscopy © 2011 Japan Gastroenterological Endoscopy Society.
Topics
  • Aged
  • Diagnosis, Differential
  • Drainage (methods)
  • Endoscopy, Digestive System (methods)
  • Endosonography (methods)
  • Humans
  • Liver Abscess (diagnostic imaging, surgery)
  • Male
  • Tuberculosis (diagnostic imaging, surgery)

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