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.