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Interventional Endoscopic Ultrasound pp 177–188Cite as

Endoscopic Ultrasound-Guided Drainage of Pelvic, Intra-abdominal, and Mediastinal Abscesses

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Abstract

Abscesses can either drain naturally or through a variety of medical, radiologic, or surgical interventions. Due to the high risk of septicemia and shock due to the proximity of deeper abscesses to vital organs, intervention for these deeper abscesses is usually necessary. EUS-guided drainage of abscesses has been studied in relation to stenting, dilation, drainage, clipping, and cutting. This chapter will review the efficacy and safety of EUS-guided drainage of pelvic, mediastinal, and intra-abdominal abscesses. This chapter will also analyze what specific conditions and procedural modifications can lead to better results.

The results from these studies demonstrate that EUS-guided abscess drainage is an effective and safe method to drain abscesses. Out of the 148 total cases in these studies, 95.27% of cases had complete abscess drainage, and 90.54% of cases had no adverse events. While limited, the data suggests that double pigtail stents may produce better outcomes than metal stents. In addition, cases that were both dilated through various methods and drained by a catheter had more adverse events than cases using a different combination of modalities to facilitate drainage for mediastinal and intra-abdominal abscess drainage. As a result, these cases displayed outcomes contrary to what was expected.

Overall, EUS-guided abscess drainage offers a safe and effective alternative option for drainage of abscesses in patients who are poor surgical candidates or in patients who prefer not to undergo surgery or percutaneous catheter drainage

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Author information

Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, NY, USA

    Enad Dawod

  2. Department of Gastroenterology and Hepatology, Borland Groover Clinic, Advanced Therapeutic Endoscopy Center, Jacksonville, FL, USA

    Jose M. Nieto

Authors
  1. Enad Dawod
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  2. Jose M. Nieto
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Editor information

Editors and Affiliations

  1. Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Utah School of Medicine, Salt Lake City, UT, USA

    Douglas G. Adler, MD, FACG, AGAF, FASGE

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EUS-guided drainage of hepatic abscesses in a 70-year-old lady using a lumen apposing metal stent (MP4 94747 kb)

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Dawod, E., Nieto, J.M. (2019). Endoscopic Ultrasound-Guided Drainage of Pelvic, Intra-abdominal, and Mediastinal Abscesses. In: Adler, MD, FACG, AGAF, FASGE, D. (eds) Interventional Endoscopic Ultrasound. Springer, Cham. https://doi.org/10.1007/978-3-319-97376-0_17

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  • DOI: https://doi.org/10.1007/978-3-319-97376-0_17

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-97376-0

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