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Endoscopic ultrasonography-guided transmural drainage of an infected hepatic cyst due to Edwardsiella tarda: a case report

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Abstract

Infected hepatic cysts are very rare compared to simple liver cysts and abscesses. We treated a 77-year-old man with an infected hepatic cyst in the lateral segment caused by Edwardsiella tarda, which has not been previously reported as a pathogenic organism associated with infected hepatic cysts. Percutaneous drainage was temporarily effective, but infection recurred after the drainage tube was removed. We then inserted two drainage tubes into the cyst using an endoscopic ultrasonography (EUS)-guided technique, which was developed from EUS-guided fine needle aspiration (EUS-FNA). The internal drainage tube was a 7 Fr double pigtail stent, and the external tube was a 6 Fr nasobiliary drainage tube. Lavage through the external drainage tube was carried out for one week. The external drainage tube was discontinued when the patient’s condition improved significantly. Sixteen days after tube insertion, he was discharged with the internal tube draining the hepatic cyst into the stomach. Fifteen months after EUS-guided drainage, CT examination showed no recurrence of the hepatic cyst. EUS-guided drainage is an effective treatment for infected hepatic cysts.

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Disclosures

Conflict of Interest:

Hiroki Taguchi, Tsutomu Tamai, Masatsugu Numata, Hitomi Maeda, Akihiko Ohshige, Hiromichi Iwaya, Shinichi Hashimoto, Shuji Kanmura, Hiroshi Fujita, Keita Funakawa, Akio Ido, and Hirohito Tsubouchi declare that they have no conflict of interest.

Human/Animal Rights:

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5).

Informed Consent:

Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Department of Digestive and Life-style Related Diseases, Human and Environmental Sciences, Health Research, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan

    Hiroki Taguchi, Tsutomu Tamai, Masatsugu Numata, Hitomi Maeda, Akihiko Ohshige, Hiromichi Iwaya, Shinichi Hashimoto, Shuji Kanmura & Akio Ido

  2. Kagoshima City Hospital, 20-17 Kajiyatyo, Kagoshima, Kagoshima, Japan

    Keita Funakawa & Hirohito Tsubouchi

  3. National Hospital Organization Kagoshima Medical Center, 8-1 Shiroyamatyo, Kagoshima, Kagoshima, Japan

    Hiroshi Fujita

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  1. Hiroki Taguchi
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  2. Tsutomu Tamai
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  3. Masatsugu Numata
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  4. Hitomi Maeda
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  12. Hirohito Tsubouchi
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Correspondence to Tsutomu Tamai.

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Taguchi, H., Tamai, T., Numata, M. et al. Endoscopic ultrasonography-guided transmural drainage of an infected hepatic cyst due to Edwardsiella tarda: a case report. Clin J Gastroenterol 7, 422–428 (2014). https://doi.org/10.1007/s12328-014-0520-4

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  • DOI: https://doi.org/10.1007/s12328-014-0520-4

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