Guidewire‐assisted successful closure of mis‐punctured transverse colon during endoscopic ultrasound‐guided cyst drainage

Abstract Endoscopic ultrasound‐guided cyst drainage (EUS‐CD) was performed for walled‐off pancreatic necrosis. Computed tomography performed the next day showed that the tip of the external drainage tube was located in the transverse colon, confirming an accidental EUS‐CD‐associated complication of...

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Main Authors: Naoki Fujita, Hideki Kamada, Ryota Nakabayashi, Takuma Yamashita, Shima Mimura, Hiroki Yamana, Kiyoyuki Kobayashi, Minoru Oshima, Keiichi Okano, Hideki Kobara
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:DEN Open
Subjects:
Online Access:https://doi.org/10.1002/deo2.70112
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author Naoki Fujita
Hideki Kamada
Ryota Nakabayashi
Takuma Yamashita
Shima Mimura
Hiroki Yamana
Kiyoyuki Kobayashi
Minoru Oshima
Keiichi Okano
Hideki Kobara
author_facet Naoki Fujita
Hideki Kamada
Ryota Nakabayashi
Takuma Yamashita
Shima Mimura
Hiroki Yamana
Kiyoyuki Kobayashi
Minoru Oshima
Keiichi Okano
Hideki Kobara
author_sort Naoki Fujita
collection DOAJ
description Abstract Endoscopic ultrasound‐guided cyst drainage (EUS‐CD) was performed for walled‐off pancreatic necrosis. Computed tomography performed the next day showed that the tip of the external drainage tube was located in the transverse colon, confirming an accidental EUS‐CD‐associated complication of mis‐puncture. A colonoscopy was performed to confirm the puncture site, which was identified as a defect measuring 2 mm in diameter. The external drainage tube was removed immediately via a guidewire. We intentionally retained the guidewire as a landmark for the puncture site in the colon. The defect was approximated using an endoclip under full vision, with the guidewire covered with surrounding mucosa. After removing the guidewire smoothly, complete closure was achieved with additional endoclips. Four days later, EUS‐CD was successfully repeated, resulting in the resolution of the walled‐off pancreatic necrosis. This is the first known case in which an accidental puncture of the transverse colon occurred during EUS‐CD for walled‐off pancreatic necrosis, and guidewire‐guided clip closure of the colon contributed to troubleshooting.
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publishDate 2025-04-01
publisher Wiley
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spelling doaj-art-149ec49e9cd34b25add3396899d54a552025-08-20T03:13:50ZengWileyDEN Open2692-46092025-04-0151n/an/a10.1002/deo2.70112Guidewire‐assisted successful closure of mis‐punctured transverse colon during endoscopic ultrasound‐guided cyst drainageNaoki Fujita0Hideki Kamada1Ryota Nakabayashi2Takuma Yamashita3Shima Mimura4Hiroki Yamana5Kiyoyuki Kobayashi6Minoru Oshima7Keiichi Okano8Hideki Kobara9Department of Gastroenterology and Neurology Faculty of Medicine Kagawa University Kagawa JapanDepartment of Gastroenterology and Neurology Faculty of Medicine Kagawa University Kagawa JapanDepartment of Gastroenterology and Neurology Faculty of Medicine Kagawa University Kagawa JapanSanuki Municipal Hospital Kagawa JapanDepartment of Gastroenterology and Neurology Faculty of Medicine Kagawa University Kagawa JapanDepartment of Gastroenterology and Neurology Faculty of Medicine Kagawa University Kagawa JapanDivision of Innovative Medicine for Hepatobiliary and Pancreatology Faculty of Medicine, Kagawa University Kagawa JapanDepartment of Gastroenterological Surgery Faculty of Medicine, Kagawa University Kagawa JapanDepartment of Gastroenterological Surgery Faculty of Medicine, Kagawa University Kagawa JapanDepartment of Gastroenterology and Neurology Faculty of Medicine Kagawa University Kagawa JapanAbstract Endoscopic ultrasound‐guided cyst drainage (EUS‐CD) was performed for walled‐off pancreatic necrosis. Computed tomography performed the next day showed that the tip of the external drainage tube was located in the transverse colon, confirming an accidental EUS‐CD‐associated complication of mis‐puncture. A colonoscopy was performed to confirm the puncture site, which was identified as a defect measuring 2 mm in diameter. The external drainage tube was removed immediately via a guidewire. We intentionally retained the guidewire as a landmark for the puncture site in the colon. The defect was approximated using an endoclip under full vision, with the guidewire covered with surrounding mucosa. After removing the guidewire smoothly, complete closure was achieved with additional endoclips. Four days later, EUS‐CD was successfully repeated, resulting in the resolution of the walled‐off pancreatic necrosis. This is the first known case in which an accidental puncture of the transverse colon occurred during EUS‐CD for walled‐off pancreatic necrosis, and guidewire‐guided clip closure of the colon contributed to troubleshooting.https://doi.org/10.1002/deo2.70112complicationsdrainageendoscopic ultrasound‐guided fine needle aspirationpuncturestransverse colon
spellingShingle Naoki Fujita
Hideki Kamada
Ryota Nakabayashi
Takuma Yamashita
Shima Mimura
Hiroki Yamana
Kiyoyuki Kobayashi
Minoru Oshima
Keiichi Okano
Hideki Kobara
Guidewire‐assisted successful closure of mis‐punctured transverse colon during endoscopic ultrasound‐guided cyst drainage
DEN Open
complications
drainage
endoscopic ultrasound‐guided fine needle aspiration
punctures
transverse colon
title Guidewire‐assisted successful closure of mis‐punctured transverse colon during endoscopic ultrasound‐guided cyst drainage
title_full Guidewire‐assisted successful closure of mis‐punctured transverse colon during endoscopic ultrasound‐guided cyst drainage
title_fullStr Guidewire‐assisted successful closure of mis‐punctured transverse colon during endoscopic ultrasound‐guided cyst drainage
title_full_unstemmed Guidewire‐assisted successful closure of mis‐punctured transverse colon during endoscopic ultrasound‐guided cyst drainage
title_short Guidewire‐assisted successful closure of mis‐punctured transverse colon during endoscopic ultrasound‐guided cyst drainage
title_sort guidewire assisted successful closure of mis punctured transverse colon during endoscopic ultrasound guided cyst drainage
topic complications
drainage
endoscopic ultrasound‐guided fine needle aspiration
punctures
transverse colon
url https://doi.org/10.1002/deo2.70112
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