PMC7145156_01
Axial abdominal computed tomography before endoscopic drainage showing large perigastric fluid collection (red arrow).
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F1
Imaging also revealed a large perigastric (6 x 7 cm) fluid collection in the splenic bed, with the wall of the collection in contact with the stomach (Figure 1).
Endoscopic ultrasound showing a 6-cm perigastric abscess (red arrow).
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F2
Gastroenterology was consulted, and the patient underwent EUS-guided drainage of the perigastric abscess using a curvilinear array echoendoscope (GF-UCT180; Olympus, Center Valley, PA) (Figure 2).
Endoscopic image showing (A) the placement of lumen apposing metal stent into the abscess and (B) the abscess cavity revealing purulent fluid.
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F3
A large amount of purulent fluid was suctioned out (Figure 3).
Coronal abdominal computed tomography performed 4 days after lumen apposing metal stent placement showing near-total resolution of the abscess (red arrow).
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F4
Follow-up imaging 4 days later revealed near-total resolution of the perigastric abscess (Figure 4).
Axial abdominal computed tomography 1 week after the removal of the AXIOS stent revealing no evidence of extravasation of oral contrast (red arrow).
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F5
Abdominal CT with oral contrast was performed 1 week after the removal of the LAMS, and this did not reveal any leak from the stomach, indicating complete closure of the gastric fistula, and no further collection was noted (Figure 5).