PMC8035029_01
Abdominal CT scan showing (a) a huge pancreatic pseudocyst with air and fluid content and (b) resolution of most of the pseudocysts after AXIOS drainage.
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fig1
An abdominal CT scan showed a huge pancreatic pseudocyst measuring 15 cm * 15 cm * 12 cm, occupying the body and tail of the pancreas (Figure 1(a)). The patient was discharged home on antibiotics (Figure 1(b)).
EUS image showing (a) a pancreatic pseudocyst before drainage and (b, c) the stent and pseudocyst after drainage (yellow dashed line).
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On the EUS, there was a huge fluid collection with air and debris consistent with the infected pancreatic pseudocyst (Figure 2(a)). A 10 mm length, 15 mm diameter Hot AXIOS stent was placed with EUS guidance with immediate drainage of >2000 cc of fluid and debris (Figures 2(b) and 2(c) and Figure 3).
Endoscopic view showing AXIOS drainage of the pseudocyst.
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A 10 mm length, 15 mm diameter Hot AXIOS stent was placed with EUS guidance with immediate drainage of >2000 cc of fluid and debris (Figures 2(b) and 2(c) and Figure 3).
Hot AXIOS and double-pigtail stents at the time of removal.
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EUS was repeated, and both AXIOS and plastic stents were removed (Figure 4); the patient made an uneventful recovery and was discharged home on antibiotics.
PMC8035029_02
Contrast-enhanced CT scan of the abdomen:huge multiseptated pseudocyst occupying the body and tail of the pancreas.
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An abdominal CT scan with contrast showed a giant multiseptated cyst measuring about 20 * 15 * 8 cm in the body and tail of the pancreas consistent with the pancreatic pseudocyst (Figure 5).
EUS image showing (a, b) a pancreatic pseudocyst before drainage and (c, d) the stent and pseudocyst after drainage.
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The Hot AXIOS stent with 10 mm * 15 mm diameter was placed with excellent drainage of >1500 cc of fluid, and then a 10 French gauge, 3 cm long double-pigtail stent was placed under fluoroscopy guidance (Figures 6 and 7).
Endoscopic view during pseudocyst drainage showing (a) the pseudocyst bulging the gastric mucosa, (b) drainage from the pseudocyst, and (c) AXIOS and double-pigtail stents.
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The Hot AXIOS stent with 10 mm * 15 mm diameter was placed with excellent drainage of >1500 cc of fluid, and then a 10 French gauge, 3 cm long double-pigtail stent was placed under fluoroscopy guidance (Figures 6 and 7).
Contrast-enhanced CT scan reveals effective drainage of the pseudocyst.
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fig8
The follow-up CT scan demonstrated almost total regression of the pseudocyst (Figure 8).