Endoscopic ultrasound-guided transesophageal drainage for acute mediastinitis caused by pancreatic fistula

• Main Authors: Yasuki Hori, Kensuke Fukumitsu, Itaru Naitoh, Tomohiro Onuki, Kazuki Hayashi, Akio Niimi, Hiromi Kataoka
• Format: Article
• Language: English
• Published: Elsevier 2021-01-01
• Series: Respiratory Medicine Case Reports
• Subjects: Acute mediastinitis; Endoscopic ultrasound; Pancreatic fistula; Transesophageal nasocystic drainage
• Online Access: http://www.sciencedirect.com/science/article/pii/S2213007121001428

Acute mediastinitis is a life-threatening condition, and standard treatment is percutaneous drainage and/or surgical treatment with antibiotics. A 58-year-old male diagnosed with acute mediastinitis originating from pancreatic fistula, detected only by endoscopic-ultrasound. We inserted a transesophageal nasocystic tube under endoscopic ultrasound guidance and successfully controlled the infection. The root of the main pancreatic duct for pancreatic juice drainage was recanalized using a duodenal endoscope. Endoscopic diagnosis and treatment by ultrasound have improved significantly; therefore, clinicians should know the potential of these procedures. The results of the present case may aid in the future treatment of patients with acute mediastinitis.