Digestive Disease Center, Konkuk University Medical Center, Seoul, Korea
ABSTRACT
A 72-year-old woman was admitted to our hospital for epigastric pain. She underwent ERCP for CBD stone removal at another hospital 6 weeks ago. She developed severe post-ERCP pancreatitis with a large pseudocyst. Initial CT scan showed a 15 cm-sized huge pseudocyst compressing the stomach. We performed linear EUS-guided cystogastrostomy and placed the first plastic stent into the pancreatic pseudocyst. At the end of the first stenting, the drainage tube migrated into the pseudocyst. We placed two plastic stents and nasocystic drain into the pseudocyst. After two weeks, we tried to remove the migrated plastic stent. We removed previously placed two plastic stents and cystogastrostomy opening was dilated up to 15 mm using a CRE balloon. After creating a large hole, the endoscope could pass into the cyst. The migrated plastic stent was grasped by a rat- toothed forceps and it was successfully removed.