Transparietal Gastric Drainage of Walled-Off Pancreatic Necrosis Using an Endoscopic Technique With the Hot Axios Stent: A Case Report

TL;DR

A 66-year-old woman with a pancreatic complication was successfully treated using an endoscopic technique with a Hot Axios stent.

Contribution

This case report presents a rare endoscopic approach for treating walled-off pancreatic necrosis using the Hot Axios stent.

Findings

Endoscopic ultrasound-guided drainage with a Hot Axios stent was effective for treating the patient's pancreatic necrosis.

Three scheduled necrosectomies were performed through the stent without complications.

The patient's symptoms resolved, and she had a favorable recovery after stent removal.

Abstract

We present the case of a 66-year-old female patient who was hospitalized six months earlier for acute biliary pancreatitis. She presented to the emergency department with a 15-day history of symptoms, which included fever, abdominal pain, and a palpable mass in the mesogastric region. An abdominal computed tomography (CT) scan revealed a peripancreatic fluid collection involving the pancreatic body and head, suggestive of a complication related to the prior episode of acute pancreatitis.

The patient was referred to the gastroenterology service, where a decision was made to pursue an uncommon therapeutic approach. Endoscopic ultrasound (EUS)-guided pancreatic drainage was performed using a lumen-apposing metal stent (LAMS) (Hot Axios, Boston Scientific, Marlborough, MA), followed by scheduled outpatient necrosectomies. A total of three necrosectomies were carried out through the stent, which was subsequently removed one month after its placement. The patient demonstrated a favorable clinical course, with resolution of symptoms and no reported complications.

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