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Related Concept Videos

Ultrasound II: Endoscopic Ultrasound and FibroScan01:25

Ultrasound II: Endoscopic Ultrasound and FibroScan

66
Endoscopic Ultrasound (EUS) and FibroScan are valuable diagnostic tools in gastroenterology and hepatology, each with specific applications and techniques.
Endoscopic Ultrasound (EUS):
66
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  11. Treatment Of Functioning Insulinoma Using Endoscopic Ultrasound-guided Radiofrequency Ablation

Treatment of functioning insulinoma using endoscopic ultrasound-guided radiofrequency ablation

Sandra Pérez Prado1, Alberto Fernández Atutxa1, María López López2

  • 1Aparato Digestivo, Hospital Universitario Galdakao-Usansolo.

Revista Espanola De Enfermedades Digestivas
|February 11, 2025

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Robotic Enucleation of an Intra-Pancreatic Insulinoma in the Pancreatic Head
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Evaluation of the Feasibility, Safety, and Accuracy of an Intraoperative High-intensity Focused Ultrasound Device for Treating Liver Metastases
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View abstract on PubMed

Summary
This summary is machine-generated.

Managing anticoagulant therapy during endoscopic ultrasound (EUS)-guided radiofrequency ablation requires caution. A patient on enoxaparin developed a pancreatic hematoma, highlighting the risks associated with this procedure.

Area of Science:

  • Gastroenterology
  • Interventional Endoscopy
  • Oncology

Background:

  • Pancreatic insulinomas are rare neuroendocrine tumors.
  • Endoscopic ultrasound (EUS)-guided radiofrequency ablation (RFA) is a minimally invasive treatment option.
  • Patients with high thrombotic risk often require anticoagulation.

Purpose of the Study:

  • To report a case of pancreatic hematoma following EUS-guided RFA in a patient on anticoagulation.
  • To emphasize the need for careful management of anticoagulant therapy in this context.

Main Methods:

  • A case report of an 85-year-old patient with a functioning pancreatic insulinoma.
  • The patient was on acenocoumarol for high thrombotic risk, switched to enoxaparin peri-procedure.
  • EUS-guided RFA was performed, followed by standard anticoagulation management.

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Main Results:

  • The patient developed an acute hematoma in the pancreas and gastric body ten days post-procedure.
  • Clinical signs included hypotension and acute anemia, necessitating repeat anticoagulation cessation.
  • This complication occurred despite a peri-procedural anticoagulation management strategy.

Conclusions:

  • Caution is advised when managing anticoagulant therapy in patients undergoing EUS-guided RFA.
  • The risk of bleeding complications, such as pancreatic hematoma, should be carefully considered.
  • Further research may be needed to establish optimal anticoagulation protocols for EUS-guided RFA.