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Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy
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Successful Endoscopic Ultrasound-Guided Transgastric Drainage for Intra-Abdominal Abscess Caused by Delayed

Fumiaki Tanino1, Akinori Shimizu1, Taiki Nobuto1

  • 1Department of Gastroenterology Onomichi General Hospital Hiroshima Japan.

DEN Open
|February 25, 2026
PubMed

Insights

Endoscopic ultrasound-guided drainage effectively treated a rare intra-abdominal abscess after gastric endoscopic mucosal resection. This EUS-guided drainage offers a safe and effective option when conservative therapy fails for post-EMR complications.

Area of Science:

  • Gastroenterology
  • Interventional Endoscopy
  • Surgical Complications

Background:

  • Delayed perforation is a rare but serious complication of gastric endoscopic mucosal resection (EMR).
  • Intra-abdominal abscess (IAA) formation can occur following delayed gastric perforation.
  • The efficacy of endoscopic ultrasound (EUS)-guided drainage for IAA secondary to EMR is not well-established.

Purpose of the Study:

  • To evaluate the safety and efficacy of EUS-guided transgastric drainage for intra-abdominal abscess (IAA) following delayed gastric perforation after EMR.
  • To present a case study illustrating the successful management of IAA using EUS-guided drainage.

Main Methods:

  • A case report of a patient undergoing EMR for gastric hyperplastic polyps.
  • Diagnosis of delayed perforation and subsequent IAA confirmed by abdominal CT.
  • EUS-guided transgastric drainage using a nasobiliary drainage tube and double-pigtail stent was performed.

Main Results:

  • The patient developed delayed perforation and IAA on postoperative days 4 and 17, respectively.
  • EUS-guided drainage led to prompt alleviation of fever and inflammatory markers.
  • Follow-up CT demonstrated significant shrinkage of the abscess cavity with an uneventful clinical course.

Conclusions:

  • EUS-guided transgastric drainage is a potentially safe and effective therapeutic option for IAA secondary to delayed gastric perforation after EMR.
  • This method is particularly valuable when conservative management fails and percutaneous drainage is not feasible.
Keywords:
delayed perforationendoscopic mucosal resectionendoscopic ultrasoundintra‐abdominal abscesstransgastric drainage

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