Complications following endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA)
biopsy are rare. A 75-year-old man underwent EUS-FNA biopsy of an enlarged mediastinal
lymph, which histologic investigation revealed to be a metastasis of a hepatocellular
carcinoma. The patient developed the postinterventional complication of suppurative
infection within the mediastinum. Under EUS guidance, a pigtail catheter and a soft
tube were inserted to respectively drain and rinse the mediastinal lesion for 8 days.
The remaining esophagomediastinal fistula was closed by gathering the fistula margins,
using band ligations and an Endoloop. The fistula healed with no further complaints
or dysphagia. Infection is a possible complication of endoluminal FNA biopsy. An endoscopically
guided therapeutic approach can be favored as the initial treatment of choice and
as a reasonable alternative that avoids surgical intervention.
References
- 1
Fritscher-Ravens A, Petrasch S, Reinacher-Schick A. et al .
Diagnostic value of ultrasonography-guided fine-needle aspiration cytology of mediastinal
masses in patients with intrapulmonary lesions and nondiagnostic bronchoscopy.
Respiration.
1999;
66
150-155
- 2
Gress F G, Savides T J, Sandler A. et al .
Endoscopic ultrasonography, fine needle aspiration biopsy guided by endoscopic ultrasonography
and computed tomography in the preoperative staging of non-small-cell lung cancer:
a comparison study.
Ann Intern Med.
1997;
127
604-612
- 3
Silvestri G A, Hoffmann B J, Bhutani M S. et al .
Endoscopic ultrasound with fine-needle aspiration in the diagnosis and staging of
lung cancer.
Ann Thorac Surg.
1996;
61
1441-1443
- 4
Wiersema M J, Vilman P, Giovanni M. et al .
Endosonography-guided fine-needle aspiration biopsy: diagnostic accuracy and complication
assessment.
Gastroenterology.
1997;
112
1087-1095
U. Will, M. D.
Department of Internal Medicine III, City Hospital
Straße des Friedens 122 · 07548 Gera · Germany
Fax: +49-365-8282402
Email: uwe.will@waldklinikumgera.de
