PS01.075: EUS-GUIDED TRANS-ESOPHAGEAL DRAINAGE OF A MEDIASTINAL ABSCESS DURING PREOPERATIVE CHEMOTHERAPY FOR THORACIC ESOPHAGEAL CANCER

Abstract

Abstract Background A Mediastinal abscess can cause sepsis and make a patient sever condition. Early drainage treatment is required. We report a case which EUS-guided drainage was effective for a mediastinal abscess. Methods A 75-year-old man with T3 upper thoracic esophageal squamous cell carcinoma received preoperative chemotherapy. On day 9 the patient had fever and nuchal swelling. CT scan revealed a mediastinal abscess adjacent to the upper esophagus and the right paratracheal region extending to a retropharyngeal abscess. There was no clinical improvement with antibiotic therapy. On day 12 EUS-guided trans-esophageal drainage for the mediastinal abscess was performed. Results The echoendoscope was positioned within the upper esophagus, and the mediastinal collection was well visualized endosonographically. The mediastinal abscess was punctured and a pigtail catheter was placed. The retropharyngeal abscess was drainaged by pharyngeal incision. A repeated CT scan confirmed resolution of the abscess. On day 25 upper endoscopy was performed to remove the pigtail catheter. A small perforated hall was identified in the center of the esophageal tumor decreased after chemotherapy. The patients underwent esophagectomy after recovery. Conclusion EUS-guided trans-esophageal drainage was useful for a mediastinal abscess. Disclosure All authors have declared no conflicts of interest.