Cho Seo-Yeon, Cho Eunae, Park Chang-Hwan, Kim Hee-Joon, Koo Joo-Yeon
Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju 61469, South Korea.
Department of Surgery, Chonnam National University Hospital, Gwangju 61469, South Korea.
World J Gastroenterol. 2021 Feb 28;27(8):751-759. doi: 10.3748/wjg.v27.i8.751.
Endoscopic ultrasound-guided fine needle aspiration or biopsy (EUS-FNA or FNB) has become a popular method for diagnosing various lesions of the gastrointestinal tract and surrounding tissue due to the accuracy and safety. To the best of our knowledge, no case report of severe infection after EUS-FNB of a solid lesion in the spleen has been described. Herein, we report a rare case of septic shock after EUS-FNB of a splenic mass.
A 45-year-old male patient presented to the outpatient clinic due to an incidentally detected splenic mass. A definitive diagnosis could not be established based on the abdominal magnetic resonance imaging. EUS of the spleen showed a 6 cm-sized, relatively well-demarcated, heterogeneous mass, and EUS-FNB with a 22G needle was performed. Ten days after the procedure patient developed septic shock and a splenic abscess was identified. Blood culture revealed growth of . After the treatment with antibiotics the patient underwent surgical resection, and the pathological examination showed diffuse large B-cell lymphoma. The patient received chemotherapy and he is in complete remission.
Infection of a splenic mass after EUS-FNB is a rare complication and prophylactic antibiotics might be considered.
由于准确性和安全性,内镜超声引导下细针穿刺抽吸或活检(EUS-FNA或FNB)已成为诊断胃肠道及周围组织各种病变的常用方法。据我们所知,尚未有关于脾脏实性病变EUS-FNB后发生严重感染的病例报告。在此,我们报告一例脾脏肿块EUS-FNB后发生感染性休克的罕见病例。
一名45岁男性患者因偶然发现脾脏肿块就诊于门诊。根据腹部磁共振成像无法明确诊断。脾脏的EUS显示一个6厘米大小、边界相对清晰的异质性肿块,并使用22G针进行了EUS-FNB。术后10天患者发生感染性休克,发现脾脏脓肿。血培养显示……生长。经抗生素治疗后,患者接受了手术切除,病理检查显示为弥漫性大B细胞淋巴瘤。患者接受了化疗,目前处于完全缓解状态。
EUS-FNB后脾脏肿块感染是一种罕见的并发症,可能需要考虑预防性使用抗生素。