Endoscopic management of pancreatic duct leak complicated by retrogastric abscess.

A patient was diagnosed with a large retrogastric abscess associated with a postsurgical pancreatic duct leak refractory to somatostatin (Sandostatin) and external drains. She was managed entirely by endoscopic means consisting of transgastric abscess decompression, irrigation via a nasocystic tube, total parenteral nutrition, and a 7-Fr pancreatic duct stent to facilitate healing of the pancreatic duct leak. Thirty days after placement, the pancreatic duct stent was removed and pancreatogram revealed closure. Fifty-one days after transgastric decompression of the abscess, near complete closure of the cavity was accomplished and the patient returned to a regular diet. One year later, the patient continues to do well.