Periesophageal Tuberculosis Abscess Post-Liver Transplantation Successfully Treated With Lumen-Apposing Metal Stent Cyst Esophagostomy.

The therapeutic utility of ultrasound-guided endoscopy has grown significantly in recent years. In this report, we describe a case of extrapulmonary tuberculosis in a liver transplant recipient found to have an encapsulated fluid collection in the inferior mediastinum, which was drained with an endoscopic ultrasound-guided technique, precluding the need for percutaneous or surgical intervention.

Gastrointestinal Bleeding Secondary to Splenic Artery Pseudoaneurysm: A Delayed Complication of a Lumen-Apposing Metal Stent.

Lumen-apposing metal stents (LAMSs) have been widely used for drainage of peripancreatic collections. A 71-year-old woman with a history of necrotizing pancreatitis who underwent LAMS placement 3 months ago for symptomatic pancreatic fluid collection presented with hematochezia and hemodynamic instability. Computed tomographic angiography of the abdomen showed concerns for stent erosion into the splenic artery. Esophagogastroduodenoscopy revealed a large pulsating nonbleeding vessel within the LAMS. She underwent a mesenteric angiogram, which showed splenic artery pseudoaneurysm, and coil embolization was performed. Gastrointestinal bleeding secondary to pseudoaneurysm should be considered in patients with recent LAMS placement who present with signs of gastrointestinal bleeding.