A catheter was percutaneously inserted into the abscess pocket, and purulent pus was drained. Systemic antibiotics were administered. Although percutaneous drainage was maintained for the liver abscess, there was no clinical or radiological improvement. Three weeks after percutaneous drainage, we found the Omipalisib order bile in percutaneous drainage effluent from the liver abscess turned green. A biliary fistula was suspected and was confirmed by endoscopic retrograde cholangiopancreatography (ERCP). Results: The patient underwent treatment by endoscopic sphincterotomy
and nasobiliary drainage. Nasobiliary drains were placed according to standard techniques. The patient had a rapid resolution of symptoms, and a follow-up abdominal ultrasonography showed that the size of abscess pocket decreased markedly measuring approximately 6.0 cm*1.4 cm ten days after. Nasobiliary drains were removed when effluent from the liver abscess stopped and closure of the fistula was confirmed by cholangiography. Conclusion: Endoscopic therapy is an effective mode of treatment for biliary fistulas complicating liver abscesses. Key Word(s): 1. Liver abscess; 2. Biliary fistula; 3. ERCP; 4. ENBD;
Presenting Author: VIJAY SHARMA Additional Authors: RICHA SHARMA, BRIJESH BHARADWAJ, MOHIT CHATURVEDI, DINESH MANGAL Corresponding Author: VIJAY SHARMA Affiliations: Regional Institute of Health, Medicine & Research; S K Soni Hospital Objective: Radiation colitis, an insidious, progressive disease of increasing frequency, IWR-1 ic50 develops 6 mo Cell press to 5 years after regional radiotherapy for malignancy, owing to the deleterious effects of the latter on the colon and the small intestine. Management of chronic radiation colitis remains a major challenge owing to the progressive evolution of the disease, including development of fibrosis, endarteritis, edema, fragility, perforation, partial obstruction, and cancer. Patients are commonly managed conservatively. Methods: Our purposes
were to (1) evaluate efficacy and safety of bipolar heater probe endoscopic coagulation compared to prior medical therapy for bleeding radiation telangiectasia, and (2) consider the impact of treatments on patients’ impression of their overall health and activity.Six months of medical management had failed in 2 men and 9 women with chronic, recurrent hematochezia and anemia after radiation treatment of pelvic malignancies. Patients had multiple rectal telangiectasias coagulated with bipolar heater probes CD 120 U with Olympus HPU 20 unit in a randomized, prospective study. Patients followed for 6 months. Results: Rectal bleeding stopped within four treatment sessions. During 6 months of endoscopic versus medical therapy, severe bleeding episodes diminished significantly for bipolar heater probe versus 6 months of prior medical therapy (79% vs 37%); mean hematocrits rose significantly for patients undergoing bipolar heater probe (40.2 vs 30.