University of Florida College of Medicine Jacksonville Jacksonville, FL
Barrett Attarha, DO, Yusuke Hashimoto, MD University of Florida College of Medicine Jacksonville, Jacksonville, FL
Introduction: A 53 yr female with a past medical history of HIV, myelodysplastic syndrome, and AML was admitted to the hospital for chemotherapy treatment. During the course of her treatment she developed diarrhea and fevers and CT scan revealed sigmoid colitis with a 2 cm colonic abscess. A lower EUS was performed and an AXIOS stent was placed to aid in drainage. It was removed 6 weeks later with complete resolution of the abscess.
Case Description/Methods: During the course of chemotherapy treatment for AML the patient developed diarrhea and fevers. A CT scan revealed sigmoid colitis with a 2 cm para-colonic abscess. The abscess did not improve with conservative management and GI was consulted for further management. A lower EUS was performed. This revealed extensive compression in the sigmoid colon secondary to the previously known abscess. The extrinsic compression was traversed and a hot AXIOS stent was placed to facilitate drainage (Figure 1). The stent was removed 6 weeks later with complete resolution of the abscess.
Discussion: AXIOS stent deployment for abscess drainage is a common modality employed at institutions with advanced endoscopic capabilities. What is novel about this case was the small size of the abscess, 2cm, and the small size of the AXIOS stent used. A 6mm by 8mm AXIOS stent was deployed and resulted in resolution of the abscess 6 weeks later. This small size AXIOS stent is usually not employed for abscess drainage and to our knowledge this is a relatively novel use. Given the clinical improvement and success, using small size AXIOS stents for abscess drainage may need further investigation.
Figure: Top panel showing EUS with peri-sigmoid colonic fluid collection prior to AXIOS deployment. Bottom Panel after EUS guided hot AXIOS deployment
Barrett Attarha indicated no relevant financial relationships.
Yusuke Hashimoto indicated no relevant financial relationships.
Barrett Attarha, DO, Yusuke Hashimoto, MD. P0900 - Abscess Drainage With an Unusually Small AXIOS Stent, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.