‘Candy Sign’ in EUS guided cysto‐gastrostomy of pancreatic fluid collection with metal stent

Abstract

A 40‐year‐old male underwent EUS guided drainage for symptomatic large WON (15 x 9 cm) due severe acute pancreatitis 6 months ago. The initial steps of EUS guided cysto‐gastrostomy with BFMS (needle puncture, passage of guidewire, creation of fistula using co‐axial 6Fr cystotome and dilation of track with 4mm balloon) were uneventful. However, there was significant resistance to cross the wall of WON while passing the stent assembly (NAGI stent, Taewoong Medical) over the guidewire. Subsequently, the stent assembly was withdrawn and its inspection revealed that conical plastic tip was loose and migrated within the blunt sheath of the delivery system.

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