case_images: PMC5822869_01
case_images: Coronal abdominal CT scan image showing retroperitoneal abscess.
case_images: CRIGM2018-6740734.001.jpg
case_images: PMC5822869_01_CRIGM2018-6740734.001.jpg
case_images: fig1
case_images: The initial computed tomography (CT) abdomen at our hospital revealed a loculated air and fluid filled, rim enhancing collection in the right retroperitoneum extending to the pelvis measuring approximately 20.8 x 6.7 x 5.3 cm with a JP drain (Figure 1).
case_images: Fistulous opening in the duodenum.
case_images: CRIGM2018-6740734.002.jpg
case_images: PMC5822869_01_CRIGM2018-6740734.002.jpg
case_images: fig2
case_images: Finally, an upper endoscopy was performed after 12 weeks of initial admission revealed a small mucosal defect in medio-posterior wall of distal portion of the duodenal bulb that was draining pus intermittently, suspicious for the site of perforation (Figure 2).
case_images: Endoscopic closure of luminal perforation of the duodenum with OVESCO over-the-scope clip.
case_images: CRIGM2018-6740734.003.jpg
case_images: PMC5822869_01_CRIGM2018-6740734.003.jpg
case_images: fig3
case_images: An OVESCO over-the-scope clip (12/6T) was used to close the defect and a second injection of methylene blue via the catheter did not show further luminal drainage (Figure 3).
case_images: Coronal abdominal CT scan images after the closure of the fistula.
case_images: CRIGM2018-6740734.004.jpg
case_images: PMC5822869_01_CRIGM2018-6740734.004.jpg
case_images: fig4
case_images: Repeat CT scan after 8 weeks from the endoscopic closure showed near complete resolution of the abscess (Figure 4).