case_images: PMC4770624_01
case_images: A small quantity of free fluid (red arrow) is seen during EUS-FNA of a peritumoral lymph node (not clearly seen); the puncturing needle is also shown (yellow arrow). EUS-FNA = Endoscopic ultrasound-guided fine-needle aspiration
case_images: EUS-5-55-g001.jpg
case_images: PMC4770624_01_EUS-5-55-g001.jpg
case_images: F1
case_images: After the first needle pass into one peritumoral lymph node, a small quantity of free fluid, not seen before, appeared in the view [Figure 1].
case_images: Planar CT image showing the position of the stent. CT = Computed tomography
case_images: EUS-5-55-g002.jpg
case_images: PMC4770624_01_EUS-5-55-g002.jpg
case_images: F2
case_images: In this context, a computer tomography (CT) abdomen was emergently performed and revealed the distal end of the previously inserted biliary plastic stent passing through the wall of the inferior genu of the duodenum [Figures 2 and 3]; ascites, but no pneumoperitoneum was present.
case_images: Distal extremity of the plastic stent penetrating the duodenal wall (yellow arrow)
case_images: EUS-5-55-g003.jpg
case_images: PMC4770624_01_EUS-5-55-g003.jpg
case_images: F3
case_images: In this context, a computer tomography (CT) abdomen was emergently performed and revealed the distal end of the previously inserted biliary plastic stent passing through the wall of the inferior genu of the duodenum [Figures 2 and 3]; ascites, but no pneumoperitoneum was present.
case_images: Confirmatory picture taken from the surgical intervention, revealing the stent penetrating through the inferior genu of the duodenum
case_images: EUS-5-55-g004.jpg
case_images: PMC4770624_01_EUS-5-55-g004.jpg
case_images: F4
case_images: The findings were confirmed during surgery [Figure 4] that besides removing the plastic stent and the bile from the peritoneal cavity, also carried out a primary duodenal repair and coledocho-jejuno-anastomosis.