MASSIVE HEMORRHAGE AFTER ENDOSCOPIC ULTRASOUND GUIDED FINE NEEDLE ASPIRATION OF A CEPHALOPANCREATIC CYSTIC LESION

A 68 years-old female was referred for endoscopic ultrasound study of a cephalopancreatic cystic lesion. A 22 G FNA was performed under ultrasound and Doppler guidance. After needle removal, a high-velocity and pulsatile hemorrhage was detected in the puncture site of the duodenal wall. Using the echoendoscope, we performed adrenaline (0.0001%) injection and applied two clips, with a partial control. We opted for switching to a gastroscope, complementing the hemostatic therapy with three more clips and injection of 2 mL of polidocanol (2%). The patient remained stable and was discharged after 72 hours of clinical vigilance.