The utility and the safety of EUS-guided FNA in the evaluation of duplication cysts

Assessment of morbidity and mortality associated with EUS-guided FNA: a systematic review

“…Ultimately, 51 articles met our inclusion and exclusion criteria. 2,[5][6][7] Of these, 20 were retrospective studies, 6,[14][15][16][17][18][21][22][23][24][25][26]30,31,40,44,[46][47][48]55 and 6 were multicenter studies. 15,23,25,35,47,48 These 51 articles included a total of 10,941 patients who underwent EUS-FNA to establish a diagnosis for ascites or lesions involving the upper or lower GI tract or organs adjacent to it, including the pancreas, liver, bile duct, adrenal gland, pelvis, and mediastinum.…”

EUS in the Evaluation of Posterior Mediastinal Lesions

“…One series in which 22 patients underwent EUS FNA of posterior mediastinal cysts with 22-gauge needles and received intravenous ciprofloxacin followed by 5 days of oral ciprofloxacin reported no cases of mediastinitis. 104 This finding suggests that periprocedure antibiotics may prevent infection or mediastinitis when FNA of a cyst is performed. 104 Despite the use of preprocedure antibiotics, in one reported case, EUS FNA of a duplication cyst resulted in Candida albicans infection of the cyst.…”

“…104 This finding suggests that periprocedure antibiotics may prevent infection or mediastinitis when FNA of a cyst is performed. 104 Despite the use of preprocedure antibiotics, in one reported case, EUS FNA of a duplication cyst resulted in Candida albicans infection of the cyst. 28 A 5-cm paratracheal cyst was aspirated, and gelatinous material was obtained.…”

“…A typical approach is to administer intravenous antibiotics during the procedure and oral antibiotics for the next 3 to 5 days afterward to minimize any risk of mediastinitis. 104 EUS-guided 19-gauge Tru-Cut needle biopsies should be avoided in suspected posterior mediastinal cysts because of the even higher risk of mediastinitis reported with the use of these larger needles.…”

Esophageal endoscopic ultrasound fine-needle aspiration as a diagnostic tool

“…Certain cysts seem to be mass-like as they consist of a thick gelatinous cyst material [57] . As most posterior mediastinal cysts are benign and mediastinitis is a recognized complication, it is still controversial if obvious cysts should be aspirated with EUS-FNA [58] . If EUS-FNA is performed on a lesion that turns out to be a cyst rather than a solid mass, then the cyst should be completely drained if possible, and prophylactic antibiotics should be administered, such as intravenous antibiotics during the procedure and oral antibiotics for the following 3 -5 days to minimize any risk of mediastinitis [58] .…”