Transbiliary intravascular ultrasound-guided diagnostic biopsy of an inaccessible pancreatic head mass.

Percutaneous image-guided biopsies of pancreatic malignancies may prove challenging and nondiagnostic due to a variety of anatomic considerations. For patients with complex post-surgical anatomy, such as a Roux-en-Y gastric bypass, diagnosis via endoscopic ultrasound with fine-needle aspiration may not be possible because of an inability to reach the proximal duodenum. This report describes the first diagnostic case of transbiliary intravascular ultrasound-guided biopsy of a pancreatic head mass in a patient with prior Roux-en-Y gastric bypass for which a diagnosis could not be achieved via percutaneous and endoscopic approaches. Transbiliary intravascular ultrasound-guided biopsy resulted in a diagnosis of pancreatic adenocarcinoma, allowing the initiation of chemotherapy.

Citation

Jeffrey Forris Beecham Chick, Benjamin B Roush, Minhaj S Khaja, Dennis Prohaska, Kyle J Cooper, Wael E Saad, Ravi N Srinivasa. Transbiliary intravascular ultrasound-guided diagnostic biopsy of an inaccessible pancreatic head mass. Radiology case reports. 2017 Jun;12(2):323-326

PMID: 28491180

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