EUS-guided transgastric drainage of caudate lobe liver abscesses.

Pyogenic liver abscess is a rare but serious condition resulting in significant morbidity and mortality if left untreated. The first line treatment for hepatic abscess is the transcutaneous or surgical approach with an 80-100% success rate. However, these modalities are associated with numerous risks including bleeding, biliary peritonitis, fistula formation, and patient discomfort. The caudate lobe is anatomically difficult to access percutaneously. Given its proximity to the stomach, a transgastric approach to drainage is feasible. We report two consecutive patients who underwent EUS-guided transgastric drainage of a caudate lobe abscess.