LAUSR

A 70-YEAR-OLD MAN with gastric carcinoma and enlargement of the mediastinal lymph nodes underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Histologic examination of the specimen revealed no malignant cells. He developed a high fever 21 days after EBUS-TBNA, and presented with a mediastinal abscess. Computed tomography (CT) revealed a mediastinal abscess adjacent to the esophagus (Fig. 1), and endoscopic ultrasound (EUS) showed isoechoic fluid collection (Fig. 2). The abscess was punctured with a 19G needle, and a 0.025-inch guidewire was maneuvered into it following a contrast medium that was used. The fistula was dilated using an ES Dilator (Zeon Medical, Tokyo, Japan), and a 5-Fr pigtail type nasobiliary tube (SilkyPass; Boston Scientific, Tokyo, Japan) was then deployed into the abscess