Freehand endoscopic ultrasound-guided transrectal drainage of diverticulitis-associated abscess with electrocautery-enhanced lumen-apposing metal stent under spinal anesthesia.

Complicated diverticulitis occurs in 12 % of all diverticulitis cases [1]. Radiological drainage is the first-line therapy in cases of large diverticulitis-associated abscess [2]. However, the pelvic location renders the radiological access challenging. Lower endoscopic ultrasound (EUS)-guided drainage, using an electrocautery-enhanced lumen-apposing metal stent (LAMS), is a feasible and safe alternative method for drainage of pelvic collections [3] [4] [5]. We present a case of a diverticulitis-associated abscess successfully treated using EUS-guided LAMS.