Abstract
Duodenal diverticula are common but rarely complicated by abscess formation. Standard management includes antibiotics, percutaneous drainage, or surgery when minimally invasive approaches fail. We report a 75-year-old woman with a 4.4 × 4.0 cm duodenal diverticular abscess refractory to antibiotics. Endoscopic ultrasound-guided drainage with an 8 × 8 mm lumen-apposing metal stent led to immediate pus evacuation and clinical resolution. This case illustrates the expanding role of lumen-apposing metal stents as a safe, minimally invasive option for complex duodenal abscesses when conventional approaches are not feasible.