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Review
Drainage for fluid collections post pancreatic surgery and acute pancreatitis: similar but different?
Yousuke Nakai, Saburo Matsubara, Tsuyoshi Mukai, Tsuyoshi Hamada, Takashi Sasaki, Hirotoshi Ishiwatari, Susumu Hijioka, Hideyuki Shiomi, Mamoru Takenaka, Takuji Iwashita, Atsuhiro Masuda, Tomotaka Saito, Hiroyuki Isayama, Ichiro Yasuda, for the WONDERFUL study group in Japan
Received October 3, 2023  Accepted November 1, 2023  Published online May 17, 2024  
DOI: https://doi.org/10.5946/ce.2023.254    [Epub ahead of print]
AbstractAbstract PDFPubReaderePub
Postoperative pancreatic fistulas (POPFs) are common adverse events that occur after pancreatic surgery. Endoscopic ultrasonography (EUS)-guided drainage (EUS-D) is a first-line treatment, similar to that for pancreatic fluid collection (PFCs) after acute pancreatitis. However, some POPFs do not develop fluid collections depending on the presence or location of the surgical drain, whereas others develop fluid collections, such as postoperative fluid collections (POPFCs). Although POPFCs are similar to PFCs, the strategy and modality for POPF management need to be modified according to the presence of fluid collections, surgical drains, and surgical type. As discussed for PFCs, the indications, timing, and selection of interventions or stents for EUS-D have not been fully elucidated for POPFs. In this review, we discuss the management of POPFs and POPFCs in comparison with PFCs due to acute pancreatitis and summarize the topics that should be addressed in future studies.
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Original Article
Self-expandable metallic stent-induced esophagorespiratory fistulas in patients with advanced esophageal cancer
Iatagan R. Josino, Bruno C. Martins, Andressa A. Machado, Gustavo R. de A. Lima, Martin A. C. Cordero, Amanda A. M. Pombo, Rubens A. A. Sallum, Ulysses Ribeiro Jr, Todd H. Baron, Fauze Maluf-Filho
Clin Endosc 2023;56(6):761-768.   Published online July 25, 2023
DOI: https://doi.org/10.5946/ce.2022.297
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Self-expandable metallic stents (SEMSs) are widely adopted for the palliation of dysphagia in patients with malignant esophageal strictures. An important adverse event is the development of SEMS-induced esophagorespiratory fistulas (SEMS-ERFs). This study aimed to assess the risk factors related to the development of SEMS-ERF after SEMS placement in patients with esophageal cancer.
Methods
This retrospective study was performed at the Instituto do Cancer do Estado de São Paulo. All patients with malignant esophageal strictures who underwent esophageal SEMS placement between 2009 and 2019 were included in the study.
Results
Of the 335 patients, 37 (11.0%) developed SEMS-ERF, with a median time of 129 days after SEMS placement. Stent flare of 28 mm (hazard ratio [HR], 2.05; 95% confidence interval [CI], 1.15–5.51; p=0.02) and post-stent chemotherapy (HR, 2.0; 95% CI, 1.01–4.00; p=0.05) were associated with an increased risk of developing SEMS-ERF, while lower-third tumors were a protective factor (HR, 0.5; 95% CI, 0.26–0.85; p=0.01). No difference was observed in overall survival.
Conclusions
The incidence of SEMS-ERFs was 11%, with a median time of 129 days after SEMS placement. Post-stent chemotherapy and a 28 mm stent flare were associated with a higher risk of SEMS-ERF.

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  • How to reduce fistula formation after self-expandable metallic stent insertion for treating malignant esophageal stricture?
    Kwang Bum Cho
    Clinical Endoscopy.2023; 56(6): 735.     CrossRef
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Case Report
Gastric cancer presenting with ramucirumab-related gastrocolic fistula successfully managed by colonic stenting: a case report
Hiroki Fukuya, Yoichiro Iboshi, Masafumi Wada, Yorinobu Sumida, Naohiko Harada, Makoto Nakamuta, Hiroyuki Fujii, Eikichi Ihara
Clin Endosc 2023;56(6):812-816.   Published online May 11, 2023
DOI: https://doi.org/10.5946/ce.2022.117
AbstractAbstract PDFPubReaderePub
We report a rare case of gastric cancer presenting with a gastrocolic fistula during ramucirumab and paclitaxel combination therapy that was successfully managed with colonic stenting. A 75-year-old man was admitted to our hospital with the chief complaint of melena. Esophagogastroduodenoscopy revealed a large ulcerated tumor in the lower stomach, judged by laparoscopy as unresectable (sT4bN1M0). After four cycles of first-line chemotherapy with S-1 plus oxaliplatin, the patient showed disease progression, and second-line therapy with ramucirumab and paclitaxel was started. At the end of the third cycle, the patient had gastric antral stenosis, which necessitated the placement of a gastroduodenal stent. When the patient complained of diarrhea 10 days later, esophagogastroduodenoscopy revealed a fistula between the greater curvature of the stomach and the transverse colon. The fistula was covered by double colonic stenting, with a covered metal stent placed within an uncovered metal stent, after which leakage from the stomach to the colon stopped.

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  • Ramucirumab

    Reactions Weekly.2024; 1989(1): 189.     CrossRef
  • Metastatic bladder cancer forming a sigmoidorectal fistula after enfortumab vedotin therapy: a case report
    Shinji Tamada, Daiki Ikarashi, Naoki Yanagawa, Moe Toyoshima, Kenta Takahashi, Tomohiko Matsuura, Shigekatsu Maekawa, Renpei Kato, Mitsugu Kanehira, Ryo Takata, Wataru Obara
    Frontiers in Oncology.2023;[Epub]     CrossRef
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Original Article
Endoscopic vacuum therapy for treatment of spontaneous and iatrogenic upper gastrointestinal defects
Kavea Panneerselvam, Jake S. Jacob, Ronald E. Samuel, Andy Tau, Gyanprakash A. Ketwaroo, Wasif M. Abidi, Robert J. Sealock
Clin Endosc 2023;56(6):754-760.   Published online May 9, 2023
DOI: https://doi.org/10.5946/ce.2022.177
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Endoscopic vacuum therapy (EVT) can heal a variety of defects within the gastrointestinal (GI) tract via applying negative pressure, which reduces the defect size, aspirates the infected fluid, and promotes granulation tissue. Here we present our experience with EVT as it relates to both spontaneous and iatrogenic upper GI tract perforations, leaks, and fistulas.
Methods
This retrospective study was conducted at four large hospital centers. All patients who underwent EVT between June 2018 and March 2021 were included. Data on multiple variables were collected, including demographics, defect size and location, number and intervals of EVT exchanges, technical success, and hospital length of stay. Student t-test and the chi-squared test were used to analyze the data.
Results
Twenty patients underwent EVT. The most common defect cause was spontaneous esophageal perforation (50%). The most common defect location was the distal esophagus (55%). The success rate was 80%. Seven patients were treated with EVT as the primary closure method. The mean number of exchanges was five with a mean interval of 4.3 days between exchanges. The mean length of hospital stay was 55.8 days.
Conclusions
EVT is a safe and effective initial management option for esophageal leaks and perforations.

Citations

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  • Endoscopic vacuum therapy: management of upper gastrointestinal anastomotic leaks and esophageal perforations
    María de Armas Conde, Carmen Díaz-López , Vanessa Concepción-Martín, María Del Pilar Borque-Barrera
    Revista Española de Enfermedades Digestivas.2024;[Epub]     CrossRef
  • Management of fistulas in the upper gastrointestinal tract
    Maria Valeria Matteo, Maria Mihaela Birligea, Vincenzo Bove, Valerio Pontecorvi, Martina De Siena, Loredana Gualtieri, Federico Barbaro, Cristiano Spada, Ivo Boškoski
    Best Practice & Research Clinical Gastroenterology.2024; : 101929.     CrossRef
  • Endoscopic Vacuum Therapy of Upper Gastrointestinal Anastomotic Leaks: How to Deal with the Challenges (with Video)
    Laurent Monino, Tom G. Moreels
    Life.2023; 13(6): 1412.     CrossRef
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Case Reports
Portal cavernography during endoscopic retrograde cholangiopancreatography: from bilhemia to hemobilia
Rawad A. Yared, Paraskevas Gkolfakis, Arnaud Lemmers, Vincent Huberty, Thierry Degrez, Jacques Devière, Daniel Blero
Clin Endosc 2023;56(4):521-526.   Published online January 5, 2023
DOI: https://doi.org/10.5946/ce.2021.276
AbstractAbstract PDFPubReaderePub
Portobiliary fistulas are rare but may lead to life-threatening complications. Biliary plastic stent-induced portobiliary fistulas during endoscopic retrograde cholangiopancreatography have been described. Herein, we present a case of portal cavernography and recurrent hemobilia after endoscopic retrograde cholangiopancreatography in which a portobiliary fistula was detected in a patient with portal biliopathy. This likely indicates a change in clinical presentation (from bilhemia to hemobilia) after biliary drainage that was successfully treated by placement of a fully covered, self-expandable metallic stent.
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Bronchoesophageal fistula in a patient with Crohn’s disease receiving anti-tumor necrosis factor therapy
Kyunghwan Oh, Kee Don Choi, Hyeong Ryul Kim, Tae Sun Shim, Byong Duk Ye, Suk-Kyun Yang, Sang Hyoung Park
Clin Endosc 2023;56(2):239-244.   Published online December 21, 2021
DOI: https://doi.org/10.5946/ce.2021.215
AbstractAbstract PDFPubReaderePub
Tuberculosis is an adverse event in patients with Crohn’s disease receiving anti-tumor necrosis factor (TNF) therapy. However, tuberculosis presenting as a bronchoesophageal fistula (BEF) is rare. We report a case of tuberculosis and BEF in a patient with Crohn’s disease who received anti-TNF therapy. A 33-year-old Korean woman developed fever and cough 2 months after initiation of anti-TNF therapy. And the symptoms persisted for 1 months, so she visited the emergency room. Chest computed tomography was performed upon visiting the emergency room, which showed BEF with aspiration pneumonia. Esophagogastroduodenoscopy with biopsy and endobronchial ultrasound with transbronchial needle aspiration confirmed that the cause of BEF was tuberculosis. Anti-tuberculosis medications were administered, and esophageal stent insertion through endoscopy was performed to manage the BEF. However, the patient’s condition did not improve; therefore, fistulectomy with primary closure was performed. After fistulectomy, the anastomosis site healing was delayed due to severe inflammation, a second esophageal stent and gastrostomy tube were inserted. Nine months after the diagnosis, the fistula disappeared without recurrence, and the esophageal stent and gastrostomy tube were removed.

Citations

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  • (Re-)introduction of TNF antagonists and JAK inhibitors in patients with previous tuberculosis: a systematic review
    Thomas Theo Brehm, Maja Reimann, Niklas Köhler, Christoph Lange
    Clinical Microbiology and Infection.2024;[Epub]     CrossRef
  • Azathioprine/infliximab/methylprednisolone

    Reactions Weekly.2023; 1963(1): 114.     CrossRef
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Focused Review Series: Endoscopic Management of Postoperative Gastrointestinal Complication: What’s New?
Over-the-Scope Clip in the Treatment of Gastrointestinal Leaks and Perforations
Mike T. Wei, Ji Yong Ahn, Shai Friedland
Clin Endosc 2021;54(6):798-804.   Published online November 30, 2021
DOI: https://doi.org/10.5946/ce.2021.250
AbstractAbstract PDFPubReaderePub
While perforations, postoperative fistulas, and leaks have traditionally led to surgical or interventional radiology consultation for management, the introduction of the over-the-scope clip has allowed increased therapeutic possibilities for endoscopists. While primarily limited to case reports and series, the over-the-scope clip successfully manages gastrointestinal bleeding, perforations, as well as postoperative leaks and fistulas. Retrospective studies have demonstrated a relatively high success rate and a low complication rate. Given the similarity to variceal banding equipment, the learning curve with the over-the-scope clip is rapid. However, given the higher risk of procedures involving the use of the over-the-scope clip, it is essential to obtain the scope in a stable position and grasp sufficient tissue with the cap using a grasping tool and/or suction. From our experience, while closure may be successful in lesions sized up to 3 cm, successful outcomes are obtained for lesions sized <1 cm. Ultimately, given the limited available data, prospective randomized trials are needed to better evaluate the utility of the over-the-scope clip in various clinical scenarios, including fistula and perforation management.

Citations

Citations to this article as recorded by  
  • A Multicenter Survey of Percutaneous Endoscopic Gastrostomy in 2019 at Korean Medical Institutions
    Jun Woo Park, Tae Gyun Kim, Kwang Bum Cho, Jeong Seok Kim, Jin Woong Cho, Jung Won Jeon, Sun Gyo Lim, Chan Gyoo Kim, Hong Jun Park, Tae Jun Kim, Eun Sun Kim, Su Jin Jeong, Yong Hwan Kwon
    Gut and Liver.2024; 18(1): 77.     CrossRef
  • Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
    Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
    Gut and Liver.2024; 18(1): 10.     CrossRef
  • Use of anchor pronged clips to close complex polyp resection defects
    Mike Tzuhen Wei, Shai Friedland
    VideoGIE.2023; 8(6): 245.     CrossRef
  • Novel endoscopic management of gastroenterological anastomosis leakage by injecting gel-forming solutions: an experimental animal study
    Yusuke Watanabe, Keiko Yamamoto, Zijian Yang, Haruna Tsuchibora, Masakazu Fujii, Masayoshi Ono, Shoko Ono, Takayuki Kurokawa, Naoya Sakamoto
    Surgical Endoscopy.2023; 37(10): 8029.     CrossRef
  • Clinical practice guidelines for percutaneous endoscopic gastrostomy
    Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
    Clinical Endoscopy.2023; 56(4): 391.     CrossRef
  • Management of complications related to colorectal endoscopic submucosal dissection
    Tae-Geun Gweon, Dong-Hoon Yang
    Clinical Endoscopy.2023; 56(4): 423.     CrossRef
  • Gastroesophageal Reflux Disease in Obesity: Bariatric Surgery as Both the Cause and the Cure in the Morbidly Obese Population
    Muaaz Masood, Donald Low, Shanley B. Deal, Richard A. Kozarek
    Journal of Clinical Medicine.2023; 12(17): 5543.     CrossRef
  • Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
    Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
    The Korean Journal of Gastroenterology.2023; 82(3): 107.     CrossRef
  • Endoscopic Management of Esophageal Cancer
    Christopher Paiji, Alireza Sedarat
    Cancers.2022; 14(15): 3583.     CrossRef
  • Use of a novel dual-action clip for closure of complex endoscopic resection defects
    Mike Tzuhen Wei, Shai Friedland
    VideoGIE.2022; 7(11): 389.     CrossRef
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Focused Review Series: Recent Updates on the Role of EUS in Pancreatobiliary Disease
What You Need to Know Before Performing Endoscopic Ultrasound-guided Hepaticogastrostomy
Tanyaporn Chantarojanasiri, Thawee Ratanachu-Ek, Nonthalee Pausawasdi
Clin Endosc 2021;54(3):301-308.   Published online May 28, 2021
DOI: https://doi.org/10.5946/ce.2021.103
AbstractAbstract PDFPubReaderePub
Endoscopic retrograde cholangiopancreatography (ERCP) is the primary treatment modality for bile duct obstruction. When ERCP is unsuccessful, percutaneous transhepatic biliary drainage can be an alternative method. Endoscopic ultrasound-guided biliary drainage (EUS-BD) has emerged as a treatment option for biliary obstruction, especially after ERCP failure. EUS-BD offers transluminal intrahepatic and extrahepatic drainage through a transgastric and transduodenal approach. EUS-guided hepaticogastrostomy (EUS-HGS) is an excellent choice for patients with hilar strictures or those with a surgically altered anatomy. The optimal steps in EUS-HGS are case selection, bile duct visualization, puncture-site selection, wire insertion and manipulation, tract dilation, and stent placement. Caution should be taken at each step to prevent complications. Dedicated devices for EUS-HGS have been developed to improve the technical success rate and reduce complications. This technical review focuses on the essential practical points at each step of EUS-HGS.

Citations

Citations to this article as recorded by  
  • Use of a novel screw-type dilator for endoscopic ultrasonography-guided hepaticogastrostomy via 22-gauge needle and 0.018-inch guidewire.
    Shin Kato, Mariko Tsukamoto, Taichi Murai, Yuta Koike
    Revista Española de Enfermedades Digestivas.2024;[Epub]     CrossRef
  • Transbulbäre und transgastrale Gallengangsdrainage
    Philipp Thies, Markus Dollhopf
    Gastroenterologie up2date.2024; 20(01): 69.     CrossRef
  • Safety of endoscopic ultrasound-guided hepaticogastrostomy in patients with malignant biliary obstruction and ascites
    Tsukasa Yasuda, Kazuo Hara, Nobumasa Mizuno, Shin Haba, Takamichi Kuwahara, Nozomi Okuno, Yasuhiro Kuraishi, Takafumi Yanaidani, Sho Ishikawa, Masanori Yamada, Toshitaka Fukui
    Clinical Endoscopy.2024; 57(2): 246.     CrossRef
  • Risk factors for recurrent stenosis after balloon dilation for benign hepaticojejunostomy anastomotic stricture
    Takafumi Mie, Takashi Sasaki, Takeshi Okamoto, Tsuyoshi Takeda, Chinatsu Mori, Yuto Yamada, Takaaki Furukawa, Akiyoshi Kasuga, Masato Matsuyama, Masato Ozaka, Naoki Sasahira
    Clinical Endoscopy.2024; 57(2): 253.     CrossRef
  • Endoscopic ultrasound-guided intervention for inaccessible papilla in advanced malignant hilar biliary obstruction
    Partha Pal, Sundeep Lakhtakia
    Clinical Endoscopy.2023; 56(2): 143.     CrossRef
  • Liver impaction technique improves technical success rate of guidewire insertion during EUS-guided hepaticogastrostomy (with video)
    Junichi Nakamura, Takeshi Ogura, Saori Ueno, Atsushi Okuda, Nobu Nishioka, Yuki Uba, Mitsuki Tomita, Kimi Bessho, Nobuhiro Hattori, Hiroki Nishikawa
    Therapeutic Advances in Gastroenterology.2023;[Epub]     CrossRef
  • Therapeutic endoscopic ultrasound: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review
    Roy L. J. van Wanrooij, Michiel Bronswijk, Rastislav Kunda, Simon M. Everett, Sundeep Lakhtakia, Mihai Rimbas, Tomas Hucl, Abdenor Badaoui, Ryan Law, Paolo Giorgio Arcidiacono, Alberto Larghi, Marc Giovannini, Mouen A. Khashab, Kenneth F. Binmoeller, Marc
    Endoscopy.2022; 54(03): 310.     CrossRef
  • Practical Tips for Safe and Successful Endoscopic Ultrasound-Guided Hepaticogastrostomy: A State-of-the-Art Technical Review
    Saburo Matsubara, Keito Nakagawa, Kentaro Suda, Takeshi Otsuka, Masashi Oka, Sumiko Nagoshi
    Journal of Clinical Medicine.2022; 11(6): 1591.     CrossRef
  • Prevention of Serious Complications during Endoscopic Ultrasound-Guided Biliary Drainage: A Case-Based Technical Review
    Surinder Singh Rana, Jimil Shah, Harish Bhujade, Ujjwal Gorsi, Mandeep Kang, Rajesh Gupta
    Journal of Digestive Endoscopy.2022; 13(02): 082.     CrossRef
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Case Reports
Endoscopic hemostasis using an over-the-scope clip for massive bleeding after percutaneous endoscopic gastrostomy removal: a case report
Sun Young Moon, Min Kyu Jung, Jun Heo
Clin Endosc 2022;55(3):443-446.   Published online May 25, 2021
DOI: https://doi.org/10.5946/ce.2020.294
AbstractAbstract PDFPubReaderePub
Percutaneous endoscopic gastrostomy (PEG) is a common method for providing long-term enteral nutrition to patients. PEG tube placement and removal are relatively safe; generally, a PEG tube can be removed using gentle traction, and excessive bleeding is rare. The over-the-scope clip system is a new device that can be used for gastrointestinal hemostasis and for closing gastrointestinal fistulae. In the present case, a 68-year-old male patient had to remove the PEG tube because of persistent leakage around the PEG tube. Although it was gently removed using traction, incessant bleeding continued, with a Rockall score of 5 points, even after hemocoagulation was attempted. An over-the-scope clip device was used to achieve hemostasis and fistula closure.

Citations

Citations to this article as recorded by  
  • Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
    Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
    Gut and Liver.2024; 18(1): 10.     CrossRef
  • Clinical practice guidelines for percutaneous endoscopic gastrostomy
    Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
    Clinical Endoscopy.2023; 56(4): 391.     CrossRef
  • Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
    Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
    The Korean Journal of Gastroenterology.2023; 82(3): 107.     CrossRef
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  • 150 Download
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A Gastrobronchial Fistula Secondary to Endoscopic Internal Drainage of a Post-Sleeve Gastrectomy Fluid Collection
Paraskevas Gkolfakis, Marc-André Bureau, Marianna Arvanitakis, Jacques Devière, Daniel Blero
Clin Endosc 2022;55(1):141-145.   Published online April 16, 2021
DOI: https://doi.org/10.5946/ce.2021.033
AbstractAbstract PDFPubReaderePub
A 44-year-old woman underwent sleeve gastrectomy, which was complicated by a leak. She was treated with two sessions of endoscopic internal drainage using plastic double-pigtail stents. Her clinical evolution was favorable, but four months after the initial stent placement, she became symptomatic, and a gastrobronchial fistula with the proximal end of the stents invading the diaphragm was diagnosed. She was treated with antibiotics, plastic stents were removed, and a partially covered metallic esophageal stent was placed. Eleven weeks later, the esophageal stent was removed with no evidence of fistula. Inappropriate stent size, position, stenting duration, and persistence of low-grade inflammation could explain the patient’s symptoms and provide a mechanism for gradual muscle rupture and fistula formation. Although endoscopic internal drainage is usually safe and effective for the management of post-laparoscopic sleeve gastrectomy leaks, close clinical and radiological follow-up is mandatory.

Citations

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  • Management of leakage and fistulas after bariatric surgery
    Stephen A. Firkins, Roberto Simons-Linares
    Best Practice & Research Clinical Gastroenterology.2024; : 101926.     CrossRef
  • Role of Endoscopic Internal Drainage in Treating Gastro-Bronchial and Gastro-Colic Fistula After Sleeve Gastrectomy
    Alessandra D’Alessandro, Giovanni Galasso, Francesco Paolo Zito, Cristiano Giardiello, Fabrizio Cereatti, Roberto Arienzo, Filippo Pacini, Jean-Marc Chevallier, Gianfranco Donatelli
    Obesity Surgery.2022; 32(2): 342.     CrossRef
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Endoscopic Ultrasound-Guided Vascular Therapy for Portoduodenal Fistula
Tanyaporn Chantarojanasiri, Apichet Sirinawasatien, Chalermrat Bunchorntavakul, Aroon Siripun, Sa-ard Treepongkaruna, Thawee Ratanachu-ek
Clin Endosc 2020;53(6):750-753.   Published online February 13, 2020
DOI: https://doi.org/10.5946/ce.2019.167
AbstractAbstract PDFPubReaderePub
Portoenteric fistula is a rare cause of massive upper gastrointestinal bleeding. Most cases can be treated with radiointervention or surgery, but portoenteric fistula is associated with a high mortality. We reported a case of intermittent massive upper gastrointestinal bleeding in a 33-year-old man with cholangiocarcinoma who underwent surgical resection followed by chemoradiation. A portoduodenal fistula due to chronic duodenal ulceration was identified. The bleeding was successfully controlled by endoscopic ultrasound-guided coil placement through the duodenal bulb using the anchoring technique. Follow-up endoscopy and computed tomography scan showed multiple coil placements between a part of the portal vein and the duodenal bulb without any evidence of portal vein thrombosis. There were no complications, and bleeding did not recur during the 8-month follow-up period.

Citations

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  • Management of non-variceal upper gastrointestinal bleeding: role of endoscopic ultrasound-guided treatments
    Chaoqun Han, Xin Ling, Jun Liu, Rong Lin, Zhen Ding
    Therapeutic Advances in Gastroenterology.2022; 15: 175628482110561.     CrossRef
  • A Case of an Internal Pancreatic Stent Penetrating the Portal Vein after Pancreaticoduodenectomy for Ampullary Carcinoma
    Masanobu Taniguchi, Atsushi Mitsunaka, Yumi Zen, Takayuki Higashiguchi, Masaru Nagato, Yasuhisa Tango, Ichiro Nakamura, Tomoaki Nakamura, Hisanori Shiomi
    The Japanese Journal of Gastroenterological Surgery.2022; 55(2): 99.     CrossRef
  • Endoscopic ultrasound-guided portal vein coiling: troubleshooting interventional endoscopic ultrasonography
    Shin Haba, Kazuo Hara, Nobumasa Mizuno, Takamichi Kuwahara, Nozomi Okuno, Akira Miyano, Daiki Fumihara, Moaz Elshair
    Clinical Endoscopy.2022; 55(3): 458.     CrossRef
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Successful Closure of a Benign Refractory Tracheoesophageal Fistula Using an Over-the-Scope Clip after Failed Esophageal Stent Placement and Surgical Management
Nonthalee Pausawasdi, Chotirot Angkurawaranon, Tanyaporn Chantarojanasiri, Arunchai Chang, Wanchai Wongkornrat, Somchai Leelakusolvong, Asada Methasate
Clin Endosc 2020;53(3):361-365.   Published online October 28, 2019
DOI: https://doi.org/10.5946/ce.2019.106
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Tracheoesophageal fistulas (TEFs) have traditionally been managed surgically, but the endoscopic approach is widely performed as a less invasive alternative. Different closure techniques have been proposed with inconsistent results. An over-the-scope clip (OTSC) appears to be a reasonable option, but long-term results have not been well defined. We report the long-term outcomes of a complex case of successful closure of a benign refractory TEF using an OTSC after failed surgical management and esophageal stent placement.

Citations

Citations to this article as recorded by  
  • Successful Closure of a Tracheoesophageal Fistula Using an Over-The-Scope Clip
    Osman Ali, Gurbani Singh, Sindhura Kolachana, Mohammed a Khan, Varun Kesar
    Cureus.2023;[Epub]     CrossRef
  • Over-the-Scope Clip Closure of Persistent Gastrocutaneous Fistula After Percutaneous Endoscopic Gastrostomy Tube Removal: A Report of Two Cases
    Shigenori Masaki, Keishi Yamada
    Cureus.2021;[Epub]     CrossRef
  • Over-the-Scope Clip-Associated Endoscopic Muscular Dissection for Seven Cases of Small Gastric Submucosal Tumor: A Video-Based Case Series
    Xin Li, Rongfen Wei, Jianfu Qin, Fei Qin, Peng Peng, Mengbin Qin, Shiquan Liu, Jiean Huang, Piero Chirletti
    Gastroenterology Research and Practice.2021; 2021: 1.     CrossRef
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  • 3 Web of Science
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Review
Role of Cardiac Septal Occluders in the Treatment of Gastrointestinal Fistulas: A Systematic Review
Diogo Turiani Hourneaux De Moura, Alberto Baptista, Pichamol Jirapinyo, Eduardo Guimarães Hourneaux De Moura, Christopher Thompson
Clin Endosc 2020;53(1):37-48.   Published online July 9, 2019
DOI: https://doi.org/10.5946/ce.2019.030
AbstractAbstract PDFPubReaderePub
Treating gastrointestinal (GI) fistulas endoscopically is challenging owing to an established epithelial tract. The variety of endoscopic approaches is transforming endoscopy into a first-line therapy. However, many sessions are often required, with variable success rates. Owing to these limitations, the off-label use of cardiac septal occluders (CSOs) has been reported.
We searched for articles related to CSOs in the MEDLINE, EMBASE, Cochrane Library, and LILACS databases and gray literature. The primary outcomes included technical success, clinical success, and safety of CSOs in GI fistula management.
A total of 25,574 records were identified, and 19 studies ultimately satisfied the inclusion criteria. Technical success was achieved in all cases. Of the 22 fistulas, 77.27% had successful closure, with a mean follow-up period of 32.02 weeks. The adverse event rate was 22.72%, with no associated mortality. Univariable and multivariable regression analyses showed no significant difference in the success of closure and adverse events in relation to several variables among the subgroups.
The use of CSOs appeared to be technically feasible, effective, and safe in the treatment of GI fistulas. The satisfactory results derived from this sparse literature suggest that it can be an option in the management of GI fistulas.

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Original Article
Efficacy of Nasobiliary Tubes and Biliary Stents in Management of Patients with Bile Leak after Liver Transplantation: A Systematic Review
Ali Raza, Anam Omer, Sara Iqbal, Vineet Gudsoorkar, Pramoda Koduru, Kumar Krishnan
Clin Endosc 2019;52(2):159-167.   Published online March 29, 2019
DOI: https://doi.org/10.5946/ce.2018.118
AbstractAbstract PDFPubReaderePub
Background
/Aims: Bile leak is one of the most common complications of liver transplantation. The treatment options for bile leaks include conservative management, surgical re-intervention, percutaneous drainage and endoscopic drainage. We aimed to perform a systematic review to identify the efficacy of endoscopic treatment in the resolution of post-transplant bile leaks. Methods: Two independent reviewers performed systematic literature search in PubMed, ISI Web of Science, grey literature and relevant references in May 2017. Human studies in English with documented post-liver transplant bile leaks were included. Results: Thirty-four studies were included in the final analysis. The pooled efficacy of biliary stents for the resolution of post-transplant bile leaks was 82.43% compared with 87.15% efficacy of nasobiliary tubes. The efficacy of biliary stents was lower for anastomotic leaks (69.23%) compared to T-tube (90.9%) or cut-surface/ cystic duct stump related leaks (92.8%). Similarly, the efficacy of nasobiliary tube was also lower for anastomotic leaks (58.33%) compared to T-tube or cut-surface related leaks (100%). Conclusions: In this systematic review, the overall efficacy was 82.43% in biliary stent group, and 87.15% in nasobiliary tube group. Both biliary stent and nasobiliary tube were more effective in managing non-anastomotic leaks compared to anastomotic leaks.

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    Shigekuni Okumura, Jun Oda, Yousuke Minami, Masaru Hirayama, Kennta Aida
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Case Report
Gastrocolocutaneous Fistula: An Unusual Case of Gastrostomy Tube Malfunction with Diarrhea
Junghwan Lee, Jinyoung Kim, Ha il Kim, Chung Ryul Oh, Sungim Choi, Soomin Noh, Hee Kyong Na, Hwoon-Yong Jung
Clin Endosc 2018;51(2):196-200.   Published online August 31, 2017
DOI: https://doi.org/10.5946/ce.2017.062
AbstractAbstract PDFPubReaderePub
A gastrocolocutaneous fistula is a rare complication of percutaneous endoscopic gastrostomy (PEG). We report a case of a gastrocolocutaneous fistula presenting with intractable diarrhea and gastrostomy tube malfunction. A 62-year-old woman with a history of multiple system atrophy was referred to us because of PEG tube malfunction. Twenty days prior to presentation, the patient started developing sudden diarrhea within minutes after starting PEG feeding. Fluoroscopy revealed that the balloon of the PEG tube was located in the lumen of the transverse colon with the contrast material filling the colon. Subsequently, the PEG tube was removed and the opening of the gastric site was endoscopically closed using hemoclips. Clinicians should be aware of gastrocolocutaneous fistula as one of the complications of PEG insertion. Sudden onset of diarrhea, immediately after PEG feedings, might suggest this complication, which can be effectively treated with endoscopic closure.

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  • A Rare Case of Severe Diarrhea: Gastrocolic Fistula Caused by Migration of Percutaneous Endoscopic Gastrostomy Tube
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    David Viso Vidal, Francisco Jorquera Plaza
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    Maha Al Shaibi, Mohamed Al Abri, Ghaitha Al Mahruqi, Alok Mittal
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    Matthew Warner, Muhammad Durrani
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    Ghadeer Alhazmi, Mroj Alsabri, Shahad Alsuwat, Adnan Al-Zangabi, Abdulaziz Al-Zahrani, Mohammed Kareemulla Shariff
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    Gonçalo Nunes, Gabriel Paiva de Oliveira, João Cruz, Carla Adriana Santos, Jorge Fonseca
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Original Article
Efficacy of the Over-the-Scope Clip System for Treatment of Gastrointestinal Fistulas, Leaks, and Perforations: A Korean Multi-Center Study
Hang Lak Lee, Joo Young Cho, Jun-Hyung Cho, Jong Jae Park, Chan Gyoo Kim, Seong Hwan Kim, Joung-Ho Han
Clin Endosc 2018;51(1):61-65.   Published online August 29, 2017
DOI: https://doi.org/10.5946/ce.2017.027
AbstractAbstract PDFPubReaderePub
Background
/Aims: Currently, a new over-the-scope clip (OTSC) system has been introduced. This system has been used for gastrointestinal perforations and fistulas in other countries. The aim of our study is to examine the therapeutic success rate of endoscopic treatment using the OTSC system in Korea.
Methods
This was a multicenter prospective study. A total of seven endoscopists at seven centers performed this procedure.
Results
A total of 19 patients were included, with gastrointestinal leakages from anastomosis sites, fistulas, or esophageal perforations due to Boerhaave’s syndrome. Among these, there were three gastrojejunostomy sites, three esophagojejunostomy sites, four esophagogastrostomy sites, one esophagocolonostomy site, one jejuno-jejunal site, two endoscopic full thickness resection site closures, one Boerhaave’s syndrome, two esophago-bronchial fistulas, one gastrocolonic fistula, and one colonopseudocyst fistula. The size of the leakage ranged from 5 to 30 mm. The median procedure time was 16 min. All cases were technically successful. Complete closure of the leak was achieved in 14 of 19 patients using OTSC alone.
Conclusions
The OTSC system is a safe and effective method for the management of gastrointestinal leakage, especially in cases of anastomotic leakage after surgery.

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Case Report
Endoscopic Management of Gastrointestinal Leaks and Perforation with Polyglycolic Acid Sheets
Sojung Han, Hyunsoo Chung, Jun Chul Park, Sung Kwan Shin, Sang Kil Lee, Yong Chan Lee
Clin Endosc 2017;50(3):293-296.   Published online March 8, 2017
DOI: https://doi.org/10.5946/ce.2016.121
AbstractAbstract PDFPubReaderePub
Gastrointestinal (GI) leakage, fistulae, and perforations can be serious and life threatening. There has been a paradigm shift in the management approach of these conditions, from surgical to conservative, including endoscopic management. Here, we report two cases of endoscopic closure of a GI fistula and perforation using polyglycolic acid (PGA) sheets with fibrin glue. The first case is of an anastomotic leak detected after subtotal gastrectomy with gastroduodenostomy. After failed application of endoclips, a PGA sheet was applied, and the fistula was successfully closed. The second case was of a 15-mm large perforated gastric ulcer, which was also successfully closed with a PGA sheet. This is the first case report that PGA sheet was used for the treatment of overt perforation. The outcome of these cases suggest that endoscopic closure using PGA sheets can be considered as a useful alternative for the management of GI leakage, fistulae, and perforations.

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  • A Randomized Controlled Trial of Fibrin Glue to Prevent Bleeding After Gastric Endoscopic Submucosal Dissection
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    Soo In Choi, Ji Young Park
    BMJ Case Reports.2021; 14(8): e240188.     CrossRef
  • The treatment for refractory rectovaginal fistula after low anterior resection with estriol, polyglycolic acid sheets and primary closure: A case report
    Masatsugu Hiraki, Toshiya Tanaka, Tadayuki Kanai, Takuya Shimamura, Osamu Ikeda, Makio Yasunaga, Shinichi Ogata, Kenji Kitahara
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    Brian Larson, Douglas G. Adler
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    Hideaki Kawabata, Yuji Okazaki, Naonori Inoue, Yukino Kawakatsu, Misuzu Hitomi, Masatoshi Miyata, Shigehiro Motoi
    Endoscopy International Open.2018; 06(08): E994.     CrossRef
  • Successful Endoscopic Closure Using Polyglycolic Acid Sheets with Fibrin Glue for Nonhealing Duodenal Ulcer with Perforation after Proton Beam Therapy of Liver Tumor
    Ko Watanabe, Takuto Hikichi, Jun Nakamura, Minami Hashimoto, Tadayuki Takagi, Rei Suzuki, Mitsuru Sugimoto, Naoki Konno, Mika Takasumi, Yuki Sato, Hiroki Irie, Takashi Kimura, Akira Kenjo, Shigeru Marubashi, Katsutoshi Obara, Hiromasa Ohira
    Case Reports in Gastroenterology.2018; 12(3): 679.     CrossRef
  • 7,824 View
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Original Article
Endoscopic Management of Gastrointestinal Leaks and Bleeding with the Over-the-Scope Clip: A Prospective Study
Mahesh Kumar Goenka, Vijay Kumar Rai, Usha Goenka, Indrajit Kumar Tiwary
Clin Endosc 2017;50(1):58-63.   Published online October 31, 2016
DOI: https://doi.org/10.5946/ce.2016.028
AbstractAbstract PDFPubReaderePub
Background
/Aims: The over-the-scope clip (OTSC) is a device used for endoscopic closure of perforations, leaks and fistulas, and for endoscopic hemostasis. To evaluate the clinical effectiveness and safety of OTSC.
Methods
Between October 2013 and November 2015, 12 patients underwent OTSC placement by an experienced endoscopist. OTSC was used for the closure of gastrointestinal (GI) leaks and fistula in six patients, three of which were iatrogenic (esophageal, gastric, and duodenal) and three of which were inflammatory. In six patients, OTSC was used for hemostasis of non-variceal upper GI bleeding. Endoscopic tattooing using India ink was used to assist the accurate placement of the clip.
Results
All subjects except one with a colonic defect experienced immediate technical success as well as long-term clinical success, during a mean follow-up of 6 weeks. Only one clip was required to close each of the GI defects and to achieve hemostasis in all patients. There were no misfirings or complications of clips. The procedure was well tolerated, and patients were hospitalized for an average of 8 days (range, 3 to 10). Antiplatelet therapy was continued in patients with GI bleeding.
Conclusions
In our experience, OTSC was safe and effective for the closure of GI defect and to achieve hemostasis of non-variceal GI bleeding.

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  • Over-the-Scope Clip to the Rescue! A Novel Tool for Refractory Acute Nonvariceal Upper Gastrointestinal Hemorrhage
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    Carolina Mangas‐Sanjuan, Belén Martínez-Moreno, Maryana Bozhychko, Luis Compañy, Juan Martinez, Francisco Ruiz, Juan Antonio Casellas, José Ramón Aparicio
    Digestive Endoscopy.2019; 31(6): 712.     CrossRef
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Review
Endoscopic Closure for Full-Thickness Gastrointestinal Defects: Available Applications and Emerging Innovations
Nobuyoshi Takeshita, Khek Yu Ho
Clin Endosc 2016;49(5):438-443.   Published online August 30, 2016
DOI: https://doi.org/10.5946/ce.2016.104
AbstractAbstract PDFPubReaderePub
Full-thickness gastrointestinal defects such as perforation, anastomotic leak, and fistula are severe conditions caused by various types of pathologies. They are more likely to require intensive care and a long hospital stay and have high rates of morbidity and mortality. After intentional full-thickness opening of hollow organs for natural orifice transluminal endoscopic surgery, safe and secure closure is urgently required. The currently available advanced endoscopic closing techniques have a major role in the treatment of full-thickness gastrointestinal defects. Appropriate usage of these techniques requires taking into account their advantages and limitations during practical application. We reviewed the available endoscopic modalities, including endoscopic clips, stents, vacuum-assisted closure, gap filling, and suturing devices, discussed their advantages and limitations when treating full-thickness gastrointestinal defects, and explored emerging innovations, including a novel endoluminal surgical platform for versatile suturing and a cell-laden scaffold for effective gap filling. Although these emerging technologies still require further pre-clinical and clinical trials to assess their feasibility and efficacy, the available modalities may be replaced and refined by these new techniques in the near future.

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    Puja Gaur Khaitan, Amber Famiglietti, Thomas J. Watson
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    Eleanor C. Fung
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Case Reports
Multidrug-Resistant Tuberculous Mediastinal Lymphadenitis, with an Esophagomediastinal Fistula, Mimicking an Esophageal Submucosal Tumor
Dongwuk Kim, Juwon Kim, Daegeun Lee, Ha Sung Chang, Hyunsung Joh, Won-Jung Koh, Jun Haeng Lee
Clin Endosc 2016;49(6):564-569.   Published online April 18, 2016
DOI: https://doi.org/10.5946/ce.2016.020
AbstractAbstract PDFPubReaderePub
Mediastinal tuberculous lymphadenitis rarely mimics esophageal submucosal tumor, particularly in the case of multidrug-resistant tuberculosis (MDR-TB). Herein, we report the case of a 61-year-old woman who visited a local hospital complaining of odynophagia. An initial esophagogastroduodenoscopy revealed an esophageal submucosal tumor, and subsequent chest computed tomography showed subcarinal lymphadenopathy with an esophagomediastinal fistula. The patient was then referred to Samsung Medical Center, and a second esophagogastroduodenoscopy showed deep central ulceration, as well as a suspicious fistula in the esophageal submucosal tumor-like lesion. A biopsy examination of the ulcerative lesion confirmed focal inflammation only. Next, an endobronchial, ultrasound-guided lymph node biopsy was performed, and TB was confirmed. The patient initially began a course of isoniazid, rifampicin, ethambutol, and pyrazinamide. However, after a drug sensitivity test, she was diagnosed with MDR-TB, and second-line anti-TB medications were prescribed. She recovered well subsequently.

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    Tarun Kumar Jain, Hemant Malhotra, Subhash Nepalia, Ganesh Narayan Saxena
    Journal of Nuclear Medicine Technology.2024; 52(2): 179.     CrossRef
  • Esophagomediastinal fistula secondary to tuberculous mediastinal lymphadenopathy
    Ming-Dong Zhou, Dong-Ge Han, Wei Liu
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    Sultan R Alharbi
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    Xi Dai, Bin Niu, Xiao-Qiong Yang, Guo-Ping Li
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    Joonhwan Kim, Youngwoo Jang, Kyung Oh Kim, Yoon Jae Kim, Dong Kyun Park, Dong Hae Chung, Eun Young Kim, Jun-Won Chung
    The Korean Journal of Gastroenterology.2016; 68(6): 312.     CrossRef
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  • 6 Crossref
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Tuberculous Prostatic Abscess with Prostatorectal Fistula after Intravesical Bacillus Calmette-Guérin Immunotherapy
Jeong Ho Eom, Jai Hoon Yoon, Seok Won Lee, Hyo Sun Kim, Tae Young Park, Chang Seok Bang, Gwang Ho Baik, Dong Joon Kim
Clin Endosc 2016;49(5):488-491.   Published online March 15, 2016
DOI: https://doi.org/10.5946/ce.2015.145
AbstractAbstract PDFPubReaderePub
Intravesical bacillus Calmette-Guérin (BCG) immunotherapy is a common treatment modality for bladder cancer after transurethral resection of a bladder tumor. This therapy is generally safe, and development of a prostatic abscess with a prostatorectal fistula after intravesical BCG immunotherapy is a very rare complication. This finding was incidentally obtained by the authors, who examined a patient with colonoscopy for evaluation of abdominal pain. The patient was successfully treated with antitubercular drugs. To the authors’ knowledge, this is the first report of a patient with a tuberculous prostatic abscess with prostatorectal fistula after BCG immunotherapy in South Korea.

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    Yuichi Sugiyama, Atsushi Fujikawa, Shuhei Yokokawa
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    Alexander J Ridgway, Angus Chin-On Luk, Ian Pearce
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    Bin Wang, Ji-Wen Song, Hui-Qing Chen
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    Anne Lenore Ackerman, Pooja S Parameshwar, Jennifer T Anger
    International Journal of Urology.2018; 25(2): 103.     CrossRef
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    Rohit Majumdar, Nancy F. Crum-Cianflone
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    V. V. Potapov, E. V. Brizhatuk
    Herald Urology.2018; 6(2): 21.     CrossRef
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  • 114 Download
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  • 7 Crossref
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Communicating Tubular Esophageal Duplication Combined with Bronchoesophageal Fistula
Ju Hwan Kim, Chang-Il Kwon, Ji Young Rho, Sang Woo Han, Ji Su Kim, Suk Pyo Shin, Ga Won Song, Ki Baik Hahm
Clin Endosc 2016;49(1):81-85.   Published online January 28, 2016
DOI: https://doi.org/10.5946/ce.2016.49.1.81
AbstractAbstract PDFPubReaderePub
Esophageal duplication (ED) is rarely diagnosed in adults and is usually asymptomatic. Especially, ED that is connected to the esophagus through a tubular communication and combined with bronchoesophageal fistula (BEF) is extremely rare and has never been reported in the English literature. This condition is very difficult to diagnose. Although some combinations of several modalities, such as upper gastrointestinal endoscopy, esophagography, computed tomography, magnetic resonance imaging, and endoscopic ultrasonography, can be used for the diagnosis, the results might be inconclusive. Here, we report on a patient with communicating tubular ED that was incidentally diagnosed on the basis of endoscopy and esophagography during the postoperational evaluation of BEF.

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    Xin Yang, Zheng Jiang, Jun Liu, Fei Chen
    Ear, Nose & Throat Journal.2023; : 014556132311734.     CrossRef
  • Tubular Duplication of the Esophagus in a Newborn, Treated by Thoracoscopy
    Igor Khvorostov, Alexey Gusev, Abdumanap Alkhasov, Sergey Yatsyk, Elena D'yakonova
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  • Endoscopic septum division of tubular esophageal duplication in two children and systematic review
    Rahşan Özcan, Ali Ekber Hakalmaz, Şenol Emre, Ayşe Karagöz, Çiğdem Tütüncü, Sebuh Kuruğoğlu, Gonca Topuzlu Tekant
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    Pietro Familiari, Rosario Landi, Francesca Mangiola, Camilla Vittoria Vita, Guido Costamagna
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    A. Francois Trappey, Shinjiro Hirose
    Seminars in Pediatric Surgery.2017; 26(2): 78.     CrossRef
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  • 91 Download
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Successful Palliation of a Malignant Cologastric Fistula with a Covered Self-Expanding Metal Stent
Mathilde Therese Winther Breitenbauch, Anders Tøttrup
Clin Endosc 2015;48(6):576-578.   Published online November 30, 2015
DOI: https://doi.org/10.5946/ce.2015.48.6.576
AbstractAbstract PDFPubReaderePub
When patients present with malignant cologastric fistulas, the tumor stage is often advanced and management is only palliative. We report the case of a 75-year-old man with a symptomatic cologastric fistula arising from an advanced tumor in the transverse colon, previously stented owing to malignant obstruction. An 8-cm-long covered self-expanding metal stent (COMVI enteral colonic stent; Taewoong Medical) was placed inside the primary stent, which sealed the fistula and completely alleviated the symptoms. Considering the successful outcome, we propose that insertion of a covered stent be considered in the palliative management of patients with malignant cologastric fistulas.
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Utility of Over-the-Scope Clipping for Closure of a Persistent Post-Percutaneous Endoscopic Gastrostomy Fistula under Long-Term Steroid Therapy
Yoshihisa Arao, Yuichi Sato, Satoru Hashimoto, Hiroki Honda, Kazumi Yoko, Masaaki Takamura, Ken-ichi Mizuno, Masaaki Kobayashi
Clin Endosc 2015;48(6):563-565.   Published online November 30, 2015
DOI: https://doi.org/10.5946/ce.2015.48.6.563
AbstractAbstract PDFPubReaderePub
A 50-year-old woman had a percutaneous endoscopic gastrostomy (PEG) tube placed after surgery for pharyngeal cancer. After 21 months, the PEG tube was removed due to improvement of per-oral ingestion. She had taken prednisolone for 31 years for systemic lupus erythematosus. The post-PEG fistula did not close spontaneously. The cause of the fistula was slow wound healing and gastrostomy site inflammation due to long-term steroid therapy. We were able to close the fistula with an over-the-scope clipping (OTSC) system. This case suggests that OTSC is useful for closing persistent post-PEG fistulas in patients receiving long-term prednisolone therapy.

Citations

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  • UEG Week 2016 Poster Presentations

    United European Gastroenterology Journal.2016; 4(5_suppl): A157.     CrossRef
  • 9,725 View
  • 66 Download
  • 1 Crossref
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Treatment of Traumatic Esophagopleural Fistula Using the Over-the-Scope-Clip System
Ji Hyoung Kim, Jong-Jae Park, Il Woo Jung, Sang Hoon Kim, Hee Dong Kim, Jung Wan Choe, Moon Kyung Joo, Hyun Gu Kim
Clin Endosc 2015;48(5):440-443.   Published online September 30, 2015
DOI: https://doi.org/10.5946/ce.2015.48.5.440
AbstractAbstract PDFPubReaderePub

Esophagopleural fistula (EPF) is a rare condition that is usually accompanied by severe infection and life-threatening morbidity. Here, we report the successful treatment of an EPF by closing an esophageal orifice using the over-the-scope-clip (OTSC) system without postprocedural complications. A 41-year-old man had serious thoracic and abdominal trauma due to a traffic accident. Computed tomography revealed findings suggestive of esophageal rupture due to Boerhaave syndrome. An emergent explorative operation was performed for primary repair with the insertion of a vacuum-assisted closure device. A postoperative upper gastrointestinal series revealed an EPF tract connecting the left pleural space and distal esophagus. We performed an endoscopic procedure using the "traumatic-type"OTSC to seal the EPF, and the esophageal orifice was completely healed 2 weeks postoperatively. The OTSC system might represent a safe and feasible modality for the treatment of EPF.

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  • A Comprehensive Review of Endoscopic Management of Sleeve Gastrectomy Leaks
    Mihajlo Gjeorgjievski, Zaid Imam, Mitchell S. Cappell, Laith H. Jamil, Michel Kahaleh
    Journal of Clinical Gastroenterology.2021; 55(7): 551.     CrossRef
  • Bevacizumab-induced esophageal pleural fistula during maintenance therapy without radiation in lung cancer
    Ting Wang, Asmitananda Thakur, Baoqing Chen
    BMC Pulmonary Medicine.2021;[Epub]     CrossRef
  • Over-the-Scope Clip Closure of an Esophageal-Pleural Fistula Secondary to Esophageal Stent Placement: A Case Report
    Justin Chuang, Naveena Luke, Khushbu Patel, Jordan Burlen, Ali Nawras
    Cureus.2021;[Epub]     CrossRef
  • Endoluminal vacuum therapy in the management of an esophago-pleural fistula as a complication of Boerhaave syndrome in a patient with eosinophilic esophagitis
    Carlos Tuñon, Juan De Lucas, Jan Cubilla, Rafael Andrade, Miguel Aguirre, Julio Zúñiga Cisneros
    BMC Gastroenterology.2021;[Epub]     CrossRef
  • Komplikationsbeherrschung bei Körperhöhlentrauma
    H. Vogelsang
    Trauma und Berufskrankheit.2017; 19(S1): 88.     CrossRef
  • Endoscopic Approach for Major Complications of Bariatric Surgery
    Moon Kyung Joo
    Clinical Endoscopy.2017; 50(1): 31.     CrossRef
  • Endoscopic clipping of spontaneous esophageal rupture: Case reports of three patients
    Koji Otsuka, Masahiko Murakami, Tomotake Ariyoshi, Takeshi Yamashita, Satoru Goto, Makoto Watanabe, Takeshi Aoki
    International Journal of Surgery Case Reports.2017;[Epub]     CrossRef
  • 7,204 View
  • 72 Download
  • 6 Web of Science
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Cholangitis Secondary to Food Material Impaction in the Common Bile Duct through a Choledochoduodenal Fistula
Bong-Koo Kang, Sung Min Park, Byung-Wook Kim, Joon Sung Kim, Ji Hee Kim, Jeong-Seon Ji, Hwang Choi
Clin Endosc 2015;48(3):265-267.   Published online May 29, 2015
DOI: https://doi.org/10.5946/ce.2015.48.3.265
AbstractAbstract PDFPubReaderePub

Biliary-enteric communications caused by duodenal ulcers are uncommon, and choledochoduodenal fistula (CDF) is by far the most common type. Usually in this situation, food material does not enter the common bile duct because the duodenal lumen is intact. Here, we report a case in which cholangitis occurred due to food materials impacted through a CDF. Duodenal obstruction secondary to duodenal ulcer prevented food passage into the duodenum in this case. Surgical management was recommended; however, the patient refused surgery because of poor general condition. Consequently, the patient expired with sepsis secondary to ascending cholangitis.

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  • Stone-Induced Purulent Choledocoduodenal Fistula Presenting with Ascending Cholangitis
    Christienne Shams, Michael Cannon, Jared Bortman, Seifeldin Hakim
    ACG Case Reports Journal.2018; 5(1): e60.     CrossRef
  • Successful Conservative Treatment of a Cholecystoduodenal Fistula Caused by a Cytomegalovirus-associated Duodenal Ulcer
    Hideki Mori, Moriya Zakimi, Shin Kato, Koki Yamada, Kenji Chinen, Tomiaki Kubota, Masayuki Arashiro, Susumu Shinoura, Kaoru Kikuchi
    Internal Medicine.2016; 55(18): 2617.     CrossRef
  • 6,325 View
  • 64 Download
  • 2 Web of Science
  • 2 Crossref
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Percutaneous Endoscopic Gastrostomy Through the Sinus Tract of a Surgical Gastrostomy
Katerina Kotzampassi, George Stavrou
Clin Endosc 2015;48(1):78-80.   Published online January 31, 2015
DOI: https://doi.org/10.5946/ce.2015.48.1.78
AbstractAbstract PDFPubReaderePub

We present the case of a woman on whom a percutaneous endoscopic gastrostomy (PEG) was performed through the sinus tract of a previous surgical gastrostomy for supraglottic obstructing malignancy. Five years after the induction of the surgical gastrostomy, she experienced a peristomal leakage, leading to severe necrotizing fasciitis, with skin irritation and inflammation. Despite extensive treatment to heal the abdominal wall close to the feeding tube, it recurred 3 months later, without any obvious cause. It was thus decided to perform a new gastrostomy in a nearby normal skin area, but, since it was totally impossible for the endoscope to be passed by mouth, due to obstruction, the sinus tract of the gastrostomy was used to facilitate endoscope insertion into the stomach for a new PEG.

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  • Percutaneous endoscopic gastrostomy through a cervical esophageal fistula. An alternative, much improved technique for patient safety
    George Stavrou, Vassilios Grosomanidis, Anastasia Sarafidou, Gavriil Tsiropoulos, Stefanos Triaridis, Katerina Kotzampassi
    American Journal of Otolaryngology.2020; 41(3): 102408.     CrossRef
  • 5,809 View
  • 51 Download
  • 1 Web of Science
  • 1 Crossref
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Endoscopic Treatment of Various Gastrointestinal Tract Defects with an Over-the-Scope Clip: Case Series from a Tertiary Referral Hospital
Woong Cheul Lee, Weon Jin Ko, Jun-Hyung Cho, Tae Hee Lee, Seong Ran Jeon, Hyun Gun Kim, Joo Young Cho
Clin Endosc 2014;47(2):178-182.   Published online March 31, 2014
DOI: https://doi.org/10.5946/ce.2014.47.2.178
AbstractAbstract PDFPubReaderePub

Recently, increasingly invasive therapeutic endoscopic procedures and more complex gastrointestinal surgeries such as endoscopic mucosal resection, endoscopic submucosal dissection, and novel laparoscopic approaches have resulted in endoscopists being confronted more frequently with perforations, fistulas, and anastomotic leakages, for which nonsurgical closure is desired. In this article, we present our experiences with the use of over-the-scope clip (OTSC) for natural orifice transluminal endoscopic surgery (NOTES) closure, prevention of perforation, anastomotic leakages, and fistula closures. The OTSC is a valuable device for closing intestinal perforations and fistulas, for NOTES closure, and for the prevention of perforation after the excision of a tumor from the proper muscle layer. Furthermore, it seems to be quite safe to perform, even by endoscopists with little experience of the technique.

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  • Experimental Evaluation of the Optimal Suture Pattern With a Flexible Endoscopic Suturing System
    Peter Halvax, Michele Diana, Yoshihiro Nagao, Jacques Marescaux, Lee Swanström
    Surgical Innovation.2017; 24(3): 201.     CrossRef
  • Management of non-acute gastrointestinal defects using the over-the-scope clips (OTSCs): a retrospective single-institution experience
    Joshua S. Winder, Afif N. Kulaylat, Jane R. Schubart, Hassan M. Hal, Eric M. Pauli
    Surgical Endoscopy.2016; 30(6): 2251.     CrossRef
  • Early endoscopic closure of colocutaneous fistula adjacent to unmatured low colorectal anastomosis with the Over-The-Scope Clip (OTSC)
    Constantinos Avgoustou, K. Paraskeva
    Hellenic Journal of Surgery.2016; 88(3): 193.     CrossRef
  • Endoscopic Closure for Full-Thickness Gastrointestinal Defects: Available Applications and Emerging Innovations
    Nobuyoshi Takeshita, Khek Yu Ho
    Clinical Endoscopy.2016; 49(5): 438.     CrossRef
  • 6,131 View
  • 59 Download
  • 3 Web of Science
  • 4 Crossref
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A Case of Spontaneous Esophagopleural Fistula Successfully Treated by Endoscopic Stent Insertion
Gu Hyum Kang, Beom Yong Yoon, Beom Hee Kim, Hee Seok Moon, Hyun Yong Jeong, Jae Kyu Sung, Eaum Seok Lee
Clin Endosc 2013;46(1):91-94.   Published online January 31, 2013
DOI: https://doi.org/10.5946/ce.2013.46.1.91
AbstractAbstract PDFPubReaderePub

The most common cause of esophagorespiratory fistulas (ERFs) is associated with malignancy. The use of self-expandable metal stents is effective for the treatment of malignant ERFs, but benign ERF is rare, which is why its optimal treatment is not defined yet. There have been few reports describing benign esophagopleural fistula and its treatments in South Korea. Here, we report a rare case of spontaneous esophagopleural fistula, which was successfully treated by endoscopic placement of a membrane covered metal stent.

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  • Delayed esophagopleural fistula after endoscopic injection sclerotherapy for esophageal varices
    Mingliang Sui, Weibing Tang, Changjiang Wu, Jinhu Yang, Huiping Liu, Chaofa Huang, Xianzhu Hu, Damei Xia, Yadi Yang
    Medicine.2020; 99(3): e18806.     CrossRef
  • Unusual Presentation of an Esophagopleural Fistula in a Patient With Severe Esophagitis: Blunt Trauma or Iatrogenic?
    Yanting Wang, Oscar A. Rivas Chicas, Anupam Basu
    ACG Case Reports Journal.2019; 6(10): e00240.     CrossRef
  • Tubercular esophago-pleural fistula—a rare case report and review of literature
    Manoj Kumar Pattnaik, Sameer Kumar Panigrahy, Sarada Prasanna Sahoo, Naba Kumar Pattnaik
    Indian Journal of Thoracic and Cardiovascular Surgery.2015; 31(4): 316.     CrossRef
  • Treatment of Esophagopleural Fistulas Using Covered Retrievable Expandable Metallic Stents
    Tae-Hyung Kim, Ji Hoon Shin, Kyung Rae Kim, Jung-Hoon Park, Jin Hyoung Kim, Ho-Young Song
    Journal of Vascular and Interventional Radiology.2014; 25(4): 623.     CrossRef
  • 6,246 View
  • 44 Download
  • 9 Web of Science
  • 4 Crossref
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Aortoenteric Fistula Diagnosed by Double Balloon Enteroscopy: A Case Report
Hyung Geun Yoon, Bong Min Ko, Jae Woong Tae, Su Jin Hong, Jong Ho Moon, Jin Oh Kim, Joon Seong Lee, Moon Sung Lee
Clin Endosc 2013;46(1):106-109.   Published online January 31, 2013
DOI: https://doi.org/10.5946/ce.2013.46.1.106
AbstractAbstract PDFPubReaderePub

A secondary aortoenteric fistula (AEF) is a direct communication between the gastrointestinal tract and the aorta in a patient who has undergone major surgery on the aorta, often an aorta graft operation. We experienced a patient who had undergone graft interposition for abdominal aortic aneurysm and was admitted due to three episodes of hematemesis and following hamatochezia. Gastroscopy, colonoscopy, and radioactive iodine scan failed to identify the bleeding site in the patient. He was diagnosed with AEF by double balloon enteroscopy and recovered after surgical intervention.

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  • Aortic Bulge: A Possible Predictive Sign of Impending Aortoenteric Fistula
    Patrick Kennedy, Sandra Monteiro, Gordon Yip, Fernando Gastaldo
    Canadian Association of Radiologists Journal.2019; 70(2): 204.     CrossRef
  • Editor's Choice – Management of Secondary Aorto-enteric and Other Abdominal Arterio-enteric Fistulas: A Review and Pooled Data Analysis
    S.K. Kakkos, C.D. Bicknell, I.A. Tsolakis, D. Bergqvist
    European Journal of Vascular and Endovascular Surgery.2016; 52(6): 770.     CrossRef
  • 5,755 View
  • 54 Download
  • 2 Crossref
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