Endoscopic closure of fecal colo-cutaneous fistula by using metal clips.

Fecal colo-cutaneous fistula often requires surgical intervention for successful closure increasing the morbidity and mortality associated with this condition. Endoscopic fistula closure can be a less invasive modality. We report successful closure of fecal colo-cutaneous fistula by endoscopic application of metal hemo-clips after failure of prolonged treatment including diverting proximal ileostomy in 2 consecutive patients after emergency primary repair of cecal perforation caused by stab injury of abdomen and iatrogenic fecal fistula after left hemicolectomy and colo-colic anastomosis for adenocarcinoma of descending colon, respectively. The endoscopic closure of fecal colo-cutaneous fistula by using metal clips is an effective, safe, and less invasive treatment modality. It can add to therapeutic armamentarium of surgeons and may obviate the need for additional surgical intervention and associated morbidity in a proportion of such patients.