VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2025
Transcutaneous closure of an enterocutaneous fistula using a cardiac septal occluder.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Nimri Faisal, Kadouh Ali, Jamali Taher, Chavarria-Viales Maria, Piraka Cyrus, Zuchelli Tobias
Аннотация
BACKGROUND AND AIMS: Enterocutaneous fistula (ECF) is an abnormal connection between the gastrointestinal tract and skin, often managed surgically with a recent shift toward endoscopic closure. We are presenting a case highlighting the off-label use of a septal occluder, placed transcutaneously under fluoroscopy, for the closure of an ECF.
METHODS: We are presenting a case of a 61-year-old woman with a history of metastatic colon cancer status post sigmoid resection with loop ileostomy and palliative chemotherapy. Her course was complicated by ECF with high-volume leakage. She was deemed not a surgical candidate and failed glue injections and surgical interventions.
RESULTS: Endoscopy including anterograde and retrograde single balloon enteroscopy failed to reach the fistula site. The patient underwent fluoroscopic ECF closure with off-label use of a septal occluder device.
CONCLUSIONS: We report a successful off-label use of a septal occluder for the closure of a refractory ECF under fluoroscopic guidance with emphasis on the importance of a multidisciplinary approach and the exploration of innovative solutions in challenging clinical scenarios.
METHODS: We are presenting a case of a 61-year-old woman with a history of metastatic colon cancer status post sigmoid resection with loop ileostomy and palliative chemotherapy. Her course was complicated by ECF with high-volume leakage. She was deemed not a surgical candidate and failed glue injections and surgical interventions.
RESULTS: Endoscopy including anterograde and retrograde single balloon enteroscopy failed to reach the fistula site. The patient underwent fluoroscopic ECF closure with off-label use of a septal occluder device.
CONCLUSIONS: We report a successful off-label use of a septal occluder for the closure of a refractory ECF under fluoroscopic guidance with emphasis on the importance of a multidisciplinary approach and the exploration of innovative solutions in challenging clinical scenarios.