Transcutaneous closure of an enterocutaneous fistula using a cardiac septal occluder.

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.