Transcutaneous closure of an enterocutaneous fistula using a cardiac septal occluder

Q3 Medicine

VideoGIE Pub Date : 2025-10-01 DOI:10.1016/j.vgie.2025.05.006

Faisal Nimri MD, Ali Kadouh MD, Taher Jamali MD, Maria Chavarria-Viales MD, Cyrus Piraka MD, Tobias Zuchelli MD

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引用次数: 0

Abstract

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.

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使用心间隔封堵器经皮封闭肠皮瘘

背景和目的皮肤瘘（ECF）是胃肠道和皮肤之间的异常连接，通常通过手术治疗，最近转向内镜关闭。我们提出了一个病例，强调了标签外使用间隔闭塞器，在透视下经皮放置，用于关闭ECF。方法我们报告了一例61岁的女性，她在乙状结肠切除术后进行了回肠袢造口术和姑息性化疗。她的病程因ECF伴大容量渗漏而变得复杂。她被认为不适合做手术，注射胶水和手术治疗都失败了。结果内镜包括顺行和逆行单气囊小肠镜均未能到达瘘口部位。患者接受了超说明书使用间隔闭塞装置的透视ECF闭合。我们报告了一个在透视指导下成功使用隔膜闭塞器关闭难治性ECF的适应症，强调了多学科方法的重要性和在具有挑战性的临床情况下探索创新解决方案的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

VideoGIE Medicine-Gastroenterology

CiteScore

1.50

自引率

0.00%

发文量

132

审稿时长

105 days

期刊介绍： VideoGIE, an official video journal of the American Society for Gastrointestinal Endoscopy, is an Open Access, online-only journal to serve patients with digestive diseases. VideoGIE publishes original, single-blinded peer-reviewed video case reports and case series of endoscopic procedures used in the study, diagnosis, and treatment of digestive diseases. Videos demonstrate use of endoscopic systems, devices, and techniques; report outcomes of endoscopic interventions; and educate physicians and patients about gastrointestinal endoscopy. VideoGIE serves the educational needs of endoscopists in training as well as advanced endoscopists, endoscopy staff and industry, and patients. VideoGIE brings video commentaries from experts, legends, committees, and leadership of the society. Careful adherence to submission guidelines will avoid unnecessary delays, as incomplete submissions may be returned to the authors before initiation of the peer review process.