Endoscopic Treatment of Postgastrectomy Duodenal Fistula With an Over-the-Scope Clip

Bini, Roberto; Coppola, Franco; Recchia, Serafino; Fusca, Marcella; Gaia, Silvia; Leli, Renzo
March 2011
Surgical Innovation;Mar2011, Vol. 18 Issue 1, p102
Academic Journal
Bleeding peptic ulcer is a life threatening condition with high mortality rate but often treatable by endoscopy. Surgical indications in case of gastroduodenal ulcers are confined to endoscopic and radiological failures in bleeding control. Duodenal fistula (DF) is a rare complication of gastric resection and even if a rare event it may be a life threatening condition. Surgical and medical options could not solve the DF. Herein we report a case of an old patient underwent emergency gastrectomy for ulcer’s bleeding who developed DF associated to sepsis, malnutrition and, hydro-electrolyte disorders not responding to surgical and medical attempts. We demonstrated, for the first time, the efficacy of over the scope clips (OTSC®) in the treatment of postoperative duodenal fistulas not responding to surgical and medical treatment in high risk patient.


Related Articles

  • Endoscopic Management of Gastrointestinal Fistulae. Kumar, Nitin; Larsen, Michael C.; Thompson, Christopher C. // Gastroenterology & Hepatology;Aug2014, Vol. 10 Issue 8, p495 

    A gastrointestinal fistula is a common occurrence, especially after surgery. Patients who develop a fistula may have an infection, surgically altered anatomy, nutritional deficiency, or organ failure, making surgical revision more difficult. With advancements in flexible endoscopic devices and...

  • Two possibly iatrogenic biliary--duodenal fistulas in a single patient after medical and surgical interventions. Maier, Joachim; Rudez, Jasna; Huber, Andreas // Canadian Journal of Surgery;Apr2008 Supplement, Vol. 51, pE28 

    The article presents a case study of an old man treated by an endoscopic injection of polidocanol for recurrent severe bleeding from a duodenal ulcer. A cholangiography was performed which showed a choledochoduodenal fistula distal to the common bile duct stenosis. Another fistula was found...

  • Bouveret's Syndrome: Case Report and Review of the Literature. Doycheva, Iliana; Limaye, Alpna; Suman, Amitabh; Forsmark, Christopher E.; Sultan, Shahnaz // Gastroenterology Research & Practice;2009, Vol. 2009, Special section p1 

    Bouveret's syndrome is defined as gastric outlet obstruction caused by duodenal impaction of a large gallstone which passes into the duodenal bulb through a cholecystogastric or cholecystoduodenal fistula. Initial attempts at endoscopic retrieval with or withoutmechanical or extracorporeal...

  • Combined endoscopic approach in the treatment of benign broncho-oesophageal fistula. De Luca, G; Griffo, S.; Monaco, M.; Fraioli, G.; Di Tommaso, L.; Stassano, P. // Thorax;Nov2008, Vol. 63 Issue 11, p1024 

    The treatment of benign broncho-oesophageal fistula is usually surgical but sometimes other methods of treatment are preferred. The case history is described of an adult in poor general condition in which an endoscopic approach combined with the use of fibrin glue on the bronchial side and...

  • Successful Closure of Lateral Duodenal Perforation by Endoscopic Band Ligation After Endoscopic Clipping Failure. Li, Yue; Han, Zelong; Zhang, Wei; Wang, Xianfei; Li, Aimin; Xu, Yangzhi; Zhou, Dan; Wan, Tianmo; Zhong, Jietao; Mi, Wenting; Liu, Side // American Journal of Gastroenterology;Feb2014, Vol. 109 Issue 2, p293 

    A letter to the editor is presented offering information related to surgical closure of lateral duodenal perforation by endoscopic band ligation after endoscopic clipping failure.

  • Depressed-type, early duodenal carcinoma (carcinoma in situ) treated by endoscopic mucosal resection.  // Journal of Gastroenterology;2003, Vol. 38 Issue 8, p813 

    Presents a letter to the editor about the treatment of duodenal carcinoma by endoscopic mucosal resection.

  • Duodenal Schistosomiasis Diagnosed by Endoscopic Biopsy of an Isolated Polyp. Thatcher, Bryan S.; Fleischer, David; Rankin, George B.; Petras, Robert // American Journal of Gastroenterology;Dec1984, Vol. 79 Issue 12, p927 

    Presents a case of duodenal schistosomiasis diagnosed by endoscopic biopsy. Parasites that caused duodenal schistosomiasis; Symptoms of schistosomiasis; Drugs for the treatment of schistosomiasis.

  • Endoscopic Treatment of a Gastrocutaneous Fistula Using the Over-The-Scope-Clip System: A Case Report. Georgios Kouklakis; Zezos, Petros; Liratzopoulos, Nikolaos; Gatopoulou, Anthia; Oikonomou, Anastasia; Pitiakoudis, Michail; Efremidou, Eleni; Simopoulos, Constantinos // Diagnostic & Therapeutic Endoscopy;2011, p1 

    The over-the-scope-clip (OTSC; Ovesco Endoscopy GmbH, Tuebingen, Germany) system is a newly designed method for the mechanical compression of large areas in the gastrointestinal tract. So far, indications for OTSC application are hemostasis of primary or postinterventional bleeding, closure of...

  • Images of the Month.  // American Journal of Gastroenterology;Sep2011, Vol. 106 Issue 9, p1580 

    The article presents images of fistula orifice and perforated duodenal bulb ulcer from an endoscopic view, and an image of acute esophageal necrosis based from Esophagogastroduodenoscopy.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics