Endoscopy 2019; 51(04): S187-S188
DOI: 10.1055/s-0039-1681725
ESGE Days 2019 ePoster podium presentations
Saturday, April 6, 2019 13:30 – 14:00: Pediatric 1 ePoster Podium 6
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC TREATMENT OF PERSISTENT GASTROCUTANEOUS FISTULA COMBINED WITH TRICHLORACETIC ACID. DESCRIPTION OF A NEW TERAPEUTIC METHOD

F Souza de Macedo
1   Alfa Institute, Federal University of Minas Gerais, Belo Horizonte, Brazil
,
J Andrade Franco Neto
1   Alfa Institute, Federal University of Minas Gerais, Belo Horizonte, Brazil
,
S Diniz Carvalho
1   Alfa Institute, Federal University of Minas Gerais, Belo Horizonte, Brazil
,
PF Souto Bittencourt
1   Alfa Institute, Federal University of Minas Gerais, Belo Horizonte, Brazil
,
V Nunes Arantes
1   Alfa Institute, Federal University of Minas Gerais, Belo Horizonte, Brazil
,
A Rodrigues Ferreira
2   Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Persistent gastrocutaneous fistula is a complication after the removal of the gastrostomy tube. It is reported in 1/3 of patients. Persistent gastrocutaneous fistula is defined by the non-closure of gastrostomy opening after one month. This situation results on abdominal skin burning by the gastric secretion and decreasing quality of life for those patients. This study describes a new method of endoscopic closure of persistent gastrocutaneous fistula using combined endoscopic techniques with trichloracetic acid.

Methods:

This is a descriptive study of two pediatric patients followed up at a tertiary center in Minas Gerais from August 2017 to August 2018 who underwent endoscopic treatment to close the gastrocutaneal fistula with the use of argon plasma scarification, cauterization with trichloroacetic acid and placement of metal clips.

Results:

Two patients were aged between 7 and 17 years. These patients had a gastrocutaneous fistula after 6 and 8 months of gastrostomy removal, with daily gastric drainage. The endoscopic treatment was performed with two sessions of trichloroacetic acid application, combined with the use of argon plasma coagulation and placement of metal clips, presenting good results. Both patients presented fistula closure, with no drainage of the gastric content some days after procedure and without complications.

Conclusion:

Endoscopic therapy for the closure of persistent gastrocutaneous fistulas with the combined use of trichloroacetic acid has been proven effective. This compination is not described in the endoscopic literature. In some studies this technique was already used for the closure of fistulas in bronchoscopy.