COMPLEX GASTRO-CUTANEOUS FISTULA AFTER SEVERE ACUTE PANCREATITIS

52-years-old female with acute severe pancreatitis and multiple intra-abdominal collections. As complications, she developed gastro-cutaneous fistula and duodenal perforation, so placement of three covered self-expandable metal stent (Two Esophagus Bariatric fully covered 28 × 180 mm and one Colon/Rectum fully covered 20 × 100 mm as duodenal stent) was carried out. Endoscopic treatment with acellular pig matrix (PERMACOL) and suture of the gastric defect using of the APOLLO OverStitch system was decided. A guidewire was inserted from the abdominal wall into gastric cavity through the fistula and was extracted through the mouth. The borders were flared with argon gas and endoscopic suture was performed.