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DOI: 10.1055/s-0040-1704788
OVER-THE-SCOPE-CLIP (OTSC) CLOSURE OF AN IATROGENIC GASTRO-COLIC FISTULA FOLLOWING MAL-DEPLOYMENT OF A LUMEN-APPOSING METAL STENT
Publication History
Publication Date:
23 April 2020 (online)
A 44-year-old man with necrotising pancreatitis was referred for EUS-guided drainage of infected 12 × 5 cm symptomatic walled-off-necrosis(WON). At EUS, 20 mm lumen-apposing-metal-stent(LAMS) was deployed through the posterior gastric wall. CT revealed that the LAMS had been inadvertently mal-deployed into the colon.
Endoscopic removal of the LAMS and closure of the resultant gastro-colic-fistula(GCF) by over-the-scope-clip(OTSC) placement was attempted.
Simultaneous upper and lower GI-endoscopy performed under general-anaesthesia. The LAMS was removed and the colonic defect was closed with a 14 mm-OTSC using twin-grasping-forceps tissue apposition, followed by similar closure of gastric defect with two 12 mm-OTSCs.
Successful closure confirmed endoscopically and radiologically with indigo-carmine-dye and contrast.
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