Colonic anastomotic fistula treated by endoscopic over-the-scope clip with fibrin glue

Abstract

Enterocutaneous fistula is a severe complication of gastrointestinal surgery, often associated with abdominal infection, bleeding, malnutrition, and multiple organ dysfunction. Among the early stages of enterocutaneous fistula, the active promotion of spontaneous healing of enterocutaneous fistula is crucial for the treatment of enterocutaneous fistula. Herein, we present a case of enterocutaneous fistula occurring in a 55-year-old Chinese male patient. The patient was operated on by sigmoid diverticulum perforation and underwent partial sigmoid resection and colostomy. Four months later and stoma reversal was done, after which the incision went through repeat infection. He presented to the outpatient department with a sinus tract within the median abdominal incision and pus in abdominal drainage. He was then diagnosed with a colonic anastomotic fistula after computer tomography and fistulography. The successful closure of the fistula confirmed by colonogram was achieved within 2 weeks by the treatment of over-the-scope clip (OTSC) combined with fibrin glue. Our case shows that the approaches of OTSC and fibrin glue are expected to be a promising and novel strategy for treating enterocutaneous fistulas.