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Review
Drainage for fluid collections post pancreatic surgery and acute pancreatitis: similar but different?
Yousuke Nakai, Saburo Matsubara, Tsuyoshi Mukai, Tsuyoshi Hamada, Takashi Sasaki, Hirotoshi Ishiwatari, Susumu Hijioka, Hideyuki Shiomi, Mamoru Takenaka, Takuji Iwashita, Atsuhiro Masuda, Tomotaka Saito, Hiroyuki Isayama, Ichiro Yasuda, for the WONDERFUL study group in Japan
Clin Endosc 2024;57(6):735-746.   Published online May 17, 2024
DOI: https://doi.org/10.5946/ce.2023.254
AbstractAbstract PDFPubReaderePub
Postoperative pancreatic fistulas (POPFs) are common adverse events that occur after pancreatic surgery. Endoscopic ultrasonography (EUS)-guided drainage (EUS-D) is a first-line treatment, similar to that for pancreatic fluid collection (PFCs) after acute pancreatitis. However, some POPFs do not develop fluid collections depending on the presence or location of the surgical drain, whereas others develop fluid collections, such as postoperative fluid collections (POPFCs). Although POPFCs are similar to PFCs, the strategy and modality for POPF management need to be modified according to the presence of fluid collections, surgical drains, and surgical type. As discussed for PFCs, the indications, timing, and selection of interventions or stents for EUS-D have not been fully elucidated for POPFs. In this review, we discuss the management of POPFs and POPFCs in comparison with PFCs due to acute pancreatitis and summarize the topics that should be addressed in future studies.

Citations

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  • Management of Postoperative Pancreatic Fluid Collection and Role of Endoscopy: A Case Series and Review of the Literature
    Chiara Coluccio, Ilaria Tarantino, Maria Chiara Petrone, Edoardo Forti, Stefano Francesco Crinò, Alessandro Fugazza, Roberto Di Mitri, Cecilia Binda, Davide Trama, Arnaldo Amato, Alessandro Redaelli, Germana De Nucci, Fabia Attili, Mario Luciano Brancacci
    Diagnostics.2025; 15(10): 1258.     CrossRef
  • Percutaneous mini–invasive interventions in the treatment of peripancreatic fluid accumulation after pancreatic resection
    M. V. Kostylev, V. P. Shkarban, V. I. Trachuk, V. O. Shatalo
    The Ukrainian Journal of Clinical Surgery.2025; 92(3): 20.     CrossRef
  • Acute Necrotizing Pancreatitis—Advances and Challenges in Management for Optimal Clinical Outcomes
    Ioana Dumitrascu, Narcis Octavian Zarnescu, Eugenia Claudia Zarnescu, Mihai Radu Pahomeanu, Alexandru Constantinescu, Dana Galieta Minca, Radu Virgil Costea
    Medicina.2025; 61(7): 1186.     CrossRef
  • Endoscopic ultrasound-guided drainage of a right liver fistula caused by percutaneous thermoablation
    Angelica Toppeta, Jean-Philippe Ratone, Solene Hoibian, Yanis Dahel, Antoine Assaf, Marc Giovannini, Fabrice Caillol
    Endoscopy.2025; 57(S 01): E788.     CrossRef
  • EUS-TD With Multiple Plastic Stents for Postoperative Pancreatic Fistula
    Koichiro Miyagawa, Shinji Oe, Yasuhisa Mori, Tsuyoshi Ueda, Nobuhiko Shinohara, Kosuke Hideshima, Yudai Koya, Yuichi Honma, Masaru Harada
    Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2025;[Epub]     CrossRef
  • 11,784 View
  • 506 Download
  • 3 Web of Science
  • 5 Crossref
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Original Article
Self-expandable metallic stent-induced esophagorespiratory fistulas in patients with advanced esophageal cancer
Iatagan R. Josino, Bruno C. Martins, Andressa A. Machado, Gustavo R. de A. Lima, Martin A. C. Cordero, Amanda A. M. Pombo, Rubens A. A. Sallum, Ulysses Ribeiro Jr, Todd H. Baron, Fauze Maluf-Filho
Clin Endosc 2023;56(6):761-768.   Published online July 25, 2023
DOI: https://doi.org/10.5946/ce.2022.297
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Self-expandable metallic stents (SEMSs) are widely adopted for the palliation of dysphagia in patients with malignant esophageal strictures. An important adverse event is the development of SEMS-induced esophagorespiratory fistulas (SEMS-ERFs). This study aimed to assess the risk factors related to the development of SEMS-ERF after SEMS placement in patients with esophageal cancer.
Methods
This retrospective study was performed at the Instituto do Cancer do Estado de São Paulo. All patients with malignant esophageal strictures who underwent esophageal SEMS placement between 2009 and 2019 were included in the study.
Results
Of the 335 patients, 37 (11.0%) developed SEMS-ERF, with a median time of 129 days after SEMS placement. Stent flare of 28 mm (hazard ratio [HR], 2.05; 95% confidence interval [CI], 1.15–5.51; p=0.02) and post-stent chemotherapy (HR, 2.0; 95% CI, 1.01–4.00; p=0.05) were associated with an increased risk of developing SEMS-ERF, while lower-third tumors were a protective factor (HR, 0.5; 95% CI, 0.26–0.85; p=0.01). No difference was observed in overall survival.
Conclusions
The incidence of SEMS-ERFs was 11%, with a median time of 129 days after SEMS placement. Post-stent chemotherapy and a 28 mm stent flare were associated with a higher risk of SEMS-ERF.

Citations

Citations to this article as recorded by  
  • Efficacy and safety of self-expanding metal stents in advanced esophageal cancer: a 12-year analysis in a referral center
    Bruno Costa Martins, Julia Mayumi Gregorio, Rafael Utimura Sueta, Déborah Marques Centeno, Pastor Joaquín Ortiz Mendieta, Marcelo Simas de Lima, Renata Nobre Moura, Luciano Lenz, Caterina Maria Pia Simioni Pennacchi, Andressa Abnader Machado, Rubens Anton
    Diseases of the Esophagus.2025;[Epub]     CrossRef
  • Clinical Implications of Circulating Tumor Cells in Patients with Esophageal Squamous Cell Carcinoma: Cancer-Draining Blood Versus Peripheral Blood
    Dong Chan Joo, Gwang Ha Kim, Hoseok I, Su Jin Park, Moon Won Lee, Bong Eun Lee
    Cancers.2024; 16(16): 2921.     CrossRef
  • How to reduce fistula formation after self-expandable metallic stent insertion for treating malignant esophageal stricture?
    Kwang Bum Cho
    Clinical Endoscopy.2023; 56(6): 735.     CrossRef
  • 4,395 View
  • 130 Download
  • 3 Web of Science
  • 3 Crossref
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Case Report
Gastric cancer presenting with ramucirumab-related gastrocolic fistula successfully managed by colonic stenting: a case report
Hiroki Fukuya, Yoichiro Iboshi, Masafumi Wada, Yorinobu Sumida, Naohiko Harada, Makoto Nakamuta, Hiroyuki Fujii, Eikichi Ihara
Clin Endosc 2023;56(6):812-816.   Published online May 11, 2023
DOI: https://doi.org/10.5946/ce.2022.117
AbstractAbstract PDFPubReaderePub
We report a rare case of gastric cancer presenting with a gastrocolic fistula during ramucirumab and paclitaxel combination therapy that was successfully managed with colonic stenting. A 75-year-old man was admitted to our hospital with the chief complaint of melena. Esophagogastroduodenoscopy revealed a large ulcerated tumor in the lower stomach, judged by laparoscopy as unresectable (sT4bN1M0). After four cycles of first-line chemotherapy with S-1 plus oxaliplatin, the patient showed disease progression, and second-line therapy with ramucirumab and paclitaxel was started. At the end of the third cycle, the patient had gastric antral stenosis, which necessitated the placement of a gastroduodenal stent. When the patient complained of diarrhea 10 days later, esophagogastroduodenoscopy revealed a fistula between the greater curvature of the stomach and the transverse colon. The fistula was covered by double colonic stenting, with a covered metal stent placed within an uncovered metal stent, after which leakage from the stomach to the colon stopped.

Citations

Citations to this article as recorded by  
  • Ramucirumab

    Reactions Weekly.2024; 1989(1): 189.     CrossRef
  • Metastatic bladder cancer forming a sigmoidorectal fistula after enfortumab vedotin therapy: a case report
    Shinji Tamada, Daiki Ikarashi, Naoki Yanagawa, Moe Toyoshima, Kenta Takahashi, Tomohiko Matsuura, Shigekatsu Maekawa, Renpei Kato, Mitsugu Kanehira, Ryo Takata, Wataru Obara
    Frontiers in Oncology.2023;[Epub]     CrossRef
  • 4,489 View
  • 169 Download
  • 1 Web of Science
  • 2 Crossref
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Original Article
Endoscopic vacuum therapy for treatment of spontaneous and iatrogenic upper gastrointestinal defects
Kavea Panneerselvam, Jake S. Jacob, Ronald E. Samuel, Andy Tau, Gyanprakash A. Ketwaroo, Wasif M. Abidi, Robert J. Sealock
Clin Endosc 2023;56(6):754-760.   Published online May 9, 2023
DOI: https://doi.org/10.5946/ce.2022.177
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Endoscopic vacuum therapy (EVT) can heal a variety of defects within the gastrointestinal (GI) tract via applying negative pressure, which reduces the defect size, aspirates the infected fluid, and promotes granulation tissue. Here we present our experience with EVT as it relates to both spontaneous and iatrogenic upper GI tract perforations, leaks, and fistulas.
Methods
This retrospective study was conducted at four large hospital centers. All patients who underwent EVT between June 2018 and March 2021 were included. Data on multiple variables were collected, including demographics, defect size and location, number and intervals of EVT exchanges, technical success, and hospital length of stay. Student t-test and the chi-squared test were used to analyze the data.
Results
Twenty patients underwent EVT. The most common defect cause was spontaneous esophageal perforation (50%). The most common defect location was the distal esophagus (55%). The success rate was 80%. Seven patients were treated with EVT as the primary closure method. The mean number of exchanges was five with a mean interval of 4.3 days between exchanges. The mean length of hospital stay was 55.8 days.
Conclusions
EVT is a safe and effective initial management option for esophageal leaks and perforations.

Citations

Citations to this article as recorded by  
  • Endoscopic vacuum therapy for gastrointestinal transmural defects: a literature review
    Tan Minh Le, Van Huy Tran, Kyu Sung Chung, Seong Woo Jeon
    Clinical Endoscopy.2025; 58(2): 181.     CrossRef
  • Endoluminal vacuum therapy for upper gastrointestinal leaks: safe, effective and minimally invasive – insights from a retrospective observational study
    María Sánchez-Rodríguez, Laura Monge-Brandi, Javier García-Lledó, Jorge De Tomás, Laura Gómez-Lanz, Miguel Ángel Steiner, Óscar Nogales, Javier Aranda, María Tudela-Lerma
    Surgical Endoscopy.2025;[Epub]     CrossRef
  • Endoscopic vacuum therapy: management of upper gastrointestinal anastomotic leaks and esophageal perforations
    María de Armas Conde, Carmen Díaz-López , Vanessa Concepción-Martín, María Del Pilar Borque-Barrera
    Revista Española de Enfermedades Digestivas.2024;[Epub]     CrossRef
  • Management of fistulas in the upper gastrointestinal tract
    Maria Valeria Matteo, Maria Mihaela Birligea, Vincenzo Bove, Valerio Pontecorvi, Martina De Siena, Loredana Gualtieri, Federico Barbaro, Cristiano Spada, Ivo Boškoski
    Best Practice & Research Clinical Gastroenterology.2024; 70: 101929.     CrossRef
  • Endoscopic Vacuum Therapy of Upper Gastrointestinal Anastomotic Leaks: How to Deal with the Challenges (with Video)
    Laurent Monino, Tom G. Moreels
    Life.2023; 13(6): 1412.     CrossRef
  • 5,132 View
  • 182 Download
  • 5 Web of Science
  • 5 Crossref
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Case Reports
Portal cavernography during endoscopic retrograde cholangiopancreatography: from bilhemia to hemobilia
Rawad A. Yared, Paraskevas Gkolfakis, Arnaud Lemmers, Vincent Huberty, Thierry Degrez, Jacques Devière, Daniel Blero
Clin Endosc 2023;56(4):521-526.   Published online January 5, 2023
DOI: https://doi.org/10.5946/ce.2021.276
AbstractAbstract PDFPubReaderePub
Portobiliary fistulas are rare but may lead to life-threatening complications. Biliary plastic stent-induced portobiliary fistulas during endoscopic retrograde cholangiopancreatography have been described. Herein, we present a case of portal cavernography and recurrent hemobilia after endoscopic retrograde cholangiopancreatography in which a portobiliary fistula was detected in a patient with portal biliopathy. This likely indicates a change in clinical presentation (from bilhemia to hemobilia) after biliary drainage that was successfully treated by placement of a fully covered, self-expandable metallic stent.

Citations

Citations to this article as recorded by  
  • Recognition and management of stent malposition in the portal vein during endoscopic retrograde cholangiopancreatography: A case report
    Rui Wu, Feng Zhang, Hao Zhu, Ming-Dong Liu, Yu-Zheng Zhuge, Lei Wang, Bin Zhang
    World Journal of Gastrointestinal Endoscopy.2024; 16(7): 432.     CrossRef
  • 3,878 View
  • 137 Download
  • 1 Web of Science
  • 1 Crossref
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Bronchoesophageal fistula in a patient with Crohn’s disease receiving anti-tumor necrosis factor therapy
Kyunghwan Oh, Kee Don Choi, Hyeong Ryul Kim, Tae Sun Shim, Byong Duk Ye, Suk-Kyun Yang, Sang Hyoung Park
Clin Endosc 2023;56(2):239-244.   Published online December 21, 2021
DOI: https://doi.org/10.5946/ce.2021.215
AbstractAbstract PDFPubReaderePub
Tuberculosis is an adverse event in patients with Crohn’s disease receiving anti-tumor necrosis factor (TNF) therapy. However, tuberculosis presenting as a bronchoesophageal fistula (BEF) is rare. We report a case of tuberculosis and BEF in a patient with Crohn’s disease who received anti-TNF therapy. A 33-year-old Korean woman developed fever and cough 2 months after initiation of anti-TNF therapy. And the symptoms persisted for 1 months, so she visited the emergency room. Chest computed tomography was performed upon visiting the emergency room, which showed BEF with aspiration pneumonia. Esophagogastroduodenoscopy with biopsy and endobronchial ultrasound with transbronchial needle aspiration confirmed that the cause of BEF was tuberculosis. Anti-tuberculosis medications were administered, and esophageal stent insertion through endoscopy was performed to manage the BEF. However, the patient’s condition did not improve; therefore, fistulectomy with primary closure was performed. After fistulectomy, the anastomosis site healing was delayed due to severe inflammation, a second esophageal stent and gastrostomy tube were inserted. Nine months after the diagnosis, the fistula disappeared without recurrence, and the esophageal stent and gastrostomy tube were removed.

Citations

Citations to this article as recorded by  
  • (Re-)introduction of TNF antagonists and JAK inhibitors in patients with previous tuberculosis: a systematic review
    Thomas Theo Brehm, Maja Reimann, Niklas Köhler, Christoph Lange
    Clinical Microbiology and Infection.2024; 30(8): 989.     CrossRef
  • Azathioprine/infliximab/methylprednisolone

    Reactions Weekly.2023; 1963(1): 114.     CrossRef
  • 6,189 View
  • 285 Download
  • 1 Web of Science
  • 2 Crossref
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Focused Review Series: Endoscopic Management of Postoperative Gastrointestinal Complication: What’s New?
Over-the-Scope Clip in the Treatment of Gastrointestinal Leaks and Perforations
Mike T. Wei, Ji Yong Ahn, Shai Friedland
Clin Endosc 2021;54(6):798-804.   Published online November 30, 2021
DOI: https://doi.org/10.5946/ce.2021.250
AbstractAbstract PDFPubReaderePub
While perforations, postoperative fistulas, and leaks have traditionally led to surgical or interventional radiology consultation for management, the introduction of the over-the-scope clip has allowed increased therapeutic possibilities for endoscopists. While primarily limited to case reports and series, the over-the-scope clip successfully manages gastrointestinal bleeding, perforations, as well as postoperative leaks and fistulas. Retrospective studies have demonstrated a relatively high success rate and a low complication rate. Given the similarity to variceal banding equipment, the learning curve with the over-the-scope clip is rapid. However, given the higher risk of procedures involving the use of the over-the-scope clip, it is essential to obtain the scope in a stable position and grasp sufficient tissue with the cap using a grasping tool and/or suction. From our experience, while closure may be successful in lesions sized up to 3 cm, successful outcomes are obtained for lesions sized <1 cm. Ultimately, given the limited available data, prospective randomized trials are needed to better evaluate the utility of the over-the-scope clip in various clinical scenarios, including fistula and perforation management.

Citations

Citations to this article as recorded by  
  • Advancements in Endoscopic Closure
    Lizeth Cifuentes, Harkirat Singh, Sultan Mahmood
    Gastrointestinal Endoscopy Clinics of North America.2026;[Epub]     CrossRef
  • Over-the-scope clip for postsurgical anastomotic dehiscence and bleeding
    Eduardo Rodríguez-Hernández, Masayoshi Yamada, Takayuki Yamazaki, Shunsuke Tsukamoto, Yutaka Saito
    VideoGIE.2025; 10(1): 57.     CrossRef
  • Treatment of duodenal fistula with combined endoscopic therapy: modified endoscopic vacuum, endoscopic internal drainage, and the over-the-scope clip
    Gustavo de Carvalho Bertaccini Guriam, Thiago de Castro Mendonça Furtado, Rodrigo Chini, Eduardo Garcia Pacheco, Luiza Ochi Delmonaco, Gustavo Murad Pinton, José Antônio Mansur Mendes, Valeria da Costa Santos
    VideoGIE.2025; 10(6): 314.     CrossRef
  • Tack-only fixation of lumen-apposing metal stents: leave the suture at home
    Yara Salameh, Hadi K. Abou Zeid, Kamal Abi Mosleh, Andrew C. Storm
    VideoGIE.2025; 10(10): 524.     CrossRef
  • Detachable over-the-scope clip for colon defects in the trans intestinal natural orifice transluminal endoscopic cholecystolithotomy: A case report
    Pei Li, Rong-Rong Ding, Jiang Liu, Ming-Qing Zhang, Yan Liu
    World Journal of Gastrointestinal Endoscopy.2025;[Epub]     CrossRef
  • Polyglycolic acid-cyanoacrylate complex for prevention of major intestinal anastomotic leakage in a rat model: an experimental animal study
    Chinock Cheong, Hyun Myung Doo, YeonUk Ju, Jun-Woo Bong, Sang-Hee Kang, Sun-Il Lee, Byung Wook Min, You-Jin Jang, Won Jun Seo, Jong-Han Kim
    Annals of Surgical Treatment and Research.2025; 109(5): 335.     CrossRef
  • A Multicenter Survey of Percutaneous Endoscopic Gastrostomy in 2019 at Korean Medical Institutions
    Jun Woo Park, Tae Gyun Kim, Kwang Bum Cho, Jeong Seok Kim, Jin Woong Cho, Jung Won Jeon, Sun Gyo Lim, Chan Gyoo Kim, Hong Jun Park, Tae Jun Kim, Eun Sun Kim, Su Jin Jeong, Yong Hwan Kwon
    Gut and Liver.2024; 18(1): 77.     CrossRef
  • Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
    Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
    Gut and Liver.2024; 18(1): 10.     CrossRef
  • Metabolic and bariatric surgery: an update from 2010
    Bao-Ngoc Nasri, Robert B. Lim, James Ellsmere, Alisha R. Fernandes, Daniel B. Jones
    Current Problems in Surgery.2024; 61(11): 101549.     CrossRef
  • Turn over the new leaf of the treatment in peptic ulcer bleeding: a review of the literature
    Meng-Hsuan Lu, Hsueh-Chien Chiang
    Therapeutic Advances in Gastroenterology.2024;[Epub]     CrossRef
  • Cierre de fistula esófago-yeyunal post operatoria con clips endoscópicos de titanio y over-the-scope clip: reporte de caso
    Lázaro Arango Molano, Andrés Sánchez Gil, Gian Núñez Rojas, Herney Solarte Pineda, Santiago Salazar Ochoa
    Revista de Gastroenterología del Perú.2024; 44(4): 406.     CrossRef
  • Use of anchor pronged clips to close complex polyp resection defects
    Mike Tzuhen Wei, Shai Friedland
    VideoGIE.2023; 8(6): 245.     CrossRef
  • Novel endoscopic management of gastroenterological anastomosis leakage by injecting gel-forming solutions: an experimental animal study
    Yusuke Watanabe, Keiko Yamamoto, Zijian Yang, Haruna Tsuchibora, Masakazu Fujii, Masayoshi Ono, Shoko Ono, Takayuki Kurokawa, Naoya Sakamoto
    Surgical Endoscopy.2023; 37(10): 8029.     CrossRef
  • Clinical practice guidelines for percutaneous endoscopic gastrostomy
    Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
    Clinical Endoscopy.2023; 56(4): 391.     CrossRef
  • Management of complications related to colorectal endoscopic submucosal dissection
    Tae-Geun Gweon, Dong-Hoon Yang
    Clinical Endoscopy.2023; 56(4): 423.     CrossRef
  • Gastroesophageal Reflux Disease in Obesity: Bariatric Surgery as Both the Cause and the Cure in the Morbidly Obese Population
    Muaaz Masood, Donald Low, Shanley B. Deal, Richard A. Kozarek
    Journal of Clinical Medicine.2023; 12(17): 5543.     CrossRef
  • Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
    Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
    The Korean Journal of Gastroenterology.2023; 82(3): 107.     CrossRef
  • Endoscopic Management of Esophageal Cancer
    Christopher Paiji, Alireza Sedarat
    Cancers.2022; 14(15): 3583.     CrossRef
  • Use of a novel dual-action clip for closure of complex endoscopic resection defects
    Mike Tzuhen Wei, Shai Friedland
    VideoGIE.2022; 7(11): 389.     CrossRef
  • 7,868 View
  • 186 Download
  • 12 Web of Science
  • 19 Crossref
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Focused Review Series: Recent Updates on the Role of EUS in Pancreatobiliary Disease
What You Need to Know Before Performing Endoscopic Ultrasound-guided Hepaticogastrostomy
Tanyaporn Chantarojanasiri, Thawee Ratanachu-Ek, Nonthalee Pausawasdi
Clin Endosc 2021;54(3):301-308.   Published online May 28, 2021
DOI: https://doi.org/10.5946/ce.2021.103
AbstractAbstract PDFPubReaderePub
Endoscopic retrograde cholangiopancreatography (ERCP) is the primary treatment modality for bile duct obstruction. When ERCP is unsuccessful, percutaneous transhepatic biliary drainage can be an alternative method. Endoscopic ultrasound-guided biliary drainage (EUS-BD) has emerged as a treatment option for biliary obstruction, especially after ERCP failure. EUS-BD offers transluminal intrahepatic and extrahepatic drainage through a transgastric and transduodenal approach. EUS-guided hepaticogastrostomy (EUS-HGS) is an excellent choice for patients with hilar strictures or those with a surgically altered anatomy. The optimal steps in EUS-HGS are case selection, bile duct visualization, puncture-site selection, wire insertion and manipulation, tract dilation, and stent placement. Caution should be taken at each step to prevent complications. Dedicated devices for EUS-HGS have been developed to improve the technical success rate and reduce complications. This technical review focuses on the essential practical points at each step of EUS-HGS.

Citations

Citations to this article as recorded by  
  • Quality Indicators for EUS
    Girish Mishra, Anne Marie Lennon, Nonthalee Pausawasdi, Vanessa M. Shami, Reem Z. Sharaiha, B. Joseph Elmunzer
    American Journal of Gastroenterology.2025; 120(5): 973.     CrossRef
  • Quality indicators for EUS
    Girish Mishra, Anne Marie Lennon, Nonthalee Pausawasdi, Vanessa M. Shami, Reem Z. Sharaiha, B. Joseph Elmunzer
    Gastrointestinal Endoscopy.2025; 101(5): 928.     CrossRef
  • Technical Review on Endoscopic Ultrasound-Guided Hepaticogastrostomy
    Vivek Kumar Singh, Vinay Dhir
    Journal of Digestive Endoscopy.2025; 16(04): 213.     CrossRef
  • Use of a novel screw-type dilator for endoscopic ultrasonography-guided hepaticogastrostomy via 22-gauge needle and 0.018-inch guidewire.
    Shin Kato, Mariko Tsukamoto, Taichi Murai, Yuta Koike
    Revista Española de Enfermedades Digestivas.2024;[Epub]     CrossRef
  • Transbulbäre und transgastrale Gallengangsdrainage
    Philipp Thies, Markus Dollhopf
    Gastroenterologie up2date.2024; 20(01): 69.     CrossRef
  • Safety of endoscopic ultrasound-guided hepaticogastrostomy in patients with malignant biliary obstruction and ascites
    Tsukasa Yasuda, Kazuo Hara, Nobumasa Mizuno, Shin Haba, Takamichi Kuwahara, Nozomi Okuno, Yasuhiro Kuraishi, Takafumi Yanaidani, Sho Ishikawa, Masanori Yamada, Toshitaka Fukui
    Clinical Endoscopy.2024; 57(2): 246.     CrossRef
  • Risk factors for recurrent stenosis after balloon dilation for benign hepaticojejunostomy anastomotic stricture
    Takafumi Mie, Takashi Sasaki, Takeshi Okamoto, Tsuyoshi Takeda, Chinatsu Mori, Yuto Yamada, Takaaki Furukawa, Akiyoshi Kasuga, Masato Matsuyama, Masato Ozaka, Naoki Sasahira
    Clinical Endoscopy.2024; 57(2): 253.     CrossRef
  • Is Endoscopic Ultrasound-Guided Hepaticogastrostomy Safe and Effective after Failed Endoscopic Retrograde Cholangiopancreatography?—A Systematic Review and Meta-Analysis
    Saqr Alsakarneh, Mahmoud Y. Madi, Dushyant Singh Dahiya, Fouad Jaber, Yassine Kilani, Mohamed Ahmed, Azizullah Beran, Mohamed Abdallah, Omar Al Ta’ani, Anika Mittal, Laith Numan, Hemant Goyal, Mohammad Bilal, Wissam Kiwan
    Journal of Clinical Medicine.2024; 13(13): 3883.     CrossRef
  • EUS-guided hepaticogastrostomy: practical tips and tricks
    Kambiz Kadkhodayan, Shayan Irani
    VideoGIE.2024; 9(9): 417.     CrossRef
  • A Possible Contraindication for Endoscopic Ultrasound-Guided Hepaticogastrostomy: A Giant Hiatal Hernia
    Koichiro Mandai, Shiho Nakamura
    Cureus.2024;[Epub]     CrossRef
  • Endoscopic ultrasound-guided intervention for inaccessible papilla in advanced malignant hilar biliary obstruction
    Partha Pal, Sundeep Lakhtakia
    Clinical Endoscopy.2023; 56(2): 143.     CrossRef
  • Liver impaction technique improves technical success rate of guidewire insertion during EUS-guided hepaticogastrostomy (with video)
    Junichi Nakamura, Takeshi Ogura, Saori Ueno, Atsushi Okuda, Nobu Nishioka, Yuki Uba, Mitsuki Tomita, Kimi Bessho, Nobuhiro Hattori, Hiroki Nishikawa
    Therapeutic Advances in Gastroenterology.2023;[Epub]     CrossRef
  • Therapeutic endoscopic ultrasound: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review
    Roy L. J. van Wanrooij, Michiel Bronswijk, Rastislav Kunda, Simon M. Everett, Sundeep Lakhtakia, Mihai Rimbas, Tomas Hucl, Abdenor Badaoui, Ryan Law, Paolo Giorgio Arcidiacono, Alberto Larghi, Marc Giovannini, Mouen A. Khashab, Kenneth F. Binmoeller, Marc
    Endoscopy.2022; 54(03): 310.     CrossRef
  • Practical Tips for Safe and Successful Endoscopic Ultrasound-Guided Hepaticogastrostomy: A State-of-the-Art Technical Review
    Saburo Matsubara, Keito Nakagawa, Kentaro Suda, Takeshi Otsuka, Masashi Oka, Sumiko Nagoshi
    Journal of Clinical Medicine.2022; 11(6): 1591.     CrossRef
  • Prevention of Serious Complications during Endoscopic Ultrasound-Guided Biliary Drainage: A Case-Based Technical Review
    Surinder Singh Rana, Jimil Shah, Harish Bhujade, Ujjwal Gorsi, Mandeep Kang, Rajesh Gupta
    Journal of Digestive Endoscopy.2022; 13(02): 082.     CrossRef
  • 8,584 View
  • 313 Download
  • 13 Web of Science
  • 15 Crossref
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Case Reports
Endoscopic hemostasis using an over-the-scope clip for massive bleeding after percutaneous endoscopic gastrostomy removal: a case report
Sun Young Moon, Min Kyu Jung, Jun Heo
Clin Endosc 2022;55(3):443-446.   Published online May 25, 2021
DOI: https://doi.org/10.5946/ce.2020.294
AbstractAbstract PDFPubReaderePub
Percutaneous endoscopic gastrostomy (PEG) is a common method for providing long-term enteral nutrition to patients. PEG tube placement and removal are relatively safe; generally, a PEG tube can be removed using gentle traction, and excessive bleeding is rare. The over-the-scope clip system is a new device that can be used for gastrointestinal hemostasis and for closing gastrointestinal fistulae. In the present case, a 68-year-old male patient had to remove the PEG tube because of persistent leakage around the PEG tube. Although it was gently removed using traction, incessant bleeding continued, with a Rockall score of 5 points, even after hemocoagulation was attempted. An over-the-scope clip device was used to achieve hemostasis and fistula closure.

Citations

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  • Life-Threatening Upper Gastrointestinal Bleeding following Percutaneous Endoscopic Gastrostomy Tube Removal under Traction: A Case Report
    Christopher J. Shephard, Xiaomin Ma, Rozemary Karamatic
    Case Reports in Gastroenterology.2025; 20(1): 16.     CrossRef
  • Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
    Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
    Gut and Liver.2024; 18(1): 10.     CrossRef
  • Clinical practice guidelines for percutaneous endoscopic gastrostomy
    Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
    Clinical Endoscopy.2023; 56(4): 391.     CrossRef
  • Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
    Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
    The Korean Journal of Gastroenterology.2023; 82(3): 107.     CrossRef
  • 5,493 View
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A Gastrobronchial Fistula Secondary to Endoscopic Internal Drainage of a Post-Sleeve Gastrectomy Fluid Collection
Paraskevas Gkolfakis, Marc-André Bureau, Marianna Arvanitakis, Jacques Devière, Daniel Blero
Clin Endosc 2022;55(1):141-145.   Published online April 16, 2021
DOI: https://doi.org/10.5946/ce.2021.033
AbstractAbstract PDFPubReaderePub
A 44-year-old woman underwent sleeve gastrectomy, which was complicated by a leak. She was treated with two sessions of endoscopic internal drainage using plastic double-pigtail stents. Her clinical evolution was favorable, but four months after the initial stent placement, she became symptomatic, and a gastrobronchial fistula with the proximal end of the stents invading the diaphragm was diagnosed. She was treated with antibiotics, plastic stents were removed, and a partially covered metallic esophageal stent was placed. Eleven weeks later, the esophageal stent was removed with no evidence of fistula. Inappropriate stent size, position, stenting duration, and persistence of low-grade inflammation could explain the patient’s symptoms and provide a mechanism for gradual muscle rupture and fistula formation. Although endoscopic internal drainage is usually safe and effective for the management of post-laparoscopic sleeve gastrectomy leaks, close clinical and radiological follow-up is mandatory.

Citations

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  • Case Report: Gastro-bronchial fistula complicating a sleeve gastrectomy: from a glimmer of hope to a plight
    Adala Mourad, Adala Ahmed, Siala Rakia, Mseddi Mohamed Ali, Yaakoubi Chaima, Ben Radhia Bechir, Amara Amal, Sallemi Karim, Guizeni Rami, Ghariani Brahim, Sassi Karim, Ben Slima Mohamed
    F1000Research.2025; 14: 948.     CrossRef
  • Case Report: Gastro-bronchial fistula complicating a sleeve gastrectomy: from a glimmer of hope to a plight
    Adala Mourad, Adala Ahmed, Siala Rakia, Mseddi Mohamed Ali, Yaakoubi Chaima, Ben Radhia Bechir, Amara Amal, Sallemi Karim, Guizeni Rami, Ghariani Brahim, Sassi Karim, Ben Slima Mohamed
    F1000Research.2025; 14: 948.     CrossRef
  • Management of leakage and fistulas after bariatric surgery
    Stephen A. Firkins, Roberto Simons-Linares
    Best Practice & Research Clinical Gastroenterology.2024; 70: 101926.     CrossRef
  • Role of Endoscopic Internal Drainage in Treating Gastro-Bronchial and Gastro-Colic Fistula After Sleeve Gastrectomy
    Alessandra D’Alessandro, Giovanni Galasso, Francesco Paolo Zito, Cristiano Giardiello, Fabrizio Cereatti, Roberto Arienzo, Filippo Pacini, Jean-Marc Chevallier, Gianfranco Donatelli
    Obesity Surgery.2022; 32(2): 342.     CrossRef
  • 5,843 View
  • 165 Download
  • 1 Web of Science
  • 4 Crossref
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Endoscopic Ultrasound-Guided Vascular Therapy for Portoduodenal Fistula
Tanyaporn Chantarojanasiri, Apichet Sirinawasatien, Chalermrat Bunchorntavakul, Aroon Siripun, Sa-ard Treepongkaruna, Thawee Ratanachu-ek
Clin Endosc 2020;53(6):750-753.   Published online February 13, 2020
DOI: https://doi.org/10.5946/ce.2019.167
AbstractAbstract PDFPubReaderePub
Portoenteric fistula is a rare cause of massive upper gastrointestinal bleeding. Most cases can be treated with radiointervention or surgery, but portoenteric fistula is associated with a high mortality. We reported a case of intermittent massive upper gastrointestinal bleeding in a 33-year-old man with cholangiocarcinoma who underwent surgical resection followed by chemoradiation. A portoduodenal fistula due to chronic duodenal ulceration was identified. The bleeding was successfully controlled by endoscopic ultrasound-guided coil placement through the duodenal bulb using the anchoring technique. Follow-up endoscopy and computed tomography scan showed multiple coil placements between a part of the portal vein and the duodenal bulb without any evidence of portal vein thrombosis. There were no complications, and bleeding did not recur during the 8-month follow-up period.

Citations

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  • An unusual case of high gastrointestinal bleeding after Whipple surgery
    E Dubois, R Geelen
    Acta Gastro Enterologica Belgica.2024; 87(3): 430.     CrossRef
  • Management of non-variceal upper gastrointestinal bleeding: role of endoscopic ultrasound-guided treatments
    Chaoqun Han, Xin Ling, Jun Liu, Rong Lin, Zhen Ding
    Therapeutic Advances in Gastroenterology.2022;[Epub]     CrossRef
  • A Case of an Internal Pancreatic Stent Penetrating the Portal Vein after Pancreaticoduodenectomy for Ampullary Carcinoma
    Masanobu Taniguchi, Atsushi Mitsunaka, Yumi Zen, Takayuki Higashiguchi, Masaru Nagato, Yasuhisa Tango, Ichiro Nakamura, Tomoaki Nakamura, Hisanori Shiomi
    The Japanese Journal of Gastroenterological Surgery.2022; 55(2): 99.     CrossRef
  • Endoscopic ultrasound-guided portal vein coiling: troubleshooting interventional endoscopic ultrasonography
    Shin Haba, Kazuo Hara, Nobumasa Mizuno, Takamichi Kuwahara, Nozomi Okuno, Akira Miyano, Daiki Fumihara, Moaz Elshair
    Clinical Endoscopy.2022; 55(3): 458.     CrossRef
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Successful Closure of a Benign Refractory Tracheoesophageal Fistula Using an Over-the-Scope Clip after Failed Esophageal Stent Placement and Surgical Management
Nonthalee Pausawasdi, Chotirot Angkurawaranon, Tanyaporn Chantarojanasiri, Arunchai Chang, Wanchai Wongkornrat, Somchai Leelakusolvong, Asada Methasate
Clin Endosc 2020;53(3):361-365.   Published online October 28, 2019
DOI: https://doi.org/10.5946/ce.2019.106
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Tracheoesophageal fistulas (TEFs) have traditionally been managed surgically, but the endoscopic approach is widely performed as a less invasive alternative. Different closure techniques have been proposed with inconsistent results. An over-the-scope clip (OTSC) appears to be a reasonable option, but long-term results have not been well defined. We report the long-term outcomes of a complex case of successful closure of a benign refractory TEF using an OTSC after failed surgical management and esophageal stent placement.

Citations

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  • Endoscopic closure of tracheoesophageal fistula using a novel over-the-scope clip
    Qi Gong, Aihong Yin, Zhi Wei
    Asian Journal of Surgery.2025; 48(5): 3450.     CrossRef
  • Successful closure using Over-the-scope-Clip of an H-type Congenital Esophagobronchial Fistula presenting in an Adult with Recurrent Pneumonia
    L. Laurel, M. Garcia, J. Co, G. Mendoza
    Endoscopy.2024; 56(S 02): S297.     CrossRef
  • Successful Closure of a Tracheoesophageal Fistula Using an Over-The-Scope Clip
    Osman Ali, Gurbani Singh, Sindhura Kolachana, Mohammed a Khan, Varun Kesar
    Cureus.2023;[Epub]     CrossRef
  • Over-the-Scope Clip Closure of Persistent Gastrocutaneous Fistula After Percutaneous Endoscopic Gastrostomy Tube Removal: A Report of Two Cases
    Shigenori Masaki, Keishi Yamada
    Cureus.2021;[Epub]     CrossRef
  • Over-the-Scope Clip-Associated Endoscopic Muscular Dissection for Seven Cases of Small Gastric Submucosal Tumor: A Video-Based Case Series
    Xin Li, Rongfen Wei, Jianfu Qin, Fei Qin, Peng Peng, Mengbin Qin, Shiquan Liu, Jiean Huang, Piero Chirletti
    Gastroenterology Research and Practice.2021; 2021: 1.     CrossRef
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  • 178 Download
  • 4 Web of Science
  • 5 Crossref
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Review
Role of Cardiac Septal Occluders in the Treatment of Gastrointestinal Fistulas: A Systematic Review
Diogo Turiani Hourneaux De Moura, Alberto Baptista, Pichamol Jirapinyo, Eduardo Guimarães Hourneaux De Moura, Christopher Thompson
Clin Endosc 2020;53(1):37-48.   Published online July 9, 2019
DOI: https://doi.org/10.5946/ce.2019.030
AbstractAbstract PDFPubReaderePub
Treating gastrointestinal (GI) fistulas endoscopically is challenging owing to an established epithelial tract. The variety of endoscopic approaches is transforming endoscopy into a first-line therapy. However, many sessions are often required, with variable success rates. Owing to these limitations, the off-label use of cardiac septal occluders (CSOs) has been reported.
We searched for articles related to CSOs in the MEDLINE, EMBASE, Cochrane Library, and LILACS databases and gray literature. The primary outcomes included technical success, clinical success, and safety of CSOs in GI fistula management.
A total of 25,574 records were identified, and 19 studies ultimately satisfied the inclusion criteria. Technical success was achieved in all cases. Of the 22 fistulas, 77.27% had successful closure, with a mean follow-up period of 32.02 weeks. The adverse event rate was 22.72%, with no associated mortality. Univariable and multivariable regression analyses showed no significant difference in the success of closure and adverse events in relation to several variables among the subgroups.
The use of CSOs appeared to be technically feasible, effective, and safe in the treatment of GI fistulas. The satisfactory results derived from this sparse literature suggest that it can be an option in the management of GI fistulas.

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Original Article
Efficacy of Nasobiliary Tubes and Biliary Stents in Management of Patients with Bile Leak after Liver Transplantation: A Systematic Review
Ali Raza, Anam Omer, Sara Iqbal, Vineet Gudsoorkar, Pramoda Koduru, Kumar Krishnan
Clin Endosc 2019;52(2):159-167.   Published online March 29, 2019
DOI: https://doi.org/10.5946/ce.2018.118
AbstractAbstract PDFPubReaderePub
Background
/Aims: Bile leak is one of the most common complications of liver transplantation. The treatment options for bile leaks include conservative management, surgical re-intervention, percutaneous drainage and endoscopic drainage. We aimed to perform a systematic review to identify the efficacy of endoscopic treatment in the resolution of post-transplant bile leaks. Methods: Two independent reviewers performed systematic literature search in PubMed, ISI Web of Science, grey literature and relevant references in May 2017. Human studies in English with documented post-liver transplant bile leaks were included. Results: Thirty-four studies were included in the final analysis. The pooled efficacy of biliary stents for the resolution of post-transplant bile leaks was 82.43% compared with 87.15% efficacy of nasobiliary tubes. The efficacy of biliary stents was lower for anastomotic leaks (69.23%) compared to T-tube (90.9%) or cut-surface/ cystic duct stump related leaks (92.8%). Similarly, the efficacy of nasobiliary tube was also lower for anastomotic leaks (58.33%) compared to T-tube or cut-surface related leaks (100%). Conclusions: In this systematic review, the overall efficacy was 82.43% in biliary stent group, and 87.15% in nasobiliary tube group. Both biliary stent and nasobiliary tube were more effective in managing non-anastomotic leaks compared to anastomotic leaks.

Citations

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  • Application of percutaneous biliary drainage in the treatment of post-operative bile leakage after liver rupture: A case report
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    De-Xin Chen, Kai-Xuan Fang, Sheng-Xin Chen, Sen-Lin Hou, Gui-Hai Wen, Hai-Kun Yang, Da-Peng Shi, Qing-Xin Lu, Ya-Qi Zhai, Ming-Yang Li
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Case Report
Gastrocolocutaneous Fistula: An Unusual Case of Gastrostomy Tube Malfunction with Diarrhea
Junghwan Lee, Jinyoung Kim, Ha il Kim, Chung Ryul Oh, Sungim Choi, Soomin Noh, Hee Kyong Na, Hwoon-Yong Jung
Clin Endosc 2018;51(2):196-200.   Published online August 31, 2017
DOI: https://doi.org/10.5946/ce.2017.062
AbstractAbstract PDFPubReaderePub
A gastrocolocutaneous fistula is a rare complication of percutaneous endoscopic gastrostomy (PEG). We report a case of a gastrocolocutaneous fistula presenting with intractable diarrhea and gastrostomy tube malfunction. A 62-year-old woman with a history of multiple system atrophy was referred to us because of PEG tube malfunction. Twenty days prior to presentation, the patient started developing sudden diarrhea within minutes after starting PEG feeding. Fluoroscopy revealed that the balloon of the PEG tube was located in the lumen of the transverse colon with the contrast material filling the colon. Subsequently, the PEG tube was removed and the opening of the gastric site was endoscopically closed using hemoclips. Clinicians should be aware of gastrocolocutaneous fistula as one of the complications of PEG insertion. Sudden onset of diarrhea, immediately after PEG feedings, might suggest this complication, which can be effectively treated with endoscopic closure.

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    George Stavrou, Persefoni Gionga, George Chatziantoniou, Georgios Tzikos, Alexandra Menni, Stavros Panidis, Anne Shrewsbury, Katerina Kotzampassi
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Original Article
Efficacy of the Over-the-Scope Clip System for Treatment of Gastrointestinal Fistulas, Leaks, and Perforations: A Korean Multi-Center Study
Hang Lak Lee, Joo Young Cho, Jun-Hyung Cho, Jong Jae Park, Chan Gyoo Kim, Seong Hwan Kim, Joung-Ho Han
Clin Endosc 2018;51(1):61-65.   Published online August 29, 2017
DOI: https://doi.org/10.5946/ce.2017.027
AbstractAbstract PDFPubReaderePub
Background
/Aims: Currently, a new over-the-scope clip (OTSC) system has been introduced. This system has been used for gastrointestinal perforations and fistulas in other countries. The aim of our study is to examine the therapeutic success rate of endoscopic treatment using the OTSC system in Korea.
Methods
This was a multicenter prospective study. A total of seven endoscopists at seven centers performed this procedure.
Results
A total of 19 patients were included, with gastrointestinal leakages from anastomosis sites, fistulas, or esophageal perforations due to Boerhaave’s syndrome. Among these, there were three gastrojejunostomy sites, three esophagojejunostomy sites, four esophagogastrostomy sites, one esophagocolonostomy site, one jejuno-jejunal site, two endoscopic full thickness resection site closures, one Boerhaave’s syndrome, two esophago-bronchial fistulas, one gastrocolonic fistula, and one colonopseudocyst fistula. The size of the leakage ranged from 5 to 30 mm. The median procedure time was 16 min. All cases were technically successful. Complete closure of the leak was achieved in 14 of 19 patients using OTSC alone.
Conclusions
The OTSC system is a safe and effective method for the management of gastrointestinal leakage, especially in cases of anastomotic leakage after surgery.

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Case Report
Endoscopic Management of Gastrointestinal Leaks and Perforation with Polyglycolic Acid Sheets
Sojung Han, Hyunsoo Chung, Jun Chul Park, Sung Kwan Shin, Sang Kil Lee, Yong Chan Lee
Clin Endosc 2017;50(3):293-296.   Published online March 8, 2017
DOI: https://doi.org/10.5946/ce.2016.121
AbstractAbstract PDFPubReaderePub
Gastrointestinal (GI) leakage, fistulae, and perforations can be serious and life threatening. There has been a paradigm shift in the management approach of these conditions, from surgical to conservative, including endoscopic management. Here, we report two cases of endoscopic closure of a GI fistula and perforation using polyglycolic acid (PGA) sheets with fibrin glue. The first case is of an anastomotic leak detected after subtotal gastrectomy with gastroduodenostomy. After failed application of endoclips, a PGA sheet was applied, and the fistula was successfully closed. The second case was of a 15-mm large perforated gastric ulcer, which was also successfully closed with a PGA sheet. This is the first case report that PGA sheet was used for the treatment of overt perforation. The outcome of these cases suggest that endoscopic closure using PGA sheets can be considered as a useful alternative for the management of GI leakage, fistulae, and perforations.

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Original Article
Endoscopic Management of Gastrointestinal Leaks and Bleeding with the Over-the-Scope Clip: A Prospective Study
Mahesh Kumar Goenka, Vijay Kumar Rai, Usha Goenka, Indrajit Kumar Tiwary
Clin Endosc 2017;50(1):58-63.   Published online October 31, 2016
DOI: https://doi.org/10.5946/ce.2016.028
AbstractAbstract PDFPubReaderePub
Background
/Aims: The over-the-scope clip (OTSC) is a device used for endoscopic closure of perforations, leaks and fistulas, and for endoscopic hemostasis. To evaluate the clinical effectiveness and safety of OTSC.
Methods
Between October 2013 and November 2015, 12 patients underwent OTSC placement by an experienced endoscopist. OTSC was used for the closure of gastrointestinal (GI) leaks and fistula in six patients, three of which were iatrogenic (esophageal, gastric, and duodenal) and three of which were inflammatory. In six patients, OTSC was used for hemostasis of non-variceal upper GI bleeding. Endoscopic tattooing using India ink was used to assist the accurate placement of the clip.
Results
All subjects except one with a colonic defect experienced immediate technical success as well as long-term clinical success, during a mean follow-up of 6 weeks. Only one clip was required to close each of the GI defects and to achieve hemostasis in all patients. There were no misfirings or complications of clips. The procedure was well tolerated, and patients were hospitalized for an average of 8 days (range, 3 to 10). Antiplatelet therapy was continued in patients with GI bleeding.
Conclusions
In our experience, OTSC was safe and effective for the closure of GI defect and to achieve hemostasis of non-variceal GI bleeding.

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    Clinical Endoscopy.2019; 52(6): 574.     CrossRef
  • Over the Scope Clips for Treatment of Acute Nonvariceal Gastrointestinal Bleeding in Children Are Safe and Effective
    Paul Tran, Joshua Carroll, Bradley A. Barth, Nandini Channabasappa, David M. Troendle
    Journal of Pediatric Gastroenterology and Nutrition.2018; 67(4): 458.     CrossRef
  • Endoscopic titanium clip closure of gastric fistula after splenectomy: A case report
    Jing Yu, Cheng-Ji Zhou, Pan Wang, Shou-Jiang Wei, Jin-Song He, Jin Tang
    World Journal of Clinical Cases.2018; 6(15): 1047.     CrossRef
  • New endoscopic techniques in treating gastrointestinal bleeding
    Young Sin Cho
    International Journal of Gastrointestinal Intervention.2018; 7(3): 131.     CrossRef
  • Over-the-Scope Clip in the Management of Gastrointestinal Defect and Intractable Non-Variceal Bleeding
    Hyungkil Kim
    Clinical Endoscopy.2017; 50(1): 3.     CrossRef
  • Hémorragies digestives : qui ? quand ? place des nouveaux traitements ?
    D. Heresbach, A. Laquière
    Acta Endoscopica.2017; 47(5): 281.     CrossRef
  • Over-the-scope clip
    Bhanwar Singh Dhandhu, Kumar Shwetanshu Narayan, Surinder Sultania, Sandeep Nijhawan
    Journal of Digestive Endoscopy.2016; 07(02): 047.     CrossRef
  • 12,362 View
  • 323 Download
  • 33 Web of Science
  • 32 Crossref
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Review
Endoscopic Closure for Full-Thickness Gastrointestinal Defects: Available Applications and Emerging Innovations
Nobuyoshi Takeshita, Khek Yu Ho
Clin Endosc 2016;49(5):438-443.   Published online August 30, 2016
DOI: https://doi.org/10.5946/ce.2016.104
AbstractAbstract PDFPubReaderePub
Full-thickness gastrointestinal defects such as perforation, anastomotic leak, and fistula are severe conditions caused by various types of pathologies. They are more likely to require intensive care and a long hospital stay and have high rates of morbidity and mortality. After intentional full-thickness opening of hollow organs for natural orifice transluminal endoscopic surgery, safe and secure closure is urgently required. The currently available advanced endoscopic closing techniques have a major role in the treatment of full-thickness gastrointestinal defects. Appropriate usage of these techniques requires taking into account their advantages and limitations during practical application. We reviewed the available endoscopic modalities, including endoscopic clips, stents, vacuum-assisted closure, gap filling, and suturing devices, discussed their advantages and limitations when treating full-thickness gastrointestinal defects, and explored emerging innovations, including a novel endoluminal surgical platform for versatile suturing and a cell-laden scaffold for effective gap filling. Although these emerging technologies still require further pre-clinical and clinical trials to assess their feasibility and efficacy, the available modalities may be replaced and refined by these new techniques in the near future.

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  • Advances in minimally invasive surgical techniques for the management of enterocutaneous fistula: a systematic review of clinical and postoperative outcomes
    Jorge Eduardo Maldonado Lopez, Alfonso Joan Massé Ponce, Andrea Yissel Franco Sánchez, Dario Javier Caguate Miranda, Ronny Ricardo Olalla Alava, Alexander David Silva, José Daniel Nuñez Moreno, Katherine Sandoval Hernández
    International Journal of Research in Medical Sciences.2025;[Epub]     CrossRef
  • Catheter Injectable Multifunctional Biomaterial for the Treatment of Infected Enterocutaneous Fistulas
    Jinjoo Kim, Zefu Zhang, Hassan Albadawi, Hyeongseop Keum, Joseph L. Mayer, Erin H. Graf, Rahmi Oklu
    Advanced Science.2025;[Epub]     CrossRef
  • Injectable nanoengineered adhesive hydrogel for treating enterocutaneous fistulas
    Natan Roberto de Barros, Ankit Gangrade, Ahmad Rashad, RunRun Chen, Fatemeh Zehtabi, Menekse Ermis, Natashya Falcone, Reihaneh Haghniaz, Safoora Khosravi, Alejandro Gomez, Shuyi Huang, Marvin Mecwan, Danial Khorsandi, Junmin Lee, Yangzhi Zhu, Bingbing Li,
    Acta Biomaterialia.2024; 173: 231.     CrossRef
  • What Is New with Cervical Perforations? A Clinical Review Article
    Hope Conrad, Praveen Sridhar
    Thoracic Surgery Clinics.2024; 34(4): 321.     CrossRef
  • Successful Endoscopic Vacuum-Assisted Closure Therapy for Esophageal Perforation: A Case Report
    Jung Huh, Jinsun Yang, Seung Joo Kang, Hyoun Woo Kang, Hyeon Jong Moon, Su Hwan Kim, Bokyung Kim, Ji Won Kim, Kook Lae Lee, Yong Won Seong, Kwang Woo Kim
    The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2024; 24(2): 187.     CrossRef
  • Novel external reinforcement device for gastrointestinal anastomosis in an experimental study
    Hiro Hasegawa, Nobuyoshi Takeshita, Woogi Hyon, Suong-Hyu Hyon, Masaaki Ito
    BMC Surgery.2023;[Epub]     CrossRef
  • Colon Sparing Endoscopic Full-Thickness Resection for Advanced Colorectal Lesions: Is It Time for Global Adoption?
    Zhong-Wei Wu, Chao-Hui Ding, Yao-Dong Song, Zong-Chao Cui, Xiu-Qian Bi, Bo Cheng
    Frontiers in Oncology.2022;[Epub]     CrossRef
  • The Etiology, Diagnosis, and Management of Esophageal Perforation
    Puja Gaur Khaitan, Amber Famiglietti, Thomas J. Watson
    Journal of Gastrointestinal Surgery.2022; 26(12): 2606.     CrossRef
  • Advanced Endoscopic Tools
    Eleanor C. Fung
    Digestive Disease Interventions.2021; 05(02): 194.     CrossRef
  • Repair of upper-GI fistulas and anastomotic leakage by the use of endoluminal vacuum-assisted closure
    Andrew Watson, Tobias Zuchelli
    VideoGIE.2019; 4(1): 40.     CrossRef
  • Effect of poly(3-hydroxyalkanoates) as natural polymers on mesenchymal stem cells
    Vera Voinova, Garina Bonartseva, Anton Bonartsev
    World J Stem Cells.2019; 11(10): 764.     CrossRef
  • Endoscopic Closure of Gastrointestinal Fistulae and Leaks
    Jaehoon Cho, Ara B. Sahakian
    Gastrointestinal Endoscopy Clinics of North America.2018; 28(2): 233.     CrossRef
  • Non-visible colovesical fistula located by cystoscopy and successfully managed with the novel Padlock® device for endoscopic closure
    Benito Velayos, L. Del Olmo, L. Merino, M. Valsero, J. M. González
    International Journal of Colorectal Disease.2018; 33(6): 827.     CrossRef
  • Poly(3-hydroxybutyrate) and Human Microbiota (Review)
    A. P. Bonartsev, V. V. Voinova, G. A. Bonartseva
    Applied Biochemistry and Microbiology.2018; 54(6): 547.     CrossRef
  • Hepatocolic fistula managed with a novel Padlock® device for endoscopic closure
    Benito Velayos Jiménez, Lourdes Del Olmo Martínez, Carmen Alonso Martín, Javier Trueba Arguiñarena, José Manuel González Hernández
    Revista Española de Enfermedades Digestivas.2017;[Epub]     CrossRef
  • Anastomotic leaks in gastrointestinal surgery and their prevention
    Tomasz Banasiewicz, Adam Dziki, Paweł Lampe, Zbigniew Lorenc, Marek Szczepkowski, Jacek Zieliński, Grzegorz Wallner
    Polish Journal of Surgery.2017; 89(2): 49.     CrossRef
  • 12,363 View
  • 203 Download
  • 13 Web of Science
  • 16 Crossref
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Case Reports
Multidrug-Resistant Tuberculous Mediastinal Lymphadenitis, with an Esophagomediastinal Fistula, Mimicking an Esophageal Submucosal Tumor
Dongwuk Kim, Juwon Kim, Daegeun Lee, Ha Sung Chang, Hyunsung Joh, Won-Jung Koh, Jun Haeng Lee
Clin Endosc 2016;49(6):564-569.   Published online April 18, 2016
DOI: https://doi.org/10.5946/ce.2016.020
AbstractAbstract PDFPubReaderePub
Mediastinal tuberculous lymphadenitis rarely mimics esophageal submucosal tumor, particularly in the case of multidrug-resistant tuberculosis (MDR-TB). Herein, we report the case of a 61-year-old woman who visited a local hospital complaining of odynophagia. An initial esophagogastroduodenoscopy revealed an esophageal submucosal tumor, and subsequent chest computed tomography showed subcarinal lymphadenopathy with an esophagomediastinal fistula. The patient was then referred to Samsung Medical Center, and a second esophagogastroduodenoscopy showed deep central ulceration, as well as a suspicious fistula in the esophageal submucosal tumor-like lesion. A biopsy examination of the ulcerative lesion confirmed focal inflammation only. Next, an endobronchial, ultrasound-guided lymph node biopsy was performed, and TB was confirmed. The patient initially began a course of isoniazid, rifampicin, ethambutol, and pyrazinamide. However, after a drug sensitivity test, she was diagnosed with MDR-TB, and second-line anti-TB medications were prescribed. She recovered well subsequently.

Citations

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  • Detection of Esophageal Tuberculosis, a Rare Cause of Abdominal Pain, on18F-FDG PET/CT
    Tarun Kumar Jain, Hemant Malhotra, Subhash Nepalia, Ganesh Narayan Saxena
    Journal of Nuclear Medicine Technology.2024; 52(2): 179.     CrossRef
  • Esophagomediastinal fistula secondary to tuberculous mediastinal lymphadenopathy
    Ming-Dong Zhou, Dong-Ge Han, Wei Liu
    Clinics and Research in Hepatology and Gastroenterology.2023; 47(10): 102243.     CrossRef
  • “Esophagomediastinal fistula presenting as drug resistant tuberculosis”
    Chinnu Sasikumar, Ketaki Utpat, Unnati Desai, Jyotsna M. Joshi
    Indian Journal of Tuberculosis.2020; 67(3): 363.     CrossRef
  • Tuberculous esophagomediastinal fistula with concomitant mediastinal bronchial artery aneurysm-acute upper gastrointestinal bleeding: A case report
    Sultan R Alharbi
    World Journal of Gastroenterology.2019; 25(17): 2144.     CrossRef
  • Combined transbronchoscopic needle aspiration (TBNA) and rapid on-site cytological evaluation (ROSE) for diagnosis of tuberculous mediastinal lymphadenitis
    Xi Dai, Bin Niu, Xiao-Qiong Yang, Guo-Ping Li
    Medicine.2018; 97(37): e11724.     CrossRef
  • Mediastinal Tuberculous Lymphadenitis Diagnosed by Endosonographic Fine Needle Aspiration
    Joonhwan Kim, Youngwoo Jang, Kyung Oh Kim, Yoon Jae Kim, Dong Kyun Park, Dong Hae Chung, Eun Young Kim, Jun-Won Chung
    The Korean Journal of Gastroenterology.2016; 68(6): 312.     CrossRef
  • 13,422 View
  • 132 Download
  • 5 Web of Science
  • 6 Crossref
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Tuberculous Prostatic Abscess with Prostatorectal Fistula after Intravesical Bacillus Calmette-Guérin Immunotherapy
Jeong Ho Eom, Jai Hoon Yoon, Seok Won Lee, Hyo Sun Kim, Tae Young Park, Chang Seok Bang, Gwang Ho Baik, Dong Joon Kim
Clin Endosc 2016;49(5):488-491.   Published online March 15, 2016
DOI: https://doi.org/10.5946/ce.2015.145
AbstractAbstract PDFPubReaderePub
Intravesical bacillus Calmette-Guérin (BCG) immunotherapy is a common treatment modality for bladder cancer after transurethral resection of a bladder tumor. This therapy is generally safe, and development of a prostatic abscess with a prostatorectal fistula after intravesical BCG immunotherapy is a very rare complication. This finding was incidentally obtained by the authors, who examined a patient with colonoscopy for evaluation of abdominal pain. The patient was successfully treated with antitubercular drugs. To the authors’ knowledge, this is the first report of a patient with a tuberculous prostatic abscess with prostatorectal fistula after BCG immunotherapy in South Korea.

Citations

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  • Afebrile tuberculous prostatic abscess with rectal fistula after intravesical Bacillus Calmette‐Guérin immunotherapy
    Tatsuhiro Sawada, Ayaka Igarashi, Seiji Arai, Akira Ohtsu, Yuji Fujizuka, Shun Nakazawa, Yoshitaka Sekine, Hidekazu Koike, Yosuke Furuya, Kazuhiro Suzuki
    IJU Case Reports.2025; 8(1): 69.     CrossRef
  • A case of perforation of the prostatic abscess into the rectum resulting in a rectoprostatic fistula
    Yuichi Sugiyama, Atsushi Fujikawa, Shuhei Yokokawa
    IJU Case Reports.2023; 6(6): 433.     CrossRef
  • Incidental findings in and around the prostate on prostate MRI: a pictorial review
    Janki Trivedi, Tom Sutherland, Mark Page
    Insights into Imaging.2021;[Epub]     CrossRef
  • Prostate abscess: A comprehensive review of the literature
    Alexander J Ridgway, Angus Chin-On Luk, Ian Pearce
    Journal of Clinical Urology.2019; 12(6): 441.     CrossRef
  • Tuberculous prostatic abscess following intravesical bacillus Calmette-Guérin immunotherapy
    Bin Wang, Ji-Wen Song, Hui-Qing Chen
    Chinese Medical Journal.2019; 132(18): 2263.     CrossRef
  • Diagnosis and treatment of patients with prostatic abscess in the post‐antibiotic era
    Anne Lenore Ackerman, Pooja S Parameshwar, Jennifer T Anger
    International Journal of Urology.2018; 25(2): 103.     CrossRef
  • An Unusual Cause of a Prostatic Abscess
    Rohit Majumdar, Nancy F. Crum-Cianflone
    Infectious Diseases in Clinical Practice.2018; 26(3): 175.     CrossRef
  • THE SIGNIFICANCE OF PATHOMORPHOLOGICAL INVESTIGATION IN THE DIAGNOSIS OF PROSTATE TUBERCULOSIS
    V. V. Potapov, E. V. Brizhatuk
    Herald Urology.2018; 6(2): 21.     CrossRef
  • 10,732 View
  • 122 Download
  • 7 Web of Science
  • 8 Crossref
Close layer
Communicating Tubular Esophageal Duplication Combined with Bronchoesophageal Fistula
Ju Hwan Kim, Chang-Il Kwon, Ji Young Rho, Sang Woo Han, Ji Su Kim, Suk Pyo Shin, Ga Won Song, Ki Baik Hahm
Clin Endosc 2016;49(1):81-85.   Published online January 28, 2016
DOI: https://doi.org/10.5946/ce.2016.49.1.81
AbstractAbstract PDFPubReaderePub
Esophageal duplication (ED) is rarely diagnosed in adults and is usually asymptomatic. Especially, ED that is connected to the esophagus through a tubular communication and combined with bronchoesophageal fistula (BEF) is extremely rare and has never been reported in the English literature. This condition is very difficult to diagnose. Although some combinations of several modalities, such as upper gastrointestinal endoscopy, esophagography, computed tomography, magnetic resonance imaging, and endoscopic ultrasonography, can be used for the diagnosis, the results might be inconclusive. Here, we report on a patient with communicating tubular ED that was incidentally diagnosed on the basis of endoscopy and esophagography during the postoperational evaluation of BEF.

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  • Reconstruction of Adult Tubular Esophageal Duplication with Supraclavicular Artery Island Flap: A Rare Case Presentation
    Xin Yang, Zheng Jiang, Jun Liu, Fei Chen
    Ear, Nose & Throat Journal.2025;[Epub]     CrossRef
  • A Rare Case of Esophageal Duplication: A Case Report and Literature Review
    Soufiane Berrichou, Aurélia Bachard, Ana Giordano, Oana Toca, Jean-François Lecompte, Valérie Triolo, Sonanda Bailleux
    European Journal of Medical and Health Sciences.2025; 7(3): 81.     CrossRef
  • Tubular Duplication of the Esophagus in a Newborn, Treated by Thoracoscopy
    Igor Khvorostov, Alexey Gusev, Abdumanap Alkhasov, Sergey Yatsyk, Elena D'yakonova
    European Journal of Pediatric Surgery Reports.2022; 10(01): e49.     CrossRef
  • Endoscopic septum division of tubular esophageal duplication in two children and systematic review
    Rahşan Özcan, Ali Ekber Hakalmaz, Şenol Emre, Ayşe Karagöz, Çiğdem Tütüncü, Sebuh Kuruğoğlu, Gonca Topuzlu Tekant
    Pediatric Surgery International.2022; 38(11): 1525.     CrossRef
  • Endoscopic management of a tubular esophageal duplication in a young adult
    Pietro Familiari, Rosario Landi, Francesca Mangiola, Camilla Vittoria Vita, Guido Costamagna
    VideoGIE.2020; 5(10): 455.     CrossRef
  • Esophageal duplication and congenital esophageal stenosis
    A. Francois Trappey, Shinjiro Hirose
    Seminars in Pediatric Surgery.2017; 26(2): 78.     CrossRef
  • 12,227 View
  • 104 Download
  • 4 Web of Science
  • 6 Crossref
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Successful Palliation of a Malignant Cologastric Fistula with a Covered Self-Expanding Metal Stent
Mathilde Therese Winther Breitenbauch, Anders Tøttrup
Clin Endosc 2015;48(6):576-578.   Published online November 30, 2015
DOI: https://doi.org/10.5946/ce.2015.48.6.576
AbstractAbstract PDFPubReaderePub
When patients present with malignant cologastric fistulas, the tumor stage is often advanced and management is only palliative. We report the case of a 75-year-old man with a symptomatic cologastric fistula arising from an advanced tumor in the transverse colon, previously stented owing to malignant obstruction. An 8-cm-long covered self-expanding metal stent (COMVI enteral colonic stent; Taewoong Medical) was placed inside the primary stent, which sealed the fistula and completely alleviated the symptoms. Considering the successful outcome, we propose that insertion of a covered stent be considered in the palliative management of patients with malignant cologastric fistulas.
  • 8,526 View
  • 50 Download
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Utility of Over-the-Scope Clipping for Closure of a Persistent Post-Percutaneous Endoscopic Gastrostomy Fistula under Long-Term Steroid Therapy
Yoshihisa Arao, Yuichi Sato, Satoru Hashimoto, Hiroki Honda, Kazumi Yoko, Masaaki Takamura, Ken-ichi Mizuno, Masaaki Kobayashi
Clin Endosc 2015;48(6):563-565.   Published online November 30, 2015
DOI: https://doi.org/10.5946/ce.2015.48.6.563
AbstractAbstract PDFPubReaderePub
A 50-year-old woman had a percutaneous endoscopic gastrostomy (PEG) tube placed after surgery for pharyngeal cancer. After 21 months, the PEG tube was removed due to improvement of per-oral ingestion. She had taken prednisolone for 31 years for systemic lupus erythematosus. The post-PEG fistula did not close spontaneously. The cause of the fistula was slow wound healing and gastrostomy site inflammation due to long-term steroid therapy. We were able to close the fistula with an over-the-scope clipping (OTSC) system. This case suggests that OTSC is useful for closing persistent post-PEG fistulas in patients receiving long-term prednisolone therapy.

Citations

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  • UEG Week 2016 Poster Presentations

    United European Gastroenterology Journal.2016; 4(5_suppl): A157.     CrossRef
  • 11,673 View
  • 71 Download
  • 1 Crossref
Close layer
Treatment of Traumatic Esophagopleural Fistula Using the Over-the-Scope-Clip System
Ji Hyoung Kim, Jong-Jae Park, Il Woo Jung, Sang Hoon Kim, Hee Dong Kim, Jung Wan Choe, Moon Kyung Joo, Hyun Gu Kim
Clin Endosc 2015;48(5):440-443.   Published online September 30, 2015
DOI: https://doi.org/10.5946/ce.2015.48.5.440
AbstractAbstract PDFPubReaderePub

Esophagopleural fistula (EPF) is a rare condition that is usually accompanied by severe infection and life-threatening morbidity. Here, we report the successful treatment of an EPF by closing an esophageal orifice using the over-the-scope-clip (OTSC) system without postprocedural complications. A 41-year-old man had serious thoracic and abdominal trauma due to a traffic accident. Computed tomography revealed findings suggestive of esophageal rupture due to Boerhaave syndrome. An emergent explorative operation was performed for primary repair with the insertion of a vacuum-assisted closure device. A postoperative upper gastrointestinal series revealed an EPF tract connecting the left pleural space and distal esophagus. We performed an endoscopic procedure using the "traumatic-type"OTSC to seal the EPF, and the esophageal orifice was completely healed 2 weeks postoperatively. The OTSC system might represent a safe and feasible modality for the treatment of EPF.

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  • Non-surgical resolution of a delayed esophagopleural fistula caused by tuberculous mediastinal lymphadenitis: Diagnostic challenges and therapeutic success
    Duk Ki Kim, Yooyoung Chong, Jeeyeon Baek, Chaeuk Chung
    Diagnostic Microbiology and Infectious Disease.2025; 112(4): 116834.     CrossRef
  • A Comprehensive Review of Endoscopic Management of Sleeve Gastrectomy Leaks
    Mihajlo Gjeorgjievski, Zaid Imam, Mitchell S. Cappell, Laith H. Jamil, Michel Kahaleh
    Journal of Clinical Gastroenterology.2021; 55(7): 551.     CrossRef
  • Bevacizumab-induced esophageal pleural fistula during maintenance therapy without radiation in lung cancer
    Ting Wang, Asmitananda Thakur, Baoqing Chen
    BMC Pulmonary Medicine.2021;[Epub]     CrossRef
  • Over-the-Scope Clip Closure of an Esophageal-Pleural Fistula Secondary to Esophageal Stent Placement: A Case Report
    Justin Chuang, Naveena Luke, Khushbu Patel, Jordan Burlen, Ali Nawras
    Cureus.2021;[Epub]     CrossRef
  • Endoluminal vacuum therapy in the management of an esophago-pleural fistula as a complication of Boerhaave syndrome in a patient with eosinophilic esophagitis
    Carlos Tuñon, Juan De Lucas, Jan Cubilla, Rafael Andrade, Miguel Aguirre, Julio Zúñiga Cisneros
    BMC Gastroenterology.2021;[Epub]     CrossRef
  • Komplikationsbeherrschung bei Körperhöhlentrauma
    H. Vogelsang
    Trauma und Berufskrankheit.2017; 19(S1): 88.     CrossRef
  • Endoscopic Approach for Major Complications of Bariatric Surgery
    Moon Kyung Joo
    Clinical Endoscopy.2017; 50(1): 31.     CrossRef
  • Endoscopic clipping of spontaneous esophageal rupture: Case reports of three patients
    Koji Otsuka, Masahiko Murakami, Tomotake Ariyoshi, Takeshi Yamashita, Satoru Goto, Makoto Watanabe, Takeshi Aoki
    International Journal of Surgery Case Reports.2017;[Epub]     CrossRef
  • 9,251 View
  • 80 Download
  • 7 Web of Science
  • 8 Crossref
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Cholangitis Secondary to Food Material Impaction in the Common Bile Duct through a Choledochoduodenal Fistula
Bong-Koo Kang, Sung Min Park, Byung-Wook Kim, Joon Sung Kim, Ji Hee Kim, Jeong-Seon Ji, Hwang Choi
Clin Endosc 2015;48(3):265-267.   Published online May 29, 2015
DOI: https://doi.org/10.5946/ce.2015.48.3.265
AbstractAbstract PDFPubReaderePub

Biliary-enteric communications caused by duodenal ulcers are uncommon, and choledochoduodenal fistula (CDF) is by far the most common type. Usually in this situation, food material does not enter the common bile duct because the duodenal lumen is intact. Here, we report a case in which cholangitis occurred due to food materials impacted through a CDF. Duodenal obstruction secondary to duodenal ulcer prevented food passage into the duodenum in this case. Surgical management was recommended; however, the patient refused surgery because of poor general condition. Consequently, the patient expired with sepsis secondary to ascending cholangitis.

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  • Stone-Induced Purulent Choledocoduodenal Fistula Presenting with Ascending Cholangitis
    Christienne Shams, Michael Cannon, Jared Bortman, Seifeldin Hakim
    ACG Case Reports Journal.2018; 5(1): e60.     CrossRef
  • Successful Conservative Treatment of a Cholecystoduodenal Fistula Caused by a Cytomegalovirus-associated Duodenal Ulcer
    Hideki Mori, Moriya Zakimi, Shin Kato, Koki Yamada, Kenji Chinen, Tomiaki Kubota, Masayuki Arashiro, Susumu Shinoura, Kaoru Kikuchi
    Internal Medicine.2016; 55(18): 2617.     CrossRef
  • 8,221 View
  • 72 Download
  • 2 Web of Science
  • 2 Crossref
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Percutaneous Endoscopic Gastrostomy Through the Sinus Tract of a Surgical Gastrostomy
Katerina Kotzampassi, George Stavrou
Clin Endosc 2015;48(1):78-80.   Published online January 31, 2015
DOI: https://doi.org/10.5946/ce.2015.48.1.78
AbstractAbstract PDFPubReaderePub

We present the case of a woman on whom a percutaneous endoscopic gastrostomy (PEG) was performed through the sinus tract of a previous surgical gastrostomy for supraglottic obstructing malignancy. Five years after the induction of the surgical gastrostomy, she experienced a peristomal leakage, leading to severe necrotizing fasciitis, with skin irritation and inflammation. Despite extensive treatment to heal the abdominal wall close to the feeding tube, it recurred 3 months later, without any obvious cause. It was thus decided to perform a new gastrostomy in a nearby normal skin area, but, since it was totally impossible for the endoscope to be passed by mouth, due to obstruction, the sinus tract of the gastrostomy was used to facilitate endoscope insertion into the stomach for a new PEG.

Citations

Citations to this article as recorded by  
  • Percutaneous endoscopic gastrostomy through a cervical esophageal fistula. An alternative, much improved technique for patient safety
    George Stavrou, Vassilios Grosomanidis, Anastasia Sarafidou, Gavriil Tsiropoulos, Stefanos Triaridis, Katerina Kotzampassi
    American Journal of Otolaryngology.2020; 41(3): 102408.     CrossRef
  • 7,548 View
  • 57 Download
  • 1 Web of Science
  • 1 Crossref
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Endoscopic Treatment of Various Gastrointestinal Tract Defects with an Over-the-Scope Clip: Case Series from a Tertiary Referral Hospital
Woong Cheul Lee, Weon Jin Ko, Jun-Hyung Cho, Tae Hee Lee, Seong Ran Jeon, Hyun Gun Kim, Joo Young Cho
Clin Endosc 2014;47(2):178-182.   Published online March 31, 2014
DOI: https://doi.org/10.5946/ce.2014.47.2.178
AbstractAbstract PDFPubReaderePub

Recently, increasingly invasive therapeutic endoscopic procedures and more complex gastrointestinal surgeries such as endoscopic mucosal resection, endoscopic submucosal dissection, and novel laparoscopic approaches have resulted in endoscopists being confronted more frequently with perforations, fistulas, and anastomotic leakages, for which nonsurgical closure is desired. In this article, we present our experiences with the use of over-the-scope clip (OTSC) for natural orifice transluminal endoscopic surgery (NOTES) closure, prevention of perforation, anastomotic leakages, and fistula closures. The OTSC is a valuable device for closing intestinal perforations and fistulas, for NOTES closure, and for the prevention of perforation after the excision of a tumor from the proper muscle layer. Furthermore, it seems to be quite safe to perform, even by endoscopists with little experience of the technique.

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  • Gastrointestinale Endoskopie im postoperativen Komplikationsmanagement
    Marcus Kantowski, Gabriel Alexander Salg
    Allgemein- und Viszeralchirurgie up2date.2025; 19(01): 53.     CrossRef
  • Global research trends in endoscopy applications in submucosal tumor: A bibliometric analysis of studies published from 2010-2024
    Ke-Xin Lin, Yan Liu, Li Wang, Pei-Rong Xu, Zu-Qiang Liu, Li-Yun Ma, Jia-Jia Lin, Tao Tan, Ping-Hong Zhou, Hao Hu
    World Journal of Gastrointestinal Oncology.2025;[Epub]     CrossRef
  • Experimental Evaluation of the Optimal Suture Pattern With a Flexible Endoscopic Suturing System
    Peter Halvax, Michele Diana, Yoshihiro Nagao, Jacques Marescaux, Lee Swanström
    Surgical Innovation.2017; 24(3): 201.     CrossRef
  • Management of non-acute gastrointestinal defects using the over-the-scope clips (OTSCs): a retrospective single-institution experience
    Joshua S. Winder, Afif N. Kulaylat, Jane R. Schubart, Hassan M. Hal, Eric M. Pauli
    Surgical Endoscopy.2016; 30(6): 2251.     CrossRef
  • Early endoscopic closure of colocutaneous fistula adjacent to unmatured low colorectal anastomosis with the Over-The-Scope Clip (OTSC)
    Constantinos Avgoustou, K. Paraskeva
    Hellenic Journal of Surgery.2016; 88(3): 193.     CrossRef
  • Endoscopic Closure for Full-Thickness Gastrointestinal Defects: Available Applications and Emerging Innovations
    Nobuyoshi Takeshita, Khek Yu Ho
    Clinical Endoscopy.2016; 49(5): 438.     CrossRef
  • 8,074 View
  • 63 Download
  • 4 Web of Science
  • 6 Crossref
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A Case of Spontaneous Esophagopleural Fistula Successfully Treated by Endoscopic Stent Insertion
Gu Hyum Kang, Beom Yong Yoon, Beom Hee Kim, Hee Seok Moon, Hyun Yong Jeong, Jae Kyu Sung, Eaum Seok Lee
Clin Endosc 2013;46(1):91-94.   Published online January 31, 2013
DOI: https://doi.org/10.5946/ce.2013.46.1.91
AbstractAbstract PDFPubReaderePub

The most common cause of esophagorespiratory fistulas (ERFs) is associated with malignancy. The use of self-expandable metal stents is effective for the treatment of malignant ERFs, but benign ERF is rare, which is why its optimal treatment is not defined yet. There have been few reports describing benign esophagopleural fistula and its treatments in South Korea. Here, we report a rare case of spontaneous esophagopleural fistula, which was successfully treated by endoscopic placement of a membrane covered metal stent.

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    Mingliang Sui, Weibing Tang, Changjiang Wu, Jinhu Yang, Huiping Liu, Chaofa Huang, Xianzhu Hu, Damei Xia, Yadi Yang
    Medicine.2020; 99(3): e18806.     CrossRef
  • Unusual Presentation of an Esophagopleural Fistula in a Patient With Severe Esophagitis: Blunt Trauma or Iatrogenic?
    Yanting Wang, Oscar A. Rivas Chicas, Anupam Basu
    ACG Case Reports Journal.2019; 6(10): e00240.     CrossRef
  • Tubercular esophago-pleural fistula—a rare case report and review of literature
    Manoj Kumar Pattnaik, Sameer Kumar Panigrahy, Sarada Prasanna Sahoo, Naba Kumar Pattnaik
    Indian Journal of Thoracic and Cardiovascular Surgery.2015; 31(4): 316.     CrossRef
  • Treatment of Esophagopleural Fistulas Using Covered Retrievable Expandable Metallic Stents
    Tae-Hyung Kim, Ji Hoon Shin, Kyung Rae Kim, Jung-Hoon Park, Jin Hyoung Kim, Ho-Young Song
    Journal of Vascular and Interventional Radiology.2014; 25(4): 623.     CrossRef
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Aortoenteric Fistula Diagnosed by Double Balloon Enteroscopy: A Case Report
Hyung Geun Yoon, Bong Min Ko, Jae Woong Tae, Su Jin Hong, Jong Ho Moon, Jin Oh Kim, Joon Seong Lee, Moon Sung Lee
Clin Endosc 2013;46(1):106-109.   Published online January 31, 2013
DOI: https://doi.org/10.5946/ce.2013.46.1.106
AbstractAbstract PDFPubReaderePub

A secondary aortoenteric fistula (AEF) is a direct communication between the gastrointestinal tract and the aorta in a patient who has undergone major surgery on the aorta, often an aorta graft operation. We experienced a patient who had undergone graft interposition for abdominal aortic aneurysm and was admitted due to three episodes of hematemesis and following hamatochezia. Gastroscopy, colonoscopy, and radioactive iodine scan failed to identify the bleeding site in the patient. He was diagnosed with AEF by double balloon enteroscopy and recovered after surgical intervention.

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  • Aortic Bulge: A Possible Predictive Sign of Impending Aortoenteric Fistula
    Patrick Kennedy, Sandra Monteiro, Gordon Yip, Fernando Gastaldo
    Canadian Association of Radiologists Journal.2019; 70(2): 204.     CrossRef
  • Editor's Choice – Management of Secondary Aorto-enteric and Other Abdominal Arterio-enteric Fistulas: A Review and Pooled Data Analysis
    S.K. Kakkos, C.D. Bicknell, I.A. Tsolakis, D. Bergqvist
    European Journal of Vascular and Endovascular Surgery.2016; 52(6): 770.     CrossRef
  • 7,749 View
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A Case of Endoscopic Treatment for Gastrocolocutaneous Fistula as a Complication of Percutaneous Endoscopic Gastrostomy
Jong Ho Hwang, Hyung Wook Kim, Dae Hwan Kang, Choel Woong Choi, Soo Bum Park, Tae Ik Park, Woo Sung Jo, Dong Hyuk Cha
Clin Endosc 2012;45(1):95-98.   Published online March 31, 2012
DOI: https://doi.org/10.5946/ce.2012.45.1.95
AbstractAbstract PDFPubReaderePub

As a rare complication of percutaneous endoscopic gastroscopy (PEG), a gastrocolocutaneous fistula may occur after PEG placement. This paper reports an interesting case which PEG tube unintentionally penetrated transverse colon during PEG. A 72-year-old female patient who suffered from medullary infarction underwent PEG procedure for enteral nutrition, and fecal materials were observed 6 days after the procedure. Transverse colon located in antero-superior site of stomach was observed through abdominal computed tomography, and also the wrong inserted tube was found through gastroscopy and colonoscopy. Endoscopic treatment for the fistula was performed by the use of hemo-clip and detachable snare, closure of the fistula was finally confirmed 6 days after the endoscopic procedure. Therefore, the gastrocolocutaneous fistula should be considered as one of the complications of PEG when fecal material is observed through PEG tube in a few days after PEG procedure and endoscopic treatment can be feasible in this case.

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    GE - Portuguese Journal of Gastroenterology.2019; 26(6): 441.     CrossRef
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    Clinical Endoscopy.2018; 51(2): 196.     CrossRef
  • Endoscopic Closure of a Gastric Perforation Developing as a Complication after Percutaneous Endoscopic Gastrostomy Insertion
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    The Korean Journal of Medicine.2018; 93(3): 291.     CrossRef
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    Yoen Young Chuah, Yeong Yeh Lee, Tzung Jiun Tsai
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    Jiri Cyrany
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  • Two Cases of Uncommon Complication during Percutaneous Endoscopic Gastrostomy Tube Replacement and Treatment
    Hyun Joo Lee, Rok Seon Choung, Min Seon Park, Jeung Hui Pyo, Seung Young Kim, Jong Jin Hyun, Sung Woo Jung, Ja Seol Koo, Sang Woo Lee, Jai Hyun Choi
    The Korean Journal of Gastroenterology.2014; 63(2): 120.     CrossRef
  • A Study of Complications Related to Percutaneous Endoscopic Gastrostomy
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    The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2014; 14(1): 24.     CrossRef
  • Two Cases of Gastrocolocutaneous Fistula with a Long Asymptomatic Period after Percutaneous Endoscopic Gastrostomy
    Hyo Sun Kim, Chang Seok Bang, Yeon Soo Kim, Oh Kyung Kwon, Min Sun Park, Jeong Ho Eom, Gwang Ho Baik, Dong Joon Kim
    Intestinal Research.2014; 12(3): 251.     CrossRef
  • First report of colonoscopic closure of a gastrocolocutaneous PEG migration with over-the-scope-clip-system
    Reto Bertolini
    World Journal of Gastroenterology.2014; 20(32): 11439.     CrossRef
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A Case of a Pancreaticogastric Fistula Following Acute Pancreatitis
Jae Sung Youn, M.D., Hyeuk Park, M.D., Min Geun Lee, M.D., Woo Jong Kim, M.D., Jang Sik Mun, M.D., Bo Hyun Myoung, M.D., Do Hyun Kim, M.D. and Ho Dong Kim, M.D.
Korean J Gastrointest Endosc 2011;42(4):245-249.   Published online April 28, 2011
AbstractAbstract PDF
A pancreatic fistula (PF) is an abnormal connection between the pancreas and adjacent or distant organs, structures, or spaces resulting from leakage of pancreatic secretions from disrupted pancreatic ducts. A PF is a rare complication that occurs during a acute and chronic pancreatitis or after traumatic or surgical disruption of the pancreatic duct. PFs are frequently classified as internal or external depending upon whether they communicate with an internal organ or the skin. Pancreatico-colonic fistulas are the most common, whereas pancreatico-gastric fistulas are the rarest. We report a rare case of a pancreatico-gastric fistula complicated by acute pancreatitis. (Korean J Gastrointest Endosc 2011;42:245-249)
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A Case of Ingesting Multiple Magnets Removed by Endoscopic Submucosal Dissection
So Hyun Gil, M.D., Yong Keun Cho, M.D., Jin Woong Cho, M.D., Ji Woong Kim, M.D., Gum Mo Jung, M.D., Young Jae Lee, M.D. and Sang Hoon Park, M.D.
Korean J Gastrointest Endosc 2011;42(3):157-160.   Published online March 28, 2011
AbstractAbstract PDF
Foreign body ingestion is common in children, but magnet ingestion is rare. Ingestion of one magnet does not creat a serious problem; however, ingesting multiple magnet can lead to hazardous complications such as pressure necrosis, intestinal perforation, fistula formation, obstruction and intestinal volvulus. Most cases with complications after multiple magnet ingestion require surgical intervention. We report a case of a fistula following the ingestion of seven small, flat and round magnets that were removed successfully by endoscopic submucosal dissection without surgery. (Korean J Gastrointest Endosc 2011;42:157-160)
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A Case of Gastro-colic Fistula with Peritonitis Due to Ingested Magnets
Yong Duck Cho, M.D., Young Woon Chang, M.D., Chang Hyun Cho, M.D., Young Hwangbo, M.D., Jaejoon Shim, M.D., Jae Young Jang, M.D., Hyo Jong Kim, M.D. and Byung Ho Kim, M.D.
Korean J Gastrointest Endosc 2010;41(3):168-171.   Published online September 30, 2010
AbstractAbstract PDF
The ingestion of a foreign body is common in children. But in adults, especially in those who have a mental illness, dysphagia, and consciousness disorders often occur. If a patient ingests more than two magnets, he can develop numerous complications such as bowel necrosis, perforation, and fistula formation. Here we report a case of a 32-year-old patient with gastro-colic fistula and peritonitis following ingestion of multiple magnets. In accidental ingestion of multiple magnets, early exploration should be considered. (Korean J Gastrointest Endosc 2010;41:168-171)
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A Case of Aortoesophageal Fistula Complicated by a Stent for Benign Esophageal Stricture
Ja Won Kim, M.D., Sung Jo Bang, M.D., Do Ha Kim, M.D., Hee Chul Jung, M.D., Ssang Yong Oh, M.D., Sang Jin Lee, M.D., Ji Eun Lee, M.D. and Jeong Hoon Lee, M.D.
Korean J Gastrointest Endosc 2010;40(6):357-360.   Published online June 30, 2010
AbstractAbstract PDF
Self-expandable metallic stents (SEMS) are widely used for the palliative treatment of malignant strictures of the gastrointestinal tract. Recently, several studies tested whether a SEMS is an effective and safe option for benign esophageal stricture. 　Serious complications such as hemorrhage, compression of the bronchus, bronchoesophageal fistula, and esophageal rupture were infrequently encountered as complications of esophageal stent placement. Aortoesophageal fistula is extremely rare as a complication of esophageal SEMS insertion; only seven cases have been reported worldwide. We now report a case of an 80-year old female with aortoesophageal fistula after placement of a SEMS for an esophageal stricture. (Korean J Gastrointest Endosc 2010;40:357-360)
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Primary Squamous Cell Carcinoma of the Gallbladder Forming a Cholecystogastric Fistula
Chang Jae Lee, M.D. and Jinsook Jung, M.D.*
Korean J Gastrointest Endosc 2010;40(4):285-289.   Published online April 30, 2010
AbstractAbstract PDF
The most common type of gallbladder cancer is adenocarcinoma. Primary squamous cell carcinoma of the gallbladder is a rare and aggressive disease. It is responsible for up to 1.7% of the malignant neoplasms of the gallbladder. It characteristically presents with invasive growth, a low tendency towards lymph node metastasis and a high incidence of local infiltration and hepatic metastasis, presenting a worse prognosis than adenocarcinoma of the gallbladder. Cases of gallbladder cancer forming a fistula to the stomach are also rare. We experienced a case of primary squamous cell carcinoma of the gallbladder which formed a fistula to the stomach. (Korean J Gastrointest Endosc 2010;40:285-289)
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A Case of Malignant Duodenocolic Fistula Treated with Covered Metallic Stents
Jeong Ah Kim, M.D., Chang Whan Kim, M.D., Chang Hoon Lim, M.D., Seok Ju Lee, M.D., Dong Hoon Ko, M.D., Tae Ho Kim, M.D., Sok Won Han, M.D. and Hiun Suk Chae, M.D.
Korean J Gastrointest Endosc 2010;40(2):116-120.   Published online February 27, 2010
AbstractAbstract PDF
Malignant duodenocolic fistula is a rare complication of colon cancer, and this usually develops as the right-side colon cancer that invades the duodenal bulb. The fistula often results in watery diarrhea, weight loss and feculent vomiting. A barium enema or duodenography have been the most useful diagnostic procedures, and the fistula is directly confirmed by an endoscopic examination. Curative resection is not possible in many cases due to metastasis or local invasion, so a palliative operation can be performed to relieve symptoms, but it cannot completely prevent the vomiting or diarrhea. Seven Korean cases of malignant duodenocolic fistula have been previously reported on, and an operation was performed in six cases. We report here on a case of duodenocolic fistula with intestinal obstruction that arouse from a right-side colon cancer, and this was successfully managed by placing covered metallic stents at the duodenum and hepatic flexure. (Korean J Gastrointest Endosc 2010;40:116-120)
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A Case of Duodenobiliary Fistula Caused by a Metal Stent in a Patient with Hepatocellular Carcinoma
Seok Bae Yoon, M.D., Hong Sik Lee, M.D., Hyuk Soon Choi, M.D., Hye Jin Cho, M.D., Tae Jung Yun, M.D., Jin Nam Kim, M.D., Ik Yoon, M.D. and Chang Duck Kim, M.D.
Korean J Gastrointest Endosc 2009;39(5):324-327.   Published online November 30, 2009
AbstractAbstract PDF
Biliary drainage can improve the quality of life in a patient with obstructive jaundice caused by malignancy. Biliary metal stent insertion is a very useful method because it drains the bile physiologically and patients have little discomfort with the procedure. It has a few complications such as restenosis, liver perforation, bowel perforation, fistula formation and stent dislocation. Perforation and fistula formation are caused by pressure due to the self expanding characteristics of the metal stent. We report here on a case of duodenobiliary fistula that was caused by a biliary metal stent in a patient suffering with hepatocellula carcinoma, and we also include a review of the relevant literature. (Korean J Gastrointest Endosc 2009; 39:324-327)
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A Case of a Pancreatic Intraductal Papillary Mucinous Neoplasm Forming Multiple Fistulas and Manifesting as Duodenal Ulcer Bleeding
Hearn Kook Kim, M.D., Jae Woo Kim, M.D., Myeong Hun Chae, M.D., Jin Hyung Lee, M.D., Hyun Soo Kim, M.D., Soon Koo Baik, M.D., Mee Yon Cho, M.D.* and Seung Whan Cha, M.D.†
Korean J Gastrointest Endosc 2009;38(4):242-245.   Published online April 30, 2009
AbstractAbstract PDF
An intraductal papillary mucinous neoplasm (IPMN) of the pancreas is an uncommon tumor characterized by the production of mucin in the pancreatic duct that occasionally involves the formation of fistulas with surrounding organs, including the stomach, duodenum and common bile duct. The mechanism underlying the formation of such fistulas is direct invasion by a tumor or a combination of high pressure in the main pancreatic duct and inflammatory stimulation. A 73-year-old man was referred to our hospital due to the presence of a gastric ulcer detected on screening gastroscopy. Endoscopic findings showed the presence of a whitish thick mucin coated ulcerative lesion that appeared as a perforation or fistula opening. Abdominal computed tomography and magnetic resonance cholangiopancreatography demonstrated the presence of an IPMN of the pancreas and multiple fistula formation with the neighboring organs. An endoscopic biopsy was carried out to obtain pancreatic tumor tissue through the pancreatogastric fistula and the mass was confirmed as a mucinous adenocarcinoma. To the best of our knowledge, this is the first case of an IPMN associated with a pancreatojejunal fistula and duodenal ulcer bleeding due to fistula formation. (Korean J Gastrointest Endosc 2009;38:242-246)
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A Case of Duodenal Fistula Caused by Intra-abdominal Tuberculous Lymphadenopathy during Anti-tuberculous Medication
Kyong Rok Lee, M.D., Kang Seok Seo, M.D., Jun Ho Cheo, M.D., Sang Cheol Choi, M.D., Kang Kim, M.D., Youn Gun Yim, M.D., Gun Young Hong, M.D. and Sang Wook Park, M.D.
Korean J Gastrointest Endosc 2008;37(6):433-437.   Published online December 30, 2008
AbstractAbstract PDF
Recently, the proportion of extrapulmonary tuberculosis in patients has increased in Korea. Though intestinal tuberculosis in not infrequent, a duodenal fistula caused by tuberculosis is a rare condition. A 29-year-old man was admitted to the Department of Internal Medicine because of fever and weight loss. The patient was a doctor participating in a resident fellowship. The patient was diagnosed with intra-abdominal tuberculous lymphadenopathy and was given anti-tuberculous medication. One month after the administration of medication, the patient showed symptoms and signs of duodenal obstruction because of marked duodenal wall edema and a deep ulcer on the second portion of the duodenum. A computerized tomogram and duodenography revealed the formation of a fistula at the second portion of the duodenum and the presence of abscess-forming tuberculous lymphadenopathy. The use of continuous anti- tuberculous medication resulted in the improvement of the clinical symptoms, with complete healing of the duodenal fistula and tuberculous lymphadenitis. This case suggests that transient clinical worsening in intra-abdominal tuberculous lymphadenitis may occur during an early period of anti- tuberculous medication. (Korean J Gastrointest Endosc 2008;37:433-437)
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A Case of Successful Closure using Endoscopic Hemostatic Clips with a Detachable Snare and Fibrin Glue Injection for a Gastro-Cutaneous Fistula following Buried Bumper Syndrome
Hye Jeong Kim, M.D., Jae Woo Kim, M.D., Il Young Lee, M.D., Kyong Won Park, M.D., Hearn Kook Kim, M.D., Ki Tae Suk, M.D., Moon Young Kim, M.D. and Soon Koo Baik, M.D.
Korean J Gastrointest Endosc 2008;37(2):116-121.   Published online August 30, 2008
AbstractAbstract PDF
The buried bumper syndrome is a well-recognized long-term complication of a percutaneous endoscopic gastrostomy (PEG). Most of the buried bumpers are removed by making an external incision over the PEG site under local anesthesia or during a laparotomy. Recently, endoscopic removal is usually attempted. While the removal of the PEG tube is usually followed by spontaneous closure of the gastrostomy tract, a non-healing gastro- cutaneous fistula is difficult to manage. The fistula is generally treated with bowel rest and total parenteral nutritional support, suppression of gastric acid secretion, and occasionally, surgical exploration and wedge excision of the fistula site are performed. However, in debilitated patients, surgical management is accompanied with high morbidity and mortality. Recently, the use of nonsurgical alternative methods, such as endoscopic therapy using tissue adhesives or hemostatic clips, has emerged with recent advances in endoscopic technology. We report a case of successful closure using endoscopic hemostatic clips with a detachable snare and fibrin glue injection for a gastro-cutaneous fistula following buried bumper syndrome. (Korean J Gastrointest Endosc 2008;37:116-121)
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A Case of a Gastric Gastrointestinal Stromal Tumor with a Fistula and Gastrointestinal Bleeding
Jin Ho Lee, M.D., Jung Youn Moon, M.D., Hyun Jung Kim, M.D., Jung Eun Huh, M.D., Jong Ryul Park, M.D., Hye Jung Jang, M.D., Ji Hoon Yoon, M.D., Seung Keun Park, M.D., Hee Ug Park, M.D. and Hye Sook Kim, M.D.*
Korean J Gastrointest Endosc 2007;35(5):337-341.   Published online November 30, 2007
AbstractAbstract PDF
There has been much debate on the origin, differentiation and prognosis of gastrointestinal stromal tumors (GIST). Based on recent studies, we consider Cajal interstitial cell as the origin of a GIST. The common symptoms of a GIST are abdominal pain, hemorrhage, and the presence of a mass. However, there are few reported cases of a GIST with abscess pockets that communicate with the lumen of the stomach via a fistula. We report a case of a GIST of the stomach presenting with an abscess and a fistula communicating with the lumen of the stomach. An 84-year-old man presented with continuous fever and general weakness. We were able to diagnose the disease by an endoscopic examination, CT scan, biopsy and by cellular immunohistochemical staining. (Korean J Gastrointest Endosc 2007;35:337-341)
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A Case of Pancreatic Arteriovenous Malformation Presenting Upper Gastrointestinal Bleeding
Su Hee Park, M.D., Mi Jeong Kim, M.D., You Sang Ko, M.D., You Jin Lim, M.D., Seung Yong Han, M.D., Hyun Woo Byun, M.D., Min Ho Choi, M.D., Hyun Joo Jang, M.D., Sea Hyub Kye, M.D. and Jin Lee, M.D.
Korean J Gastrointest Endosc 2007;35(5):359-363.   Published online November 30, 2007
AbstractAbstract PDF
A pancreatic arteriovenous malformation (AVM) is a very rare disease entity that is usually asymptomatic; however, it may present with a massive gastrointestinal hemorrhage. Recent advances in cross-sectional imaging and the widespread availability of angiography have contributed to the diagnosis of this condition. A patient was transferred to our clinic due to unknown origin gastrointestinal bleeding and upper abdominal pain. Double balloon enteroscopy and duodenoscopy revealed a bleeding pancreatico-cholangio-duodenal fistula. We were able to diagnose an arteriovnous malformation with a pancreatico- cholangio-duodenal fistula by the use of angiography and from the post-operative pathological findings. (Korean J Gastrointest Endosc 2007;35:359-363)
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Intestinal Tuberculosis with a Duodenal Fistula
Eun Bum Park, M.D., Yoon Tae Jeen, M.D., Jae Hong Ahn, M.D., Sang-jun Suh, M.D., Sun Jae Lee, M.D., Nark-Soon Park, M.D., Bora Keum, M.D., Yeon Seok Seo, M.D., Yong Sik Kim, M.D., Hoon Jai Chun, M.D., Hong Sik Lee, M.D., Soon Ho Um, M.D., Sang Woo Lee, M.
Korean J Gastrointest Endosc 2007;35(5):346-350.   Published online November 30, 2007
AbstractAbstract PDF
Intestinal tuberculosis is a common disease of extrapulmonary tuberculosis. A diagnosis of intestinal tuberculosis is difficult as the symptoms and laboratory findings are not specific for the disease. Intestinal tuberculosis may cause various complications, such as intestinal obstruction, intestinal perforation, intraabdominal abscess, intestinal hemorrhage and fistula formation. A duodenal fistula caused by tuberculosis is an especially rare condition. We experienced a case of intestinal tuberculosis with a duodenal fistula as a complication. The patient was a 25- year-old man that presented with weight loss and diarrhea. Esophagogastroduodenoscopy showed a deep ulcerative lesion on the third portion of the duodenum with a fistula opening. A histological finding revealed granulomatous inflammation with multinucleated giant cells. In addition, the result of a Tb PCR assay was positive. After two months of treatment with the appropriate medication, the symptoms improved and the fistula has closed completely. We report the case with a review of the literature. (Korean J Gastrointest Endosc 2007;35:346-350)
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A Case of Tuberculosis of the Esophagus and Duodenum Associated with Pulmonary Tuberculosis
Seok Jin Kang, M.D., Tae Hyo Kim, M.D., Won Hyun Lee, M.D., Seung Suk You, M.D., Jong Ha, M.D., Sun Pil Choi, M.D., Dong O Kang, M.D., In Gye Bae, M.D., Hyun Jin Kim, M.D. and Ok Jae Lee, M.D.
Korean J Gastrointest Endosc 2007;35(3):165-169.   Published online September 30, 2007
AbstractAbstract PDF
Esophageal and duodenal tuberculosis are rare form of gastrointestinal tuberculosis. The common complications due to esophageal and duodenal tuberculosis are fistulous communications with the adjacent structures, perforation, obstruction, and upper gastrointestinal bleeding. Massive bleeding in esophageal and duodenal tuberculosis is quite rare. We encountered a case of a 55-year-old male who presented with hematemesis and melena. Esophageal and Duodenal tuberculosis with a duodenal fistula was diagnosed by an endoscopic and radiology examination. He improved after treatment with anti-tuberculosis medication over a 9 month period. We report this case of esophageal and duodenal tuberculosis associated with pulmonary tuberculosis with a review of the relevant literature. (Korean J Gastrointest Endosc 2007;35:165-169)
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A Case of Choledochoduodenal Fistula due to Duodenal Ulcer
Hey Jin Jeong, M.D., Seong Hun Kim, M.D., Kyoung Deok Shin, M.D., In Hee Kim, M.D., Sang Wook Kim, M.D., Seung Ok Lee, M.D., Soo Teik Lee, M.D. and Dae Ghon Kim, M.D.
Korean J Gastrointest Endosc 2007;35(1):38-41.   Published online July 30, 2007
AbstractAbstract PDF
Spontaneous internal biliary fistulas are not an uncommon complication of primary biliary disease. Almost 90% of the abnormal biliary-enteric communications between the gallbladder and the duodenum are caused by perforation via gallstones into an otherwise normal duodenum. However, biliary-enteric communications that are caused by primary duodenal ulcer disease are much less common. We experienced a case of duodenal peptic ulcer disease that perforated into the common bile duct in a 45-year-old woman.
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A Case of Choledocho-Duodeno-Colonic Fistula
Jeong Sook Seo, M.D., Sung Yeun Yang, M.D., Jae Hwan Kim, M.D., Su Kyoung Kwon, M.D., Sang Bun Choi, M.D., Su Kyoung Jo, M.D., Yang Cheon Han, M.D. and Eun Ju Lee, M.D.
Korean J Gastrointest Endosc 2007;34(5):278-281.   Published online May 30, 2007
AbstractAbstract PDF
Biliary-enteric fistula is a rare disease, and the common causes of biliary-enteric fistula are gallstone, peptic ulcer, malignancy and trauma. It is known that the most common type of biliary-enteric fistula is the cholecysto- duodenal fistula, yet the combination of choledocho- duodeno-colonic fistula is a rare finding. A 78-year-old woman was admitted because she had suffered with right upper quadrant pain, a febrile sense and chills for 2 days. We confirmed the choledocho-duodeno-colonic fistula by performing gastroduodenoscopy, abdominal CT and an upper GI series. So, we report here on an usual case of choledocho-duodeno-colonic fistula, along with a review of the relevant literatures. (Korean J Gastrointest Endosc 2007;34:278⁣281)
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Two Cases of Double Papilla of Vater
Kwang Ro Joo, M.D., Hyun Phil Shin, M.D., Hyun Jeong Kim, M.D., Jae Myung Cha, M.D., Jong Beom Park, M.D. and Joung Il Lee, M.D.
Korean J Gastrointest Endosc 2007;34(3):170-173.   Published online March 30, 2007
AbstractAbstract PDF
The Vaterian system consists of the common bile duct and the duct of Wirsung as they conjoin at the level of the duodenum, forming the major papilla of Vater. A double papilla of Vater with separate openings that form the bile duct and the pancreatic duct is a rare anatomic anomaly, which is observed in 0.18% of patients during endoscopic retrograde cholangiopancreatography. When a double papilla is noted, the additional problem is to determine if it is an anatomic variant or a choledochoduodenal fistula. We report two cases of a double papilla; one was associated with choledocholithiasis, and the other was identified incidentally during screening upper gastrointestinal endoscopy. (Korean J Gastrointest Endosc 2007;34:170⁣173)
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A Case of Gastrogastric Fistula as a Complication of Benign Gastric Ulcer
Sun Taek Choi, M.D., Jong Ryul Eun, M.D., Jung Hoon Lee, M.D., Yoon Seon Park, M.D., Jae Won Choi, M.D., Kook Hyun Kim, M.D., Byung Ik Jang, M.D., Tae Nyun Kim, M.D. and Heon Ju Lee, M.D.
Korean J Gastrointest Endosc 2006;33(6):364-367.   Published online December 30, 2006
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Gastrogastric fistula is an extremely rare complication of benign gastric ulcer. We report a case of gastrogastric fistula in a 67-year-old male who presented with symptoms of dyspnea on exertion, pretibial pitting edema, and dyspepsia. He suffered from a peptic ulcer 9 years ago and from a gastric outlet obstruction 5 years ago. A gastrogastric fistula was observed by endoscopy, and the biopsy forceps were passed through the fistulous tract. The patient was treated with proton pump inhibitors, and H. pylori was eradicated. Gastrogastric fistula, unlike other types of gastric fistulas, can be cured using non-surgical therapy as long as complications such as peritonitis, gastric outlet obstruction, and bleeding do not occur. (Korean J Gastrointest Endosc 2006;33:364⁣367)
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A Case of Pancreatogastric Fistula Associated with Intraductal Papillary Mucinous Neoplasm
Seung Geun Lee, M.D., Il Du Kim, M.D., Hye Jeong Lee, M.D., Tae Oh Kim, M.D., Gwang Ha Kim, M.D., Jeong Heo, M.D., Dae Hwan Kang, M.D., Geun Am Song, M.D., Mong Cho, M.D., Jee Yeon Kim, M.D.* and Suk Kim, M.D.†
Korean J Gastrointest Endosc 2006;33(4):257-260.   Published online October 30, 2006
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There have been an increasing number of reports of intraductal papillary mucinous neoplasm (IPMN) of the pancreas since its first report by Ohhasi et al. in 1982. However, fistula formation associated with IPMN to other organs is rare. A 79-year -old woman visited our hospital due to diarrhea and dyspepsia for 3 months. Abdominal computed tomography and magnetic resonance imaging revealed IPMN of the pancreas and fistula formation in the stomach. Endoscopic retrograde cholangiography after injecting a dye through the pancreatic duct showed dye flowing out into stomach. An endoscopic biopsy was carried out through the pancreatogastric fistula and this tumor was confirmed to be IPMN. We report a case of pancreatogastric fistula associated with IPMN that was confirmed by histology. (Korean J Gastrointest Endosc 2006;33:257⁣261)
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