Successful endoscopic closure of a benign gastrocolonic fistula using human fibrin sealant through gastroscopic approach: a case report and review of the literature.
Gastrocolonic fistula is a well-recognized but rare complication of a variety of diseases, and surgical or endoscopic procedures. If not promptly treated it might result in death due to severe nutritional debility, fluid and electrolyte imbalances. The rarity of the condition leaves clinicians without a proven management option. Traditionally, operative treatment has been advocated. Spontaneous closure of a gastrocolonic fistula, with conservative management only, is infrequent. In the era of minimally invasive surgery the management approach warrants a review. We report a case where non-surgical treatment with local instillation of human fibrin glue was successfully undertaken, as demonstrated by contrast studies, to treat a benign gastrocolonic fistula, and might be a valid alternative to both surgical and medical treatment, although the patient's return to high risk behaviour resulted in a recurrence. Furthermore, in high operative risk patients or those with poor prognosis, this approach might prevent major morbidity, mortality or prolonged hospital stay.
Rots
Wim I
WI
University of Pretoria, Department of Surgery, Kalafong Hospital, Pretoria, South Africa. wimrots@hotmail.com
Mokoena
Taole
T
D000328:Adult; D003108:Colonic Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005747:Gastric Fistula / Q000000981:diagnostic imaging / Q000628:therapy*; D005773:Gastroscopy; D006801:Humans; D007412:Intestinal Fistula / Q000000981:diagnostic imaging / Q000628:therapy*; D011859:Radiography; D014014:Tissue Adhesives / Q000627:therapeutic use*
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives