title: Ethanol injection for ablation of an intractable digestive tract fistula: report of a case.
abstract: We successfully occluded an intractable digestive tract fistula by injecting it with absolute ethanol after all other treatments failed. A 48-year-old man suffered from a complex and relapsing digestive tract fistula after curative surgery for advanced colon cancer invading the pancreas and duodenum. After conservative management by fasting, drainage, and irrigation failed, fibrin glue infusion achieved only transient occlusion. We performed surgical repair and he was discharged from hospital, at which time fistulography showed no fistula. However, 1 month later fistulography showed that the fistula had recurred and involved the transverse colon, stomach, and intrahepatic bile duct via the jejunum. Finally, we gave five injections of absolute ethanol into the fistula, which resulted in complete occlusion within 6 months. Considering its clinical efficacy, safety, and cost efficiency, we think that ethanol sclerotherapy is a feasible treatment for intractable digestive tract fistula when conservative therapy fails.
authors.affiliation: Department of Surgery, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga 849-8501, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Matsuyama
authors.forename: Seiji
authors.initials: S
authors.lastname: Sato
authors.forename: Yukie
authors.initials: Y
authors.lastname: Yoda
authors.forename: Keita
authors.initials: K
authors.lastname: Kai
authors.forename: Mayumi
authors.initials: M
authors.lastname: Mitsuno
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nakafusa
authors.forename: Kohji
authors.initials: K
authors.lastname: Miyazaki
mesh_terms: D000431:Ethanol / Q000008:administration & dosage*; D005747:Gastric Fistula / Q000628:therapy*; D006801:Humans; D015552:Injections, Intralesional; D007412:Intestinal Fistula / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D015911:Sclerotherapy / Q000379:methods*
chemical_list: D000431:Ethanol