title: Tulip bundle technique and fibrin glue injection: unusual treatment of colonic perforation.
abstract: We report a case of a 63-year-old male who experienced an iatrogenic sigmoid perforation repaired combining three endoscopic techniques. The lesion was large and irregular with three discrete perforations, therefore, we decided to close it by placing one clip per perforation, and then connecting all the clips with two endoloops. Finally we chose to use a fibrin glue injection to obtain a complete sealing. Four days after the colonoscopy the patient underwent a laparoscopic right hemicolectomy due to evidence of a large polyp of the caecum with high grade dysplasia and focal carcinoma in situ. Inspection of the sigma showed complete repair of the perforation. This report underlines how a conservative approach, together with a combination of various endoscopic techniques, can resolve complicated iatrogenic perforations of the colon.
authors: Department of Gastroenterology, IsMeTT, UPMC, Palermo, Italy. fmocciaro@gmail.com
authors: Filippo
authors: F
authors: Mocciaro
authors: Gabriele
authors: G
authors: Curcio
authors: Ilaria
authors: I
authors: Tarantino
authors: Luca
authors: L
authors: Barresi
authors: Marco
authors: M
authors: Spada
authors: Sergio Li
authors: SL
authors: Petri
authors: Mario
authors: M
authors: Traina
mesh_terms: D003108:Colonic Diseases / Q000601:surgery*; D003111:Colonic Polyps / Q000601:surgery; D003113:Colonoscopy / Q000009:adverse effects; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D007049:Iatrogenic Disease; D007416:Intestinal Perforation / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013525:Surgical Instruments; D013536:Suture Techniques; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive