title: Percutaneous embolization of persistent low-output enterocutaneous fistulas.
abstract: OBJECTIVE
  To present and retrospectively evaluate the technique of percutaneous embolization of chronic enterocutaneous fistulas (ECFs) using n-butyl-2-cyanoacrylate and Lipiodol under fluoroscopic guidance.
  
  
  METHODS
  Six patients with a total of seven post-operative low-output ECFs of the large intestine were treated. After fistulography a hydrophilic guide wire and a catheter were advanced through the ECF into the intestine. After dilation of the bowel with saline and contrast medium, the catheter was withdrawn into the enteric orifice and glue together with Lipiodol was injected while simultaneously pulling the catheter.
  
  
  RESULTS
  Complete closure of all seven fistulas was achieved. There were no peri-procedural complications. In one patient 1 month following embolization a low-output enteric discharge was observed, but the ECF spontaneously healed 5 days later. In one patient 18 months after the embolization a new perforation due to diverticulitis close to the embolization site occurred and resection of the sigmoid colon was performed. One patient needed reoperation due to a recurrence of rectal carcinoma.
  
  
  CONCLUSIONS
  In our series of patients, the presented technique of percutaneous embolization proved to be efficacious and easy to perform. It may have potential as a first-line treatment of low-output ECFs but a prospective study with a larger series of patients and a longer follow-up is required.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Split, Spinciceva 1, 21 000 Split, Croatia. lianacambj@hotmail.com
authors.forename: Liana
authors.initials: L
authors.lastname: Cambj Sapunar
authors.forename: Budimir
authors.initials: B
authors.lastname: Sekovski
authors.forename: Dario
authors.initials: D
authors.lastname: Matić
authors.forename: Andro
authors.initials: A
authors.lastname: Tripković
authors.forename: Leo
authors.initials: L
authors.lastname: Grandić
authors.forename: Nikica
authors.initials: N
authors.lastname: Družijanić
mesh_terms: D000368:Aged; D003287:Contrast Media; D004659:Enbucrilate / Q000627:therapeutic use*; D004998:Ethiodized Oil; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D007412:Intestinal Fistula / Q000000981:diagnostic imaging* / Q000628:therapy*; D007420:Intestine, Large / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D006490:Hemostatics; D004998:Ethiodized Oil; D004659:Enbucrilate