title: Non-healing post-surgical fistulae: treatment with image-guided percutaneous injection of cyanoacrylic glue.
abstract: OBJECTIVE
  To present the results of our experience with cyanoacrylic glue percutaneous injection to treat post-surgical non-healing enteric fistulae after failure of standard treatments.
  
  
  METHODS
  Eighteen patients (14 males; age range 33-84, mean 69 years) were treated for a non-healing post-surgical enteric fistula after failure of standard treatments. Under computed tomography and/or fluoroscopic guidance, a mixture of cyanoacrylic glue (Glubran 2, GEM, Viareggio, Italy) and ethiodized oil was injected at the site of the fistula. Fistula was considered healed when no material was drained by the percutaneous drainage and a subsequent computed tomography confirmed the disappearance of any fluid collection.
  
  
  RESULTS
  In all cases, it was possible to reach the site of the fistula using a percutaneous access. A median of 1 injection (range 1-5) was performed. Fistula healing was achieved in 16/18 (89 %) patients. One patient died for other reasons before fistula healing. Median time for fistula healing was 0 days (mean 8, range 0-58 days). No complications occurred. Reoperation was needed in one patient.
  
  
  CONCLUSIONS
  Percutaneous injection of cyanoacrylic glue is feasible, safe, and effective to treat non-healing post-surgical enteric fistulae. It may represent a further option to avoid surgical reoperation in frail patients.
authors.affiliation: Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, San Donato Milanese, 20097, Milan, Italy. vanni.mauri@gmail.com.|Department of Interventional Radiology, European Institute of Oncology, Via Ripamonti 435, 20100, Milan, Italy. vanni.mauri@gmail.com.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mauri
authors.affiliation: Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy.
authors.forename: Lorenzo C
authors.initials: LC
authors.lastname: Pescatori
authors.affiliation: Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Mattiuz
authors.affiliation: Department of Radiology, Humanitas Research Hospital, Rozzano, 20089, Milan, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Poretti
authors.affiliation: Department of Radiology, Humanitas Research Hospital, Rozzano, 20089, Milan, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Pedicini
authors.affiliation: Department of Radiology, San Paolo Hospital, Via Antonio di Rudinì, 8, 20142, Milan, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Melchiorre
authors.affiliation: Division of Radiology and Interventional Radiology, Department of Diagnostic Sciences, San Carlo Borromeo Hospital, Via Pio II 3, 20153, Milan, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Rossi
authors.affiliation: Humanitas University, Rozzano, 20089, Milan, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Solbiati
authors.affiliation: Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Pascal 36, 20133, Milan, Italy.|Unit of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy.
authors.forename: Luca Maria
authors.initials: LM
authors.lastname: Sconfienza
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003487:Cyanoacrylates / Q000008:administration & dosage*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D007412:Intestinal Fistula / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy; D015641:Radiography, Interventional / Q000379:methods; D012189:Retrospective Studies; D014014:Tissue Adhesives / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D003487:Cyanoacrylates; D014014:Tissue Adhesives
keywords: Cyanoacrilyc glue; Enteric fistula; Glubran; Image-guided technique; Percutaneous treatment