title: Endoscopic closure instead of surgery to close an ileal pouch fistula with the over-the-scope clip system.
abstract: An ileal pouch fistula is an uncommon complication after an ileal pouch anal anastomosis. Most patients who suffer from an ileal pouch fistula will need surgical intervention. However, the surgery can be invasive and has a high risk compared to endoscopic treatment. The over-the-scope clip (OTSC) system was initially developed for hemostasis and leakage closure in the gastrointestinal tract during flexible endoscopy. There have been many successes in using this approach to apply perforations to the upper gastrointestinal tract. However, this approach has not been used for ileal pouch fistulas until currently. In this report, we describe one patient who suffered a leak from the tip of the "J" pouch and was successfully treated with endoscopic closureviathe OTSC system. A 26-year-old male patient had an intestinal fistula at the tip of the "J" pouch after an ileal pouch anal anastomosis procedure. He received endoscopic treatmentviaOTSC under intravenous anesthesia, and the leak was closed successfully. Endoscopic closure of a pouch fistula could be a simpler alternative to surgery and could help avoid surgery-related complications.
authors.affiliation: Yao Wei, Jian-Feng Gong, Wei-Ming Zhu, Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Wei
authors.affiliation: Yao Wei, Jian-Feng Gong, Wei-Ming Zhu, Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China.
authors.forename: Jian-Feng
authors.initials: JF
authors.lastname: Gong
authors.affiliation: Yao Wei, Jian-Feng Gong, Wei-Ming Zhu, Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu Province, China.
authors.forename: Wei-Ming
authors.initials: WM
authors.lastname: Zhu
keywords: Endoscopic treatment; Ileal pouch fistula; Over-the-scope clip system; Restorative proctocolectomy; Ulcerative colitis