Novel multimodality endoscopic closure of postoperative esophageal fistula.

Abstract

INTRODUCTION:

Esophageal fistula following esophagectomy is associated with significant morbidity and mortality.

PRESENTATION OF CASE:

We present the case of a 71-year-old man who underwent salvage Ivor-Lewis esophagectomy, following definitive chemoradiotherapy 1 year previously. On postoperative day 9 the patient complained of chest pain, and a CT scan demonstrated extravasation of oral contrast from the gastric conduit into the right chest. A right chest drain and fully covered esophageal stent were placed at this time. Despite these measures, after 8 weeks, the esophageal fistula persisted. Ultimately, fistula closure was achieved using an interventional radiology-guided, endoscopically placed over-the-scope clip (OTSC). The patient had no further complications and was well at 3 months follow-up.

DISCUSSION:

The case reported herein describes this novel, combined-modality approach to esophageal fistula closure.

CONCLUSION:

This case report demonstrates a novel, minimally invasive, multidisciplinary approach to the closure of a post-esophagectomy anastamotic leak.

• Authors: Sheraz R Markar, Richard Koehler, Donald E Low, Andrew Ross
• Journal: International journal of surgery case reports (Int J Surg Case Rep) Vol. 3 Issue 11 Pg. 577-9 ( 2012) ISSN: 2210-2612 [Electronic] Netherlands
• PMID: 22943885 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.