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A 50-year-old woman had a percutaneous endoscopic gastrostomy (PEG) tube placed after surgery for pharyngeal cancer. After 21 months, the PEG tube was removed due to improvement of per-oral ingestion. She had taken prednisolone for 31 years for systemic lupus erythematosus. The post-PEG fistula did not close spontaneously. The cause of the fistula was slow wound healing and gastrostomy site inflammation due to long-term steroid therapy. We were able to close the fistula with an over-the-scope clipping (OTSC) system. This case suggests that OTSC is useful for closing persistent post-PEG fistulas in patients receiving long-term prednisolone therapy.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676652 | PMC |
http://dx.doi.org/10.5946/ce.2015.48.6.563 | DOI Listing |
Aortoesophageal fistula (AEF) is a rare but life-threatening condition. Initial management typically includes thoracic endovascular aortic repair (TEVAR) or aortic graft replacement to achieve hemostasis, followed by esophagectomy with aortic graft replacement and greater omentum wrapping to eliminate the source of infection. We report a case of successful endoscopic closure of a chronic esophageal fistula secondary to AEF.
View Article and Find Full Text PDFS D Med
August 2025
Department of Surgery, University of South Dakota Sanford School of Medicine.
Colonoscopic perforation is a severe but rare complication of lower gastrointestinal endoscopies, linked to high morbidity and mortality rates. Iatrogenic perforation during colonoscopy can lead to serious outcomes including extended hospital stays, need for surgical intervention, intra-abdominal sepsis, or death. While perforations have traditionally required surgical or interventional radiology management, use of over-the-scope clipping has offered the option of endoscopic management.
View Article and Find Full Text PDFWorld J Gastrointest Endosc
August 2025
Department of Gastroenterology, The 909th Hospital, School of Medicine, Xiamen University, Zhangzhou 363000, Fujian Province, China.
Background: Secure transluminal closure remains a fundamental barrier to endoscopic surgery. It has been reported that through-the-scope clips were used to secure the incision of the gallbladder during natural orifice transluminal endoscopic cholecystolithotomy and were left in the body post-operation. The over-the-scope clip (OTSC) is favored for its rapid deployment and strong anchoring capabilities.
View Article and Find Full Text PDFACG Case Rep J
August 2025
Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Tracheoesophageal fistula can develop after surgical repair of congenital esophageal atresia, but it usually occurs in pediatric populations. Here, we present an adult patient with an unusual very-delayed onset of a large tracheoesophageal fistula and near esophagocutaneous fistula treated with serial multimodal endoscopic management featuring over-the-scope clips, argon plasma coagulation, and endoscopic suturing.
View Article and Find Full Text PDFAnn Med Surg (Lond)
August 2025
Department of Medicine, Kabul, Afghanistan.
Gastrointestinal (GI) defects pose a significant clinical challenge, impacting patient outcomes and healthcare costs. Endoscopic closure techniques have emerged as effective and minimally invasive approaches to manage these defects. This review explores the various endoscopic techniques, including over-the-scope clips (OTSC), endo suturing systems, through-the-scope (TTS) clips, and the X-Tack system.
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