Published online Sep 16, 2024. doi: 10.4253/wjge.v16.i9.533
Revised: August 24, 2024
Accepted: August 28, 2024
Published online: September 16, 2024
Processing time: 36 Days and 11 Hours
Esophagopericardial fistula (EPF) is a rare, life-threatening condition with limited scientific literature and no established management guidelines. This case report highlights a successful multidisciplinary approach and the innovative use of endoscopic vacuum assisted closure (endoVAC) therapy in treating this complex condition.
A 16-year-old male with a history of esophageal atresia and colon interposition presented with progressive chest pain, fever, and dyspnea. Imaging revealed an EPF with associated pleural and pericardial effusions. Initial management with an esophageal stent failed, prompting the use of an endoVAC system. The patient underwent multiple endoVAC device changes and received broad-spectrum antibiotics and nutritional support. The fistula successfully closed, and the patient recovered, demonstrating no new symptoms at a 6-month follow-up.
EndoVAC therapy can effectively manage EPF, providing a minimally invasive treatment option.
Core Tip: This case report highlights the successful use of endoscopic vacuum assisted closure (endoVAC) therapy in treating a rare esophagopericardial fistula (EPF) in a 16-year-old male. The innovative approach involved a multidisciplinary strategy, resulting in the resolution of the fistulous tract and significant clinical improvement. Our findings suggest that endoVAC therapy can be an effective minimally invasive alternative for EPF management, offering a promising solution for complex cases where traditional surgical methods may be less feasible. This report emphasizes the need for further research to establish standardized protocols and validate the long-term efficacy of endoVAC therapy.