Yu J, Zhou CJ, Wang P, Wei SJ, He JS, Tang J. Endoscopic titanium clip closure of gastric fistula after splenectomy: A case report. World J Clin Cases 2018; 6(15): 1047-1052 [PMID: 30568962 DOI: 10.12998/wjcc.v6.i15.1047]
Corresponding Author of This Article
Pan Wang, MD, Associate Professor, Department of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Sichuan Key Laboratory of Medical Imaging, 63 Wenhua Road, Nanchong 637000, Sichuan Province, China. wpan@nsmc.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
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Yu J, Zhou CJ, Wang P, Wei SJ, He JS, Tang J. Endoscopic titanium clip closure of gastric fistula after splenectomy: A case report. World J Clin Cases 2018; 6(15): 1047-1052 [PMID: 30568962 DOI: 10.12998/wjcc.v6.i15.1047]
World J Clin Cases. Dec 6, 2018; 6(15): 1047-1052 Published online Dec 6, 2018. doi: 10.12998/wjcc.v6.i15.1047
Endoscopic titanium clip closure of gastric fistula after splenectomy: A case report
Jing Yu, Cheng-Ji Zhou, Pan Wang, Shou-Jiang Wei, Jin-Song He, Jin Tang
Jing Yu, Cheng-Ji Zhou, Pan Wang, Shou-Jiang Wei, Jin-Song He, Jin Tang, Department of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
Jing Yu, Cheng-Ji Zhou, Pan Wang, Sichuan Key Laboratory of Medical Imaging, Nanchong 637000, Sichuan Province, China
Author contributions: Yu J and Zhou CJ contributed equally to this work; Yu J, Zhou CJ, and Wang P wrote the manuscript; Yu J, Zhou CJ, Wang P, Wei SJ, He JS, and Tang J diagnosed and treated the patient; all authors discussed the results and commented on the manuscript.
Supported bythe Program of Central Financial Support for Local Universities of China, No. SCKBMI-13-004; and the Project of Sichuan Provincial Health Bureau of China, No. 130334.
Informed consent statement: The patient agreed to the publication of the article and signed the consent form.
Conflict-of-interest statement: All authors declare that they have no financial or personal relationships with other people or organizations that could inappropriately influence (bias) their work.
CARE Checklist (2016) statement: The manuscript was prepared and revised according to the CARE Checklist (2016).
Correspondence to: Pan Wang, MD, Associate Professor, Department of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Sichuan Key Laboratory of Medical Imaging, 63 Wenhua Road, Nanchong 637000, Sichuan Province, China. wpan@nsmc.edu.cn
Telephone: +86-817-2262417 Fax: +86-817-2262417
Received: August 3, 2018 Peer-review started: August 6, 2018 First decision: October 5, 2018 Revised: November 8, 2018 Accepted: November 14, 2018 Article in press: November 15, 2018 Published online: December 6, 2018 Processing time: 125 Days and 8.2 Hours
Abstract
This report describes a 52-year-old male patient with blunt abdominal traumatic rupture of the spleen due to injuries sustained in an automobile accident. Following splenectomy, the patient developed a gastric fistula. He underwent a long period of conservative treatment, including antibiotics and total parenteral nutrition, which was ineffective. The fistula could not be closed and titanium clip closure using a gastroscopy was then performed in order to close the fistula. After endoscopic therapy and clipping surgery, the patient’s general condition improved significantly, and he had no post-procedural abdominal complications. On post-clipping day 6, the gastric fistula was completely closed as shown by X-ray examination of the upper digestive tract. The patient was discharged from hospital and no complications were observed during the six-month follow-up period. Our report suggests that titanium clip closure using endoscopy may be the choice of treatment in patients with a gastric fistula.
Core tip: Gastric fistula after splenectomy is an uncommon complication, and is difficult to treat and cure. The current management of gastric fistula mainly includes conservative treatment and surgery. There are only a few reports concerning gastric fistula treatment using endoscopy. This is the first report of successful treatment of a gastric fistula after splenectomy using titanium endoscopic clipping.
