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
ARTICLE HIGHLIGHTS
Case characteristics
A 52-year-old male patient with blunt abdominal traumatic rupture of the spleen developed a gastric fistula after splenectomy. Following conservative treatment in a local hospital for almost 3 wk that was ineffective, he was transferred to our hospital.
Clinical diagnosis
The patient was diagnosed with a gastric fistula and abdominal infection.
Differential diagnosis
Pancreatic fistula should be excluded.
Laboratory diagnosis
Laboratory examination showed that the white blood cell count, percentage of neutrophils, and high sensitivity C-reactive protein level were significantly increased.
Imaging diagnosis
A fistula of the greater curvature of the gastric body accompanied by abdominal infection was confirmed by upper digestive tract ioversol angiography and dynamic abdominal computed tomography scanning.
Treatment
Anti-infective treatment and nutritional support was ineffective for the fistula of the patient. Therefore, endoscopic titanium clip closure was performed and the gastric fistula was successfully closed.
Experiences and lessons
As conservative treatment may be ineffective for medium-sized gastric fistulas after splenectomy, endoscopic titanium clipping is a good and safe treatment choice, which avoids the risk of re-operation.
