Copyright
©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 16, 2026; 14(5): 117850
Published online Feb 16, 2026. doi: 10.12998/wjcc.v14.i5.117850
Published online Feb 16, 2026. doi: 10.12998/wjcc.v14.i5.117850
Staged multimodal endoscopic vacuum therapy for a complex gastro-pleuro-broncho-cutaneous fistula: A case report
Beanie Conceição Medeiros Nunes, Rodrigo Silva de Paula Rocha, Angelo So Taa Kum, Endoscopy Unit, Department of Gastroenterology, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, Sao Paulo 05403-010, Brazil
Tyler M Berzin, Center for Advanced Endoscopy, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, United States
Matheus Cavalcante Franco, Division of Gastroenterology, UT Health San Antonio, San Antonio, TX 78229, United States
Author contributions: Nunes BCM and Kum AST designed the conceptualization and performed the original draft; Kum AST and Rocha RSP performed the endoscopic procedures and the data collection; Berzin TM and Franco MC reviewed the article; all authors participated in the writing, editing and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Angelo So Taa Kum, MD, Senior Researcher, Endoscopy Unit, De
Received: December 22, 2025
Revised: January 9, 2026
Accepted: January 26, 2026
Published online: February 16, 2026
Processing time: 55 Days and 3.3 Hours
Revised: January 9, 2026
Accepted: January 26, 2026
Published online: February 16, 2026
Processing time: 55 Days and 3.3 Hours
Core Tip
Core Tip: This case demonstrates the successful resolution of a complex gastro-pleuro-broncho-cutaneous fistula using a staged endoscopic vacuum therapy (EVT) approach. Following failed surgical interventions, a sequential strategy involving initial percutaneous EVT followed by transluminal EVT was implemented. Concurrently, the bronchial defect was managed with argon plasma coagulation and a custom collagen-cellulose plug. This multidisciplinary technique achieved complete fistula closure and nutritional restoration, suggesting that staged EVT is a promising, organ-preserving salvage option for refractory, multi-system fistulas.