Endoscopic titanium clip closure of gastric fistula after splenectomy: A case report

Figure 1 Abdominal B-ultrasonography findings. A: Abdominal B-ultrasonography showed a limited non-echo area (about 6.3 cm × 2.9 cm in diameter) in the splenic fossa area, which suggested effusion in this area (arrow); B: Chest x-ray revealed a high density in the left lower chest (blue arrow), the left diaphragm angle was unclear, and a moderate volume of pleural effusion was seen in the left side of the chest (red arrow).

Figure 2 Upper abdominal computed tomography findings. A: Upper abdominal computed tomography examination indicated a large amount of effusion in the left upper abdominal cavity (red arrow), and enhanced lesions and a hematocele in the drainage tube (blue arrow); B: Upper digestive tract ioversol angiography showed contrast agent overflow from the greater curvature of the gastric body to the abdominal drainage tube (arrow).

Figure 3 Gastroscopic findings. A: Gastroscopy showed a fistula (approximately 2.0 cm × 2.5 cm in diameter) with a black blood scab on the surface of the upper side of the greater curvature of the gastric body in which the surrounding mucosa was congestive and edematous (arrow); B: The gastric body fistula was fully closed using two titanium clips guided by gastroscopy (arrow).

Figure 4 Upper digestive tract ioversol angiography findings. A: Upper digestive tract ioversol angiography showed that the gastric fistula was completely closed, and no leakage of contrast medium was observed (arrow); B: Abdominal computed tomography examination showed almost no liquid retained in the abdominal cavity, and the granulation tissue was organized (arrow).