Endoscopic closure instead of surgery to close an ileal pouch fistula with the over-the-scope clip system

• 作者: Jian-Feng Gong Wei-Ming Zhu Yao Wei
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: Over-the-scope 片断系统 内视镜的处理 补药 proctocolectomy Ulcerative 大肠炎 Ileal 小袋管
• 年，卷（期）: 2017,（2）
• 页码范围: 95-98
• 页数: 4页
• 分类号: R656

摘要

An ileal pouch fistula is an uncommon complication after an ileal pouch anal anastomosis. Most patients who suffer from an ileal pouch fistula will need surgical intervention. However, the surgery can be invasive and has a high risk compared to endoscopic treatment. The over-the-scope clip(OTSC) system was initially developed for hemostasis and leakage closure in the gastrointestinal tract during flexible endoscopy. There have been many successes in using this approach to apply perforations to the upper gastrointestinal tract. However, this approach has not been used for ileal pouch fistulas until currently. In this report, we describe one patient who suffered a leak from the tip of the 'J' pouch and was successfully treated with endoscopic closure via the OTSC system. A 26-year-old male patient had an intestinal fistula at the tip of the 'J' pouch after an ileal pouch anal anastomosis procedure. He received endoscopic treatment via OTSC under intravenous anesthesia, and the leak was closed successfully. Endoscopic closure of a pouch fistula could be a simpler alternative to surgery and could help avoid surgeryrelated complications.