Abstract

CORREIA, Tito; AMARO, Pedro  and  SOFIA, Carlos. Treatment of severe surgical dehiscence with Over-the-scope clip. J Port Gastrenterol. [online]. 2013, vol.20, n.6, pp.261-265. ISSN 0872-8178.  https://doi.org/10.1016/j.jpg.2013.09.004.

We present a case of post-surgical jejunal dehiscence complicated by complex abdominal and thoracic fistula. It developed after total gastrectomy and Roux-en-Y esofagojejunostomy (gastric adenocarcinoma) and caused severe sepsis. We report endoscopic treatment success of the dehiscence using ‘‘Over-the-Scope Clip’’ (OTSC) system. Besides the unusual topography of the dehiscence, the uniqueness of this case relies on the new endoscopic approach. OTSC was not conventionally performed directly on the fistula orifice, but upstream in the normal jejunal mucosa, closing the loop at that level. This allowed the exclusion of the most distal segment, including the dehiscence, and subsequent resolution of the fistula and associated loci by secondary intention. The results obtained led to a strike clinical improvement.

Keywords : Surgical dehiscence; Over-the-scope clip; Roux-en-Y.

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