<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2341-4545</journal-id>
<journal-title><![CDATA[GE-Portuguese Journal of Gastroenterology]]></journal-title>
<abbrev-journal-title><![CDATA[GE Port J Gastroenterol]]></abbrev-journal-title>
<issn>2341-4545</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Gastrenterologia]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2341-45452023000700052</article-id>
<article-id pub-id-type="doi">10.1159/000526507</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Endoscopic Management of a Chronic Gastrocutaneous Fistula after Bariatric Revisional Surgery Using a Novel Cardiac Septal Occluder]]></article-title>
<article-title xml:lang="pt"><![CDATA[Tratamento endoscópico de fístula gastrocutânea crônica após cirurgia bariátrica revisional com novo dispositivo de oclusão septal cardíaco]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fonseca]]></surname>
<given-names><![CDATA[Mariana Kumaira]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Coelho]]></surname>
<given-names><![CDATA[Nelson Heitor Vieira]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Manica]]></surname>
<given-names><![CDATA[João Luiz Langer]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramblo]]></surname>
<given-names><![CDATA[Rafael Ramos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Spier]]></surname>
<given-names><![CDATA[Ingrid Elisa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Seabra]]></surname>
<given-names><![CDATA[Artur Pacheco]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Moinhos de Vento General Surgery Department ]]></institution>
<addr-line><![CDATA[Porto Alegre ]]></addr-line>
<country>Brazil</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Moinhos de Vento Gastroenterology and Endoscopy Department ]]></institution>
<addr-line><![CDATA[Porto Alegre ]]></addr-line>
<country>Brazil</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Moinhos de Vento Interventional Cardiology in Congenital Heart Disease Department ]]></institution>
<addr-line><![CDATA[Porto Alegre ]]></addr-line>
<country>Brazil</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital Moinhos de Vento Radiology and Diagnostic Imaging Department ]]></institution>
<addr-line><![CDATA[Porto Alegre ]]></addr-line>
<country>Brazil</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Hospital Moinhos de Vento Critical Care and Internal Medicine Departments ]]></institution>
<addr-line><![CDATA[Porto Alegre ]]></addr-line>
<country>Brazil</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>08</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>08</month>
<year>2023</year>
</pub-date>
<volume>30</volume>
<fpage>52</fpage>
<lpage>56</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2341-45452023000700052&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2341-45452023000700052&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2341-45452023000700052&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Endoscopic techniques are now considered the first-line approach for the management of bariatric surgery-related fistulas. The off-label use of cardiac septal defect occluders (CSDO) is an emerging technique that has demonstrated favorable outcomes for the closure of extra-vascular defects, including gastrointestinal (GI) disruptions. Previous case reports have reported similar results with the CSDO Amplatzer&#8482; for the management of GI disruptions following bariatric surgery. However, the use of similar alternative devices for this purpose has not yet been described.  Case Presentation:  This case report presents the first reported use of the Occlutech® CSDO for the treatment of a chronic gastrocutaneous fistula after bariatric revisional surgery. Despite apparent initial success - no extravasation of contrast material through the device in the contrast study after the CSDO placement - fistula closure failed due to partial dislodgement of the device. The placement of a second device between the discs of the former one ultimately sealed the fistulous orifice.  Discussion:  In chronic GI fistulas, the mature tract is often not liable to the application of standard endoscopic methods, leading to failed closure attempts. A new application of Occlutech® CSDO can obviate the clinical burden of a high-risk laparotomy in these cases. Appropriate endoscopic equipment as well as the involvement of a multidisciplinary team are prime conditions to ensure successful patient outcomes.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  As técnicas endoscópicas são atualmente consideradas abordagens de primeira linha no manejo das fístulas associadas a cirurgia bariátrica. O uso off-label de dispositivos de oclusão do septo cardíaco (CSDO) é uma técnica nova que tem demonstrado resultados favoráveis no encerramento de defeitos extra-vasculares, incluindo fístulas gastrointestinais. Relatos de caso prévios reportaram resultados semelhantes com o CSDO Amplatzer&#8482; para o tratamento de fístulas gastrointestinais pós cirurgia bariátrica. No entanto, o uso de dispositivos alternativos semelhantes para esse fim ainda não foi descrito.  Relato de Caso:  Este relato de caso apresenta o primeiro uso reportado do CSDO Occlutech® para tratamento de fístula gastrocutânea crônica após cirurgia bariátrica revisional. Apesar do aparente sucesso inicial - nenhum extravasamento de contraste através do dispositivo na fluoroscopia após a colocação do CSDO, houve recorrência da drenagem fistulosa devido ao deslocamento parcial do dispositivo. A colocação de um segundo dispositivo entre os discos do primeiro acabou por encerrar o orifício fistuloso.  Discussão:  Nas fístulas gastrointestinais crônicas, o trajeto epitelizado muitas vezes não é passível de aplicação dos métodos endoscópicos tradicionais, levando a múltiplas tentativas fracassadas de encerramento. A nova aplicação de Occlutech® CSDO pode evitar o risco de uma laparotomia de alto risco nesses casos. Equipamentos endoscópicos adequados, bem como o envolvimento de equipe multidisciplinar são condições primordiais para garantir o sucesso do tratamento.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Bariatric surgery]]></kwd>
<kwd lng="en"><![CDATA[Gastric fistula]]></kwd>
<kwd lng="en"><![CDATA[Endoscopy]]></kwd>
<kwd lng="en"><![CDATA[Gastrointestinal]]></kwd>
<kwd lng="en"><![CDATA[Septal occluder device]]></kwd>
<kwd lng="pt"><![CDATA[Cirurgia bariátrica]]></kwd>
<kwd lng="pt"><![CDATA[Fístula gástrica]]></kwd>
<kwd lng="pt"><![CDATA[Endoscopia]]></kwd>
<kwd lng="pt"><![CDATA[Gastrointestinal]]></kwd>
<kwd lng="pt"><![CDATA[Dispositivo para oclusão septal]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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