Hernia Formation and Persistent Fistula after Percutaneous Endoscopy Gastrostomy: Unusual Complications of a Common Procedure

McElrath, LaPortia; Pauli, Eric M.; Marks, Jeffrey M.

doi:10.1177/000313481207800404

Cited by 9 publications

(4 citation statements)

References 4 publications

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“…Gastrocutaneous fistula can occur following removal of percutaneous endoscopic gastrostomy (PEG) tube placed for feeding or gastric decompression. Rarely, the tract does not close leading to a persistent gastrocutaneous fistula in ~1% of patients (29,30).…”

Section: Gastroduodenal Defectsmentioning

confidence: 99%

“…Gastric fistulas are rare but can be seen following PEG removal or more commonly following bariatric surgery in the percutaneous drain tracts (27,29,30). Endoscopic clips, mostly OTSC has been successful in immediate closure of benign esophageal, gastric and colonic fistulas, although long-term success has either not been tested or disappointing with high rate of fistula recurrence (104).…”

Section: Leaksmentioning

confidence: 99%

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Endoscopic management of perforations, leaks and fistulas

Singh

Nussbaum

Kumta

2018

Transl. Gastroenterol. Hepatol

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The endoscopic management armamentarium of gastrointestinal disruptions including perforations, leaks, and fistulas has slowly but steadily broadened in recent years. Previously limited to surgical or conservative medical management, innovations in advanced endoscopic techniques like natural orifice transluminal endoscopic surgery (NOTES) have paved the path towards development of endoscopic closure techniques. Early recognition of a gastrointestinal defect is the most important independent variable in determining successful endoscopic closure and patient outcome. Some devices including through the scope clips and stents have been well studied for other indications and have produced encouraging results in closure of gastrointestinal perforations, leaks and fistulas. Over the scope clips, endoscopic sutures, vacuum therapy, glue, and cardiac device occluders are other alternative techniques that can be employed for successful endoscopic closure.

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Section: Gastroduodenal Defectsmentioning

confidence: 99%

Section: Leaksmentioning

confidence: 99%

Endoscopic management of perforations, leaks and fistulas

Singh

Nussbaum

Kumta

2018

Transl. Gastroenterol. Hepatol

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“…Selection of the technique often depends on the location, size of the defect, surrounding tissue and experience of the endoscopist with different techniques. Gastric fistulas are infrequent and are noticed following percutaneous gastrostomy tube removal or post bariatric surgery [ 5 , 68 ]. Immediate closure is highly successful using OTSC in the setting of benign esophageal, gastric and colonic fistulas [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal fistula endoscopic closure techniques

Bhurwal

Mutneja

Tawadross

et al. 2020

aog

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With the improvement in flexible endoscopic technology and the availability of new endoscopic devices, current endoscopic therapies spare many patients who would otherwise undergo surgical repair of gastrointestinal fistulas. These endoscopic techniques include gastrointestinal stents, endoscopic suturing, cardiac septal occluders, endo-sponge, vacuum therapy and others. This review elaborates on the indications, evidence, procedural details, efficacy, and complications of various endoscopic techniques for the management of gastrointestinal fistulas.

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“…32 Although the rate of persistent fistula after percutaneous endoscopic gastrostomy (PEG) tube removal is low (1.1%), the vast number of PEG tubes placed per year makes this a substantial problem not well reported in the literature. 33 Management strategies for GI tract defects are often multimodal and require careful communication and planning across the multispecialty care team (primary surgeon, endoscopist, interventional radiologist, critical care provider) managing the patient. Although a perforation of the GI tract is traditionally listed as a contraindication to endoscopy, new techniques and technologies have continued to evolve permitting endoscopists to gain experience in the diagnosis and management of full-thickness defects.…”

Section: Full-thickness Luminal Defectsmentioning

confidence: 99%

Endoscopic Management of Gastrointestinal Complications

Witte

Pauli

2018

Dig Dis Interv

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Despite improvements in preoperative patient optimization, refinements in surgical methodology and technology, and the implementation of enhanced recovery protocols, complications following gastrointestinal (GI) surgery remain a fact of life. As the rates of GI surgical procedures increase worldwide, so will the volume of complications. The surgical management of complications is often not ideal, as some (such as acute staple line bleeding or the development of an anastomotic stricture) are luminal-based processes that are difficult to approach from an extraluminal (i.e., surgical) perspective. Endoscopy has largely replaced surgery for the management of such postoperative problems. Leak, the most feared complications of GI surgery, can result from intestinal resection, anastomosis formation, or from iatrogenic injury. With advancements in both diagnostic and therapeutic endoscopy, novel endoluminal and transluminal management options for leak continue to evolve. In centers where these interventions are readily available, they are becoming a first-line treatment option. This article will review the endoscopic management of GI complications with a particular focus on the management of postoperative strictures and of full-thickness GI tract defects (perforations, acute leaks, and chronic fistulae).

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Hernia Formation and Persistent Fistula after Percutaneous Endoscopy Gastrostomy: Unusual Complications of a Common Procedure

Cited by 9 publications

References 4 publications

Endoscopic management of perforations, leaks and fistulas

Endoscopic management of perforations, leaks and fistulas

Gastrointestinal fistula endoscopic closure techniques

Endoscopic Management of Gastrointestinal Complications

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