2017 Volume 59 Issue 12 Pages 2719-2724
We report a case of persistent jejunocutaneous fistula that was successfully treated using an over-the-scope clip (OTSC) device under guidewire guidance. A 71-year-old man who had undergone jejunostomy after cerebral infarction two years previously, was referred to our institution for buried bumper syndrome of the jejunostomy catheter. Even after removal of the catheter by conservative therapy at our institution, the jejunocutaneous fistula did not fully close and leakage of intestinal juice continued. Therefore, we attempted endoscopic closure of the fistula using an OTSC device. Initially, a guidewire was inserted through the fistula, grasped by the endoscope, and pulled out with the endoscope perorally. Then, an endoscope equipped with an OTSC was introduced along the guidewire into the fistula, and the clip was released to close the fistula. Use of a guidewire was effective in accurately positioning the OTSC on the jejunocutaneous fistula.
