A woman in her 70s with systemic sclerosis experienced dyspnea, and consequently, she was diagnosed with an esophago-pleural fistula, which was caused by a perforated esophageal ulcer. We administered conservative treatments including continuous pleural drainage and total parenteral nutrition. The fistula was closed but recurred, at which point we attempted to close the fistula by filling and shielding using polyglycolic acid (PGA) sheets and fibrin glue (FG). We were able to safely and smoothly fill and shield the fistula using the PGA sheets with a guidewire. We show that endoscopic closure of an esophago-pleural fistula using this technique is an effective, low-invasive treatment for gastrointestinal perforation and refractory fistulas.
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http://dx.doi.org/10.11405/nisshoshi.118.78 | DOI Listing |
Int J Surg Case Rep
October 2023
Department of Surgery, Teaching Hospital Jaffna, Sri Lanka.
Introduction And Importance: Boerhaave syndrome is a rare life-threatening condition that represents about 15 % of esophageal perforation and is associated with significant mortality. A subset of patients with effort rupture of the esophagus can present with esophago-pleural fistula. Management of esophago-pleural fistula remains a challenge due to the lack of high-quality evidence studies and the rarity of reported cases.
View Article and Find Full Text PDFIntern Med
April 2024
Department of Gastroenterology, The First Affiliated Hospital of Ningbo University, China.
A 48-year-old man developed sudden-onset haematemesis and melena after decompensated posthepatitic cirrhosis. Endoscopic variceal injectional sclerotherapy was emergently performed. However, the patient developed esophago-pleural fistula, empyema, and liver failure.
View Article and Find Full Text PDFVideoGIE
May 2023
Division of Gastroenterology and Hepatology, Virginia Mason Medical Center, Seattle, Washington.
Video 1Suturing pexy to seal a leak around an esophageal stent in the setting of a malignant esophago-pleural fistula.
View Article and Find Full Text PDFCase Rep Gastroenterol
November 2022
Division of Internal Medicine, St. Luke's Hospital, Chesterfield, Missouri, USA.
Laparoscopic adjustable gastric banding was previously a commonly performed bariatric procedure. However, in recent years, the procedure has become less commonly performed. Long-term complications nonetheless persist and continue to be seen in clinical practice.
View Article and Find Full Text PDFCase Rep Gastroenterol
June 2022
Department of Surgery, NorthShore University Health System, Chicago, Illinois, USA.
Pill-induced esophagitis due to calcium supplements is extremely uncommon. We present a 60-year-old female patient with pill-induced esophageal perforation complicated by mediastinal abscess and esophago-pleural fistula following ingestion of a single over-the-counter "bone supplement" tablet containing mainly calcium.
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