Post written by Ali Alshati, MD, from the Department of Internal Medicine, Maricopa Integrated Health System, Creighton University, Phoenix, Arizona, USA.

This is a case of a gastric fistula due to involvement with lymphoma that was successfully managed endoscopically and then with systemic therapy. Endoscopic closure consisted of ablation of the fistula track with argon plasma coagulation, then multi-layer suturing to close the gastric wall defect.

Endoscopy played a major role in this patient management and avoided a major surgery that the patient may have not tolerated. The endoscopic tools and techniques used for managing a gastroretroperitoneal fistula were important to be recorded.

This technique ran a layer of sutures followed by 3 interrupted sutures (multi-layer suturing) to lessen the tension from the first layer and increase the chance of healing.

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