Post written by Tamasha Persaud, MD, from New York Presbyterian/Weill Cornell Medical Center, New York, New York, USA.

In this video case report, we describe the formation of a gastrojejunocolic fistula (GCF) as a rare delayed sequela of EUS-guided gastrojejunostomy (EUS-GJ) and demonstrate how tandem stent placement with a long covered metal stent can be an effective rescue maneuver for this adverse event.

We chose to showcase this video because, to our knowledge, this is the first reporting of a GCF after EUS-GJ. Moreover, closure of GCFs can be particularly challenging in the setting of inflammatory states such as malignancy.

Several endoscopic interventions are available for repair that have inherent limitations. However, this video highlights a promising rescue technique.

The formation of a GCF is a rare adverse event after EUS-GJ. There are few examples of optimal rescue maneuvers for this. However, tandem stent placement with a long covered metal stent may be very effective.

Initial gastrojejunostomy showing 15-mm lumen-apposing metal stent with distal end in the jejunum and the proximal end in the stomach (A). A 7F × 5-cm anchoring double-pigtail plastic stent within 15-mm lumen-apposing metal stent (B).

Read the full article online.

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