Endoscopic management of gastrojejunocolic fistula after endoscopic gastrojejunostomy

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

Persaud_photo

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.

Persaud_figureInitial 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.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.

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