Endoscopic treatment of a gastrocutaneous fistula in a chil.

Abstract

Introduction: Gastric leaks and gastrocutaneous fistulae (GCF) after digestive surgery are unusual in children. Common treatments are based on conservative measures and surgery but endoscopic techniques are not a widespread option in pediatrics.

Case report: An underweight child developed a GCF after surgery (esophagocoloplasty with right colon). It was managed endoscopically, placing double J ureteral stents (DJUS) with one tip in the gastric lumen and the other tip exiting through the cutaneous orifice via the fistula. A laminar drain was used to evacuate the intra-abdominal cavity. The patient was fed with a gastro-jejunal tube and the diameter of DJUS was reduced progressively. Ninety-two days after the initial endoscopic therapy the gastric orifice was closed. There were no severe complications or recurrences.

Discussion: The relevance of this case lies in the low prevalence of this complication and in the innovative endoscopic approach in children, which was safe and effective.