Colonoscopic Treatment Of Colocutaneous Fistula With Collagen Plug

Background -Digestive fistulas remain as frequent complications after abdominal operations. When they occur, hospitalization time, cost, morbidity and post-operative mortality increase significantly. Despite various treatment options, a significant number of patients require complex surgical procedures to close them. The development of interventional endoscopy has provided new treatment option for gastro-intestinal fistulas. Case report -Patient with colocutaneous fistula was successfully treated with a collagen plug. Percutaneous injection of methylene-blue identified the internal orifice of the fistula in the transverse colon. Previous clips application was unsuccessful. The fistula closed in few days after collagen plug introduction through a combined percutaneous-colonoscopic procedure. Conclusion -The use of plugs of collagen by combined percutaneous and endoscopic procedure has the advantage of allowing reduced time for treatment of intestinal fistulae and may avoid surgical operations.