New MethodCombined endoscopic cautery and clip closure of chronic gastrocutaneous fistulas
Section snippets
Patient 1
A girl with epidermolysis bullosa simplex underwent surgical placement of a gastrostomy tube at 1 month of age for supplemental feeding when perioral bullous formation prevented adequate oral feeding. By 1 year of age, the child had improved, no longer requiring supplemental tube feedings, and the gastrostomy tube was removed. The gastrocutaneous fistula continued to drain for the next month, causing maceration of the skin from exposure to gastric contents. The tract was too small to cauterize
Discussion
The endoscopic clipping technique described in this study resulted in complete closure of a chronic gastrocutaneous fistula in two patients and partial closure in a third patient. Several factors may have contributed to incomplete fistula closure in the third patient with the longest established gastrostomy tract. Although cautery of the tract with both silver nitrate and electrocoagulation was used to ablate the epithelial lining of the tract and to promote bridging scar formation, this
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Cited by (0)
This work was presented, in part, at the annual meeting of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition, October 2-5, 2003, Montreal, Canada.