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KMID : 1038120150480050440
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Clinical Endoscopy
2015 Volume.48 No. 5 p.440 ~ p.443
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Treatment of Traumatic Esophagopleural Fistula Using the Over-the-Scope-Clip System
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Kim Ji-Hyoung
Park Jong-Jae
Jung Il-Woo
Kim Sang-Hoon
Kim Hee-Dong
Choe Jung-Wan
Joo Moon-Kyung
Kim Hyun-Gu
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Abstract
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Esophagopleural fistula (EPF) is a rare condition that is usually accompanied by severe infection and life-threatening morbidity. Here, we report the successful treatment of an EPF by closing an esophageal orifice using the over-the-scope-clip (OTSC) system without postprocedural complications. A 41-year-old man had serious thoracic and abdominal trauma due to a traffic accident. Computed tomography revealed findings suggestive of esophageal rupture due to Boerhaave syndrome. An emergent explorative operation was performed for primary repair with the insertion of a vacuum-assisted closure device. A postoperative upper gastrointestinal series revealed an EPF tract connecting the left pleural space and distal esophagus. We performed an endoscopic procedure using the "traumatic-type"OTSC to seal the EPF, and the esophageal orifice was completely healed 2 weeks postoperatively. The OTSC system might represent a safe and feasible modality for the treatment of EPF.
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KEYWORD
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Esophagopleural fistula, Over-the-scope-clip, Negative-pressure wound therapy
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