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KMID : 1038120150480060563
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Clinical Endoscopy
2015 Volume.48 No. 6 p.563 ~ p.565
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Utility of Over-the-Scope Clipping for Closure of a Persistent Post-Percutaneous Endoscopic Gastrostomy Fistula under Long-Term Steroid Therapy
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Arao Yoshihisa
Sato Yuichi
Hashimoto Satoru
Honda Hiroki
Yoko Kazumi
Takamura Masaaki
Mizuno Ken ichi
Kobayashi Masaaki
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Abstract
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A 50-year-old woman had a percutaneous endoscopic gastrostomy (PEG) tube placed after surgery for pharyngeal cancer. After 21 months, the PEG tube was removed due to improvement of per-oral ingestion. She had taken prednisolone for 31 years for systemic lupus erythematosus. The post-PEG fistula did not close spontaneously. The cause of the fistula was slow wound healing and gastrostomy site inflammation due to long-term steroid therapy. We were able to close the fistula with an over-the-scope clipping (OTSC) system. This case suggests that OTSC is useful for closing persistent post-PEG fistulas in patients receiving long-term prednisolone therapy.
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KEYWORD
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Over-the-scope clipping, Fistula, Percutaneous endoscopic gastrostomy tube, Fibrosis, Steroids
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