J Korean Soc Radiol.  2011 Apr;64(4):325-328. 10.3348/jksr.2011.64.4.325.

Percutaneous Treatment of a Jejunovaginal Fistula Using a Combination of the Amplatzer Vascular Plug II and N-Butyl-2-Cyanoacrylate: A Case Report

• Lee HK
• Kwak HS
• Han YM
• Kim YK

• KMID: 1443534
• DOI: http://doi.org/10.3348/jksr.2011.64.4.325

Abstract

Treatment for an enterovaginal fistula should consider the location of an intestinal fistula. Most rectovaginal fistulas develop in the lower third of the vagina and can be treated surgically. Jejunovaginal fistulas can spontaneously close during conservative management. We report the first use of the Amplatzer vascular plug II (AVP II; AGA Medical Corp, Golden Valley, MN, USA) and the use of an N-butyl-2-cyanoacrylate (NBCA; Histoacryl, Braun, Melsungen, Germany)-iodized oil (Lipiodol Ultra-Fluid, Guerbet, Aulnay-sous-Bois, France) mixture for treatment of a patient with a jejunovaginal fistula which failed to close after conservative management. The patient did not have any vaginal discharge one day later after deployment of the AVP II.

MeSH Terms

Enbucrilate
Fistula
Humans
Intestinal Fistula
Rectovaginal Fistula
Vagina
Vaginal Discharge
Enbucrilate

Figure

• 

  Fig. 1 Fistulogram through a transvaginal approach shows the tract of the jejunovaginal fistula (arrows).

• 

  Fig. 2 Fistulogram obtained after deployment of the Amplatzer vascular plug (AVP) II (white arrows) and injection of the N-butyl-2-cyanoacrylate (NBCA)-lipiodol mixture (black arrow) at the site of the jejunovaginal fistula shows that the fistula to be completely occluded.

• 

  Fig. 3 Coronal view of contrast-enhanced CT scan obtained at three months after placement showing that the AVP II is remained into the jejunovaginal fistula (arrow).

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