Clin Endosc.  2015 Nov;48(6):576-578. 10.5946/ce.2015.48.6.576.

Successful Palliation of a Malignant Cologastric Fistula with a Covered Self-Expanding Metal Stent

• Breitenbauch MTW
• Tottrup A

• KMID: 2380420
• DOI: http://doi.org/10.5946/ce.2015.48.6.576

Abstract

When patients present with malignant cologastric fistulas, the tumor stage is often advanced and management is only palliative. We report the case of a 75-year-old man with a symptomatic cologastric fistula arising from an advanced tumor in the transverse colon, previously stented owing to malignant obstruction. An 8-cm-long covered self-expanding metal stent (COMVI enteral colonic stent; Taewoong Medical) was placed inside the primary stent, which sealed the fistula and completely alleviated the symptoms. Considering the successful outcome, we propose that insertion of a covered stent be considered in the palliative management of patients with malignant cologastric fistulas.

Keyword

Cologastric; Fistula; Stents

MeSH Terms

Aged
Colon
Colon, Transverse
Fistula*
Humans
Stents*

Figure

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  Fig. 1. Endoscopic view of the newly placed covered stent.

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  Fig. 2. Fluoroscopic image of the two stents with the colonoscope tip inside the distal end of the stents and the guidewire left in situ.

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  Fig. 3. Contrast study showing filling of the cologastric fistula and accumulation of contrast outside the stent with no contrast passage to the colon.

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