Colovaginal fistula closure using a cardiac septal defect occluder

Sadiq, Omar; Simmer, Stephen; Watson, Andrew; Eng, Marvin H.; Frisoli, Tiberio; Zuchelli, Tobias

doi:10.1016/j.vgie.2020.09.001

Cited by 2 publications

(7 citation statements)

References 3 publications

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“…Colovaginal fistula is a rare condition. Aetiologies include diverticular disease, iatrogenic, inflammatory bowel disease, neoplasm and obstetric causes 1. Colovaginal fistula complicates ~14% of diverticulitis after an acute episode 3.…”

Section: Discussionmentioning

confidence: 99%

“…These techniques require multiple sessions and the recurrence rate is relatively high. The limitations of the current therapeutic approaches necessitate investigation into use of other modalities for management of GI tract fistulas, such as CSOs 1 2…”

Section: Discussionmentioning

confidence: 99%

“…Cardiac septal occluders (CSOs) are typically used in the closure of atrial septal defects and ventricular septal defects. There have been some reports of CSO use in closure of upper GI fistulas 1 2. We present two cases of colovaginal fistula closure using the Amplatzer cardiac septal defect occluder.…”

Section: Introductionmentioning

confidence: 95%

“…While the clinical presentation is variable, most patients present with passage of gastrointestinal (GI) contents or gas into the vagina, pelvic pain, or recurrent urinary tract infections (UTIs). Several aetiologies have been described including diverticular disease, malignancy of the GI or GU tracts, radiotherapy to the pelvis, or previous pelvic surgery (ie, hysterectomy) 1–4. Colovaginal fistula is a clinical diagnosis supported by imaging such as CT with contrast enema and endoscopic evaluation 3.…”

Section: Introductionmentioning

confidence: 99%

“…Endoscopic techniques include use of clips, cap mounted clips, self-expanding metal stents, sealants and endoscopic sutures. However, these therapies have varying success rates and often result in multiple procedures 1 2 4. Cardiac septal occluders (CSOs) are typically used in the closure of atrial septal defects and ventricular septal defects.…”

Section: Introductionmentioning

confidence: 99%

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Closure of recurrent colovaginal fistulas using AMPLATZER occluder device

Simmons

Ahmed

Mader

et al. 2022

BMJ Open Gastroenterol

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A 79-year-old woman and a 92-year-old woman were referred to the gastroenterology department for management of persistent colovaginal fistula despite surgical and non-surgical management. Both patients had several hospitalisations for recurrent urinary tract infections. After failed surgical management and endoscopy using over-the-scope clipping, both patients underwent endoscopic closure using the Amplatzer cardiac septal occluder device. Both patients underwent successful closure and had no recurrence of symptoms at 6-month follow-up. Although there are several therapies available for persistent colovaginal fistulas, most involve multiple sessions and have high recurrence rate. There have been reports in the literature of cardiac septal occluders being used in the management of upper gastrointestinal tract fistulas, but few cases exist explaining their role in the management of colovaginal fistulas. Our cases demonstrate that cardiac septal occluders may be a viable option for management of fistulas and warrants further studies to reproduce its effectiveness and safety.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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