3497 Endoscopic repair of perforated gut using endoscopic sewing machine

• Published in: Gastrointestinal endoscopy 2000-04, Vol.51 (4), p.AB109-AB109
• Main Authors: Awan, Amjad, Kadirkamanathan, Sritharan S., Gong, Feng, Appleyard, Mark, Murfitt, Janet
• Format: Article
• Language: English
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/S0016-5107(00)14938-7

BACKGROUND: Endoscopic repair of the perforated gut has been reported in rare cases. Various techniques have been used to close the gut perforations via an endoscope. We describe three cases of endoscopic repair of oesophageal and gastric perforations using an endoscopic sewing machine. CASE 1: A 54 year old man had a partial gastrectomy for gastric cancer. A postoperative fistulous leak between the gastrojejunostomy and the chest was demonstrated by contrast study. Six stitches were placed to close the leak using the endoscopic sewing machine. Post procedure contrast x-ray showed that the leak had sealed. CASE 2: A 70 year old man with carcinoma of the oesophagus had a distal oesophageal perforation during Savary dilatation. Three stitches were placed with endoscopic sewing machine to close the perforation. A repeat contrast study showed no leak. Patient died three months later in hospital due to unrelated causes. CASE 3: A 54 year old man with lymphoma of the oesophagus and stomach developed a fistula between the oesophagus and the mediastinum. Covered metal stents were placed twice previously and had fallen into the stomach. A covered Z stent [Wilson Cook] was sewn to the oesophagus using the endoscopic sewing machine. The stent remained in position and the fistula healed nicely. The patient who had been in the intensive care unit for three months was able to leave intensive care unit. CONCLUSION: Successful closure of the gut perforations was possible using endoscopic sewing machine.