Ethanol injection for ablation of an intractable digestive tract fistula: report of a case

We successfully occluded an intractable digestive tract fistula by injecting it with absolute ethanol after all other treatments failed. A 48-year-old man suffered from a complex and relapsing digestive tract fistula after curative surgery for advanced colon cancer invading the pancreas and duodenum...

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Bibliographic Details
Published in:Surgery today (Tokyo, Japan) Japan), 2006-08, Vol.36 (8), p.744-746
Main Authors: Matsuyama, Satoru, Sato, Seiji, Yoda, Yukie, Kai, Keita, Mitsuno, Mayumi, Nakafusa, Yuji, Miyazaki, Kohji
Format: Article
Language:English
Subjects:
Ethanol - administration & dosage
Gastric Fistula - therapy
Humans
Injections, Intralesional
Intestinal Fistula - therapy
Male
Middle Aged
Postoperative Complications
Sclerotherapy - methods
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Summary:We successfully occluded an intractable digestive tract fistula by injecting it with absolute ethanol after all other treatments failed. A 48-year-old man suffered from a complex and relapsing digestive tract fistula after curative surgery for advanced colon cancer invading the pancreas and duodenum. After conservative management by fasting, drainage, and irrigation failed, fibrin glue infusion achieved only transient occlusion. We performed surgical repair and he was discharged from hospital, at which time fistulography showed no fistula. However, 1 month later fistulography showed that the fistula had recurred and involved the transverse colon, stomach, and intrahepatic bile duct via the jejunum. Finally, we gave five injections of absolute ethanol into the fistula, which resulted in complete occlusion within 6 months. Considering its clinical efficacy, safety, and cost efficiency, we think that ethanol sclerotherapy is a feasible treatment for intractable digestive tract fistula when conservative therapy fails.
ISSN:0941-1291
1436-2813
DOI:10.1007/s00595-006-3238-1