Non-visible colovesical fistula located by cystoscopy and successfully managed with the novel Padlock® device for endoscopic closure

Int J Colorectal Dis. 2018 Jun;33(6):827-829. doi: 10.1007/s00384-018-3008-8. Epub 2018 Mar 12.

Abstract

Introduction: The development of novel mechanical endoscopic closure systems allows now the management of some gastrointestinal fistula types in a minimally invasive way. However, the correct location of the fistulous tract is essential to achieve successful endoscopic closure.

Case report: A 69-year-old woman with high risk for surgery presented with recurrent cystitis, pneumaturia, and enteruria 2 months after medical-treated diverticulitis. Computerized tomography demonstrated colovesical fistula but colonoscopy could not locate the fistulous opening. A cystoscopy was performed and the fistulous tract was shown using a guidewire. Then, a novel over-the-scope clip device Padlock® system was released in the sigmoid colon, with successful endoscopic closure through this not previously described collaborative approach between urologists, surgeons, and gastroenterologists.

Keywords: Diverticulitis; Fistula closure; Over-the-scope clip; Therapeutic endoscopy; Uroenteric fistula.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Colonoscopy*
  • Cystoscopy*
  • Female
  • Humans
  • Intestinal Fistula / diagnosis*
  • Intestinal Fistula / diagnostic imaging
  • Intestinal Fistula / surgery*
  • Surgical Instruments*
  • Tomography, X-Ray Computed
  • Urinary Bladder / diagnostic imaging
  • Urinary Bladder / surgery