UGI Esophagus-INNOVATIVE MULTIMODAL ENDOSCOPIC MANAGEMENT OF A VASCULAR-ENTERIC FISTULA

INNOVATIVE MULTIMODAL ENDOSCOPIC MANAGEMENT OF A VASCULAR-ENTERIC FISTULA

Video Transcription

Video Summary

This video case report discusses the innovative endoscopic techniques used to manage a patient with a life-threatening upper GI hemorrhage due to a vascular enteric fistula. The patient had a complex surgical history and presented with hemoptysis and acute blood loss anemia. Initial tests did not identify the source of bleeding, but a repeat endoscopy revealed a lesion in the upper esophagus. The patient underwent thoracic endovascular aortic repair to address a presumed aortic anastomosis disruption. However, the bleeding persisted, and an interventional gastroenterologist used a vascular occlusion balloon to stop the bleeding. An endoscopic angiogram showed a vascular enteric fistula from a smaller vessel. The lesion was then treated with an over-the-scope clip, and the patient stabilized. Despite postoperative complications, the successful endoscopic evaluation and management highlight the importance of initial vascular control, situational awareness, reliance on surgical principles, and a multidisciplinary care team. The patient ultimately succumbed to underlying comorbidities.

Asset Subtitle

Best of the Best - Authors: Colin G. Delong, Rolfy Perez-Holguin, Alexander T. Liu, Michael F. Reed, Karima C. Fitzgerald, Maria Castello Ramirez, Mathew Abraham, Eric Pauli

Keywords

endoscopic techniques

upper GI hemorrhage

vascular enteric fistula

thoracic endovascular aortic repair

over-the-scope clip