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

• Published in: International journal of colorectal disease Vol. 33; no. 6; pp. 827 - 829
• Main Authors: Velayos, Benito, Del Olmo, L., Merino, L., Valsero, M., González, J. M.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-06-2018; Springer Nature B.V
• Subjects: Colon; Computed tomography; Cystitis; Endoscopy; Fistula; Fistulae; Gastroenterology; Hepatology; Internal Medicine; Medicine; Medicine & Public Health; Proctology; Short Communication; Surgery; Therapeutic endoscopy; Uroenteric fistula; Over-the-scope clip; Fistula closure; Diverticulitis
• ISSN: 0179-1958; 1432-1262
• DOI: 10.1007/s00384-018-3008-8

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.