Dual-sided closure of an iatrogenic gastrocolonic fistula with over-the-scope clips

An 86-year-old man with walled-off pancreatic necrosis (WON) was initially managed with a percutaneous drain. He was referred to our service because of a persistent collection. After fluid had been instilled via the drain to expand the collapsed collection, endoscopic ultrasound (EUS)-guided cystogastrostomy was performed with a lumen-apposing metal stent (LAMS; 15-mm wide × 10 mm in length). A computed tomography (CT) scan the following week revealed a gastrocolostomy due to stent misdeployment. As the patient was clinically stable, we opted to wait 4 weeks to facilitate tract maturation prior to LAMS removal and definitive closure [1].