Profuse diarrhea after percutaneous change of a computed tomography-guided gastrostomy: endoscopic closure of a colocutaneous fistula

A 71-year-old patient was admitted after the accidental dislodgement of a computed tomography (CT)-guided percutaneous gastrostomy, placed 1 year prior. The initial procedure was uneventful and facilitated rapid weight gain. A percutaneous MIC-KEY tube (Avanos, Alpharetta, Georgia, USA) was rapidly placed along the previous route. As soon as nutrition was restarted, "on and off" profuse diarrhea occurred, ceasing as the nutrition was stopped and resuming immediately upon resumption. Opacification of the MIC-KEY tube revealed a fistulous tract between the transverse colon and the skin ([Video 1]). Conservative treatment was decided, involving the endoscopic closure of the residual colocutaneous fistula, achieved by placing an Ovesco clip (Ovesco Endoscopy, Tübingen, Germany) during a colonoscopy [1].