Treatment of duodenal fistula with combined endoscopic therapy: modified endoscopic vacuum, endoscopic internal drainage, and the over-the-scope clip

GI fistulas are often severe adverse events associated with high morbidity and mortality.1,2 Recently, several endoscopic techniques have been developed and have proven to be effective in the treatment of GI fistulas. However, in some specific cases, a combination of endoscopic techniques may be necessary to achieve better results.3-7 We report a case of duodenal fistula successfully treated with 3 complementary endoscopic techniques (Video 1, available online at www.videogie.org).