Publication:

Successful management of gastric fistulas with endoluminal vacuum therapy after a type IV hiatal hernia repair: a case report

Endoluminal vacuum therapy (Endo-Vac) is currently part of the first line in the endoscopic management of gastrointestinal fistulas or perforations, due to its high success rates and low percentage of adverse events. We present the case of a 48-year-old man who presented with two gastric fistulas after the correction of a type IV hiatal hernia and anti-reflux surgery, which was successfully managed with endoluminal vacuum therapy without complications. Endo-Vac therapy is currently a safe and effective technique for the treatment of transmural defects in the digestive tract. However, it is necessary to develop an algorithm based on the location, size of the defect, associated stenosis, infection, and available experience to reduce complications and possible adverse events, always in conjunction with a multidisciplinary team.