Curative endoscopic closure of a chronic esophagopleural fistula after Boerhaave syndrome using an over-the-scope clip: A case report

Figure 4 Endoscopic closure using an over-the-scope clip. A: Endoscopic view of the 2-mm fistula located on the left wall just above the esophagogastric junction; B: The fistula and surrounding mucosa were suctioned into the over-the-scope clip (OTSC) cap to achieve adequate tissue capture; C: The OTSC was deployed after confirmation of sufficient tissue inversion into the cap, achieving full-thickness closure; D: Immediate water-soluble esophagography after OTSC placement demonstrated no visualization of the fistula and no leakage into the left pleural cavity; additional clips were not required; the esophagopleural fistula is indicated by an arrow.