Mocciaro F, Curcio G, Tarantino I, Barresi L, Spada M, Petri SL, Traina M. Tulip bundle technique and fibrin glue injection: Unusual treatment of colonic perforation. World J Gastroenterol 2011; 17(8): 1088-1090 [PMID: 21451724 DOI: 10.3748/wjg.v17.i8.1088]
Corresponding Author of This Article
Filippo Mocciaro, MD, PhD, Department of Gastroenterology, IsMeTT, Via Tricomi 1, Palermo 90100, Italy. fmocciaro@gmail.com
Article-Type of This Article
Case Report
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World J Gastroenterol. Feb 28, 2011; 17(8): 1088-1090 Published online Feb 28, 2011. doi: 10.3748/wjg.v17.i8.1088
Tulip bundle technique and fibrin glue injection: Unusual treatment of colonic perforation
Filippo Mocciaro, Gabriele Curcio, Ilaria Tarantino, Luca Barresi, Marco Spada, Sergio Li Petri, Mario Traina
Filippo Mocciaro, Gabriele Curcio, Ilaria Tarantino, Luca Barresi, Mario Traina, Department of Gastroenterology, IsMeTT, UPMC, Via tricomi 1, Palermo 90100, Italy
Marco Spada, Sergio Li Petri, Surgery Unit, IsMeTT, UPMC, Via tricomi 1, Palermo 90100, Italy
Author contributions: Mocciaro F collected data and wrote the article; Curcio G and Tarantino I, Barresi L participated in drafting the article, collected data and reviewed the final version; Spada M and Li Petri S performed the operation; Traina M was the lead investigator, performed the endoscopy, and reviewed the final version.
Correspondence to: Filippo Mocciaro, MD, PhD, Department of Gastroenterology, IsMeTT, Via Tricomi 1, Palermo 90100, Italy. fmocciaro@gmail.com
Telephone: +39-91-900347 Fax: +39-91-2192400
Received: August 22, 2010 Revised: November 11, 2010 Accepted: November 18, 2010 Published online: February 28, 2011
Abstract
We report a case of a 63-year-old male who experienced an iatrogenic sigmoid perforation repaired combining three endoscopic techniques. The lesion was large and irregular with three discrete perforations, therefore, we decided to close it by placing one clip per perforation, and then connecting all the clips with two endoloops. Finally we chose to use a fibrin glue injection to obtain a complete sealing. Four days after the colonoscopy the patient underwent a laparoscopic right hemicolectomy due to evidence of a large polyp of the caecum with high grade dysplasia and focal carcinoma in situ. Inspection of the sigma showed complete repair of the perforation. This report underlines how a conservative approach, together with a combination of various endoscopic techniques, can resolve complicated iatrogenic perforations of the colon.
