First report of colonoscopic closure of a gastrocolocutaneous PEG migration with over-the-scope-clip-system

Figure 1 Computed tomography of the abdomen confirmed a buried bumper syndrome with displacement of the internal bumper (short arrow) into the transverse colon (long arrow).

Figure 2 Colonoscopy also revealed the internal bumper (arrow) in the transverse colon. The fistula (arrowhead) measured 3-4 mm in diameter.

Figure 3 Removal of the internal bumper with a polypectomy snare.

Figure 4 Over-the-scope-clip system device (arrow) is being deployed on top of the fistula.

Figure 5 Deployed over-the-scope-clip system device in transcolonic fistula.