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Case Reports
. 2011 Feb 28;17(8):1088-90.
doi: 10.3748/wjg.v17.i8.1088.

Tulip bundle technique and fibrin glue injection: unusual treatment of colonic perforation

Filippo Mocciaro  1 , Gabriele Curcio, Ilaria Tarantino, Luca Barresi, Marco Spada, Sergio Li Petri, Mario Traina
Affiliations
Case Reports

Tulip bundle technique and fibrin glue injection: unusual treatment of colonic perforation

Filippo Mocciaro et al. World J Gastroenterol. .

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.

Keywords: Colonic perforation; Endoscopic treatment; Fibrin glue injection; Tulip bundle technique.

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Figures

Figure 1
Figure 1
Figure shows the colonic perforation (A), two borders of the perforation did not fit well (arrow) after clips and endoloops placement (B) and completely sealing after fibrin glue injection (C, D).
Figure 2
Figure 2
Complete repair of the perforation at laparoscopy (arrow).
See this image and copyright information in PMC

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