Treatment of ileocolonic anastomosis fistula with endoclips

This patient developed ischemic colitis following an aspirin overdose and required a subtotal colectomy and temporary ileostomy. Following creation of an ileal-sigmoid anastomosis he developed a large abscess and was found the have a large post-operative fistula at the anastomotic site as shown above. In addition to percutaneous abscess drainage, twelve Resolution clips were placed during colonoscopy to close the defect. Subsequently, the abscess drainage subsided and the patient was able to tolerate refeeding within two weeks without the subsequent need for reoperation.