Novel endoscopic management of a chronic gastro-gastric fistula using a cardiac septal defect occluder

Closure of gastro-gastric(GG) fistulas after Roux-en-Y gastric bypass(RYGB) it’s a challenge. A 51-year-old woman, status-post RYGB in 2008, presented with a six-month history of weight regain and reflux. She had regained weight to 84kg when she was found to have a GG fistula. She underwent successful Cardiac septal defect occluders(CSDO) placement, and 3-months later, had lost 10kg with improvement in her reflux. Repeat evaluation confirmed successful closure without contrast leak. This is the first report of use of a CSDO for closure of a GG fistula. The use of CSDO was technically feasible and appeared to be effective and safe.