Novel treatment options for perforations of the upper gastrointestinal tract: Endoscopic vacuum therapy and over-the-scope clips

Figure 1 Sponge mounted on a gastric tube for endoscopic vacuum therapy (A), and over-the-scope clip mounted on a gastroscope (B). A suture loop at the tip of the sponge facilitates endoscopic handling (A).

Figure 2 Dehiscence of an esophagogastric stapler anastomosis with esophago-bronchial fistula in a 65-year old woman: endoscopic vacuum therapy and over-the-scope clip application. A: Anastomotic dehiscence (after extraction of a covered stent); B: Mediastinal cavity; C: Endoscopic vacuum therapy. Gastric tube with sponge placed in the defect (center), additional tube placed in the duodenum for enteral nutrition; D: Persistent fistula (below) after endoscopic vacuum therapy; E: Over-the-scope clip (OTSC) closure of the fistula; F: Eleven months after OTSC closure.