Treatment of a duodenojejunal fistula with percutaneous transgastric drainage

We report a case of high output duodenojejunal fistula which developed after resection of the distal duodenum, first jejunal loop and the uncinate process of the pancreas, infiltrated by duodenal cancer. The high flow fistula complicated an urgent re-operation to deal with a perforation of the superior mesenteric artery. As the patient was in a critical condition a drain was positioned into the fistula through a percutaneous gastrostomy, Over 18 days the daily amount of fluid decreased from 1600 ml to zero and the lesion healed completely. Technical details and indications are discussed.