Non-visible colovesical fistula located by cystoscopy and successfully managed with the novel Padlock device for endoscopic closure.

INTRODUCTION

The development of novel mechanical endoscopic closure systems allows now the management of some gastrointestinal fistula types in a minimally invasive way. However, the correct location of the fistulous tract is essential to achieve successful endoscopic closure.

CASE REPORT

A 69-year-old woman with high risk for surgery presented with recurrent cystitis, pneumaturia, and enteruria 2 months after medical-treated diverticulitis. Computerized tomography demonstrated colovesical fistula but colonoscopy could not locate the fistulous opening. A cystoscopy was performed and the fistulous tract was shown using a guidewire. Then, a novel over-the-scope clip device Padlock system was released in the sigmoid colon, with successful endoscopic closure through this not previously described collaborative approach between urologists, surgeons, and gastroenterologists.