Percutaneous obliteration of duodenal fistula

High output external duodenal fistula is a difficult condition to treat and despite the advances in nutritional care, morbidity and mortality remain high. Although, non surgical methods (e.g. endoscopy, fistuloscopy and percutaneous injection of substances) have been reported sporadically in the treatment of enterocutaneous fistulae, gelfoam has not been tried. We present a case of duodenal fistula following blunt abdominal trauma which persisted for 14 weeks on conservative management. Percutaneous obliteration of the duodenal fistula was successfully performed using gelfoam injection through a catheter. This procedure is simple, safe and cheap and further experience may demonstrate that it is an easy and more practical tool in dealing with this problem.