Endoscopic Deployment of Cardiac Septal Occluder Device to Close an Enterovaginal Fistula

Enterovaginal fistulas (EF) are a rare, pathologic connection between the small bowel and vagina. EF commonly present with abnormal passage of stool, flatus, and purulence through the vaginal orifice, leading to increased risk of severe infections, and cause extreme discomfort for patients. A 70-year-old woman with a history of urothelial carcinoma was treated surgically, resulting in a persistent symptomatic EF. Her course was complicated by multiple failed surgical attempts to fistula closure. Ultimately, she was deemed a poor surgical candidate. Gastroenterology successfully closed her fistula using a cardiac occluder device. This case highlights an innovative solution to treat patients with refractory fistulas.