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Updated: May 27, 2025

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Hybrid Endoscopic/Fluoroscopic Gastrostomy Tube Placement: Case Report of a Novel Technique
Nicholas Girardi1, Benjamin Wharton1, Kenneth Cicuto2
1University of Colorado School of Medicine, Aurora, CO, USA.
Introduction:
We report the case of a 60-year-old female with a history of perforated gastric ulcer, abdominal abscesses, enterocutaneous fistula, and small bowel obstruction requiring durable gastric decompression prior to delayed fistula takedown. The patient had contraindications to or failed attempts at traditional gastrostomy approaches (surgical, endoscopic, interventional radiology).
Case Report:
Gastrostomy was successfully performed via a novel technique combining interventional radiology and endoscopic placement.
Discussion:
In certain patients with complex presentations, a hybrid approach to gastrostomy tube placement using fluoroscopy and endoscopy may prove a viable alternative when traditional methods are contraindicated or unsuccessful.
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