A 62-year-old man presented with an esophageal-jejunal anastomotic fistula complicated by an abscess following gastric cancer resection. The CT confirmed the fistula (A). Endoscopy revealed a significant amount of pus in the sinus cavity. Simple drainage was insufficient in promptly and effectively removing the pus. The continuous irrigation and drainage technique has been shown to be safe and effective in treating delayed perforations. Therefore, this technique was implemented after a multidisciplinary consultation. First, two tubes were placed into the fistula cavity (B). One tube was connected to normal saline solution for continuous irrigation (15, 000 mL daily), while the other tube was connected to a negative pressure drainage bag. During the treatment period, continuous irrigation and drainage was strictly implemented, and intravenous antibiotics were continued.

On day 22, the drainage was light yellow and clear, and the CT revealed the fistula had closed, with a significant reduction in the abscess cavity (C). Thus, the continuous irrigation and drainage was discontinued. On day 30, endoscopy confirmed the sinus had healed (D).

Overall, continuous irrigation and drainage for fistula with abscess was effective and feasible. However, further studies are necessary to validate the outcomes.