Abbreviation: CSDO (cardiac septal defect occluder) Introduction Gastrointestinal fistulas can be challenging to manage endoscopically. Fistulas can occur as a result of malignancy, inflammatory conditions, postoperative states, endoscopic interventions, or radiation therapy. Various endoscopic techniques have been used because of high rates of morbidity and mortality associated with fistula formation. However, these endoscopic therapies offer varying ranges of clinical success.