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Sample records for anomalies tracheoesophageal fistula

  1. Tracheoesophageal Fistula; A Case Report

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    ÖZDEN, Okan; Gün, İsmet

    2012-01-01

    A tracheoesophageal fistula is an abnormal con- nection between the esophagus and the trachea and is a rarely seen pathology. The absence of the fetal stomach or visualization of the fetal stom- ach smaller than normal by ultrasound in early gestation, and detection of polyhydramnios in third trimester are the most valuable signs in ul- trasonographic examination. In addition to this, depending on the type of the anomaly, blind pouch sign of the esophagus can be detected at the medi- astinum ...

  2. Early Recognition of H-Type Tracheoesophageal Fistula

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    Muhammad Riazulhaq

    2012-02-01

    Full Text Available Tracheoesophageal fistula (TEF without associated esophageal atresia (EA is a rare congenital anomaly. Diagnosis in neonatal period is usually not made and most of the patients are treated as cases of pneumonia. A case of H-type of tracheoesophageal fistula, diagnosed within 24 hours of delivery based upon choking and cyanosis on first trial of feed, is being reported. Diagnosis was confirmed with contrast esophagram. Through cervical approach fistula was repaired and baby had uneventful post operative outcome.

  3. H type tracheoesophageal fistula detected by radionuclide salivagram

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    Lee, Dong Yun; Kim, Kyung Mo; Kim, Jae Seung [Univ. of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2012-09-15

    Congenital H type tracheoesophageal fistula is a rare anomaly in infants and the early diagnosis of this disorder is still a challenge to pediatricians due to scarcity, non specific symptoms and lack of a single diagnostic examination. We report the case of a 3 month old baby with choking and recurrent aspiration which finally turned out to be a tracheoesophageal fistula without esophageal atresia (H type)by radionuclide salivagram.

  4. A case of Scimitar syndrome with H-type tracheoesophageal fistula and multiple anomalies: Diagnosis using electrocardiography-gate chest CT

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    Lim, Kyung Jae; Kang, Eun Ju; Lee, Ki Nam; Jo, Jeong Hyun [Dept. of Radiology, Dong-A University Hospital, Dong-A University College of Medicine, Busan (Korea, Republic of)

    2014-10-15

    Scimitar syndrome is a rare, combined abnormality of bronchopulmonary development and pulmonary vascular development characterized by an anomalous pulmonary venous return to the inferior vena cava. Although the scimitar syndrome has been associated with many anomalies, a tracheoesophageal fistula (TEF), especially from H-type, is extremely rare and only a few cases have been reported without detailed descriptions. Herein we report a rare case of scimitar syndrome with H-type TEF and multiple anomalies in a newborn infant, with a special emphasis on the imaging features associated with the radiologic diagnosis using an electrocardiography-gated computed tomography.

  5. Spectrum of bronchopulmonary anomalies associated with tracheoesophageal malformations

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    Benson, J.E.; Fletcher, B.D.; Olsen, M.

    1985-09-01

    The combination of tracheoesophageal and pulmonary malformations is unusual and reportedly carries a high mortality. We have observed six patients with esophageal atresia and tracheoesophageal fistula and one with a bronchoesophageal fistula who had associated bronchopulmonary anomalies ranging from lobar hypoplasia and agenesis to unilateral pulmonary hypoplasia or agenesis. All of the pulmonary malformations were right-sided. Vertebral or rib anomalies were present in five patients, congenital heart disease in two, imperforate anus in one and one patient had radial aplasia and Pierre Robin syndrome. The bronchopulmonary anomalies complicated the surgical care of tracheoesophageal malformations and required radiologic differentiation from aspiration pneumonia and atelectasis. Six of the seven patients survived. Mortality and morbidity were related to complications and associated cardiac anomalies as well as severity of the lung anomaly.

  6. Medical image of the week: tracheoesophageal fistula

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    Wong C

    2013-06-01

    Full Text Available A 51 year old woman with a history of tracheal and bronchial stents for airway impingment from small cell carcinoma was intubated for respiratory failure. After prolonged intubation, she underwent tracheostomy to transition into hospice. The tracheal stent was removed during the procedure due to its location. A tracheoesophageal fistula was demonstrated by visualization of her feeding tube on bronchoscopy performed the next day. The patient underwent palliative ablation of the tracheal tumor and died several days later in hospice.

  7. Tracheoesophageal fistula associated with paracoccidioidomicosis

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    Antonio Carlos Nogueira

    2011-09-01

    Full Text Available Paracoccidioidomycosis is a systemic fungal disease caused byParacoccidioides brasiliensis, agent geographically distributed to certainareas of Central and South America. The infection by P. brasiliensis hasbeen reported from north Mexico to south Argentina. Paracoccidioidomycosispresents similar clinical findings of many other diseases whatever in acute or chronic scenarios. Chronic pulmonary paracoccidioidomycosis is frequentlymisdiagnosed as malignancy or tuberculosis. The authors present a caseof a 57 year-old man admitted to the hospital due to a chronic consumptivesyndrome. He underwent anti-tuberculous treatment with rifampin, isoniazid andpyrazinamide 1 year ago without resolution of the simptoms. During the clinicalinvestigation, pulmonary paracoccidioidomycosis with tracheoesophagealfistula was diagnosed. The systemic infection was treated with deoxicolate Bamphotericin followed by sulfametoxazole and trimetoprin due to acute renalfunction impairment. The fistula was endoscopically treated; inittialy with theprotection of left main bronchus with a tracheal prosthesis followed by theesophageal fistula’s ostium clipping.

  8. Tracheoesophageal fistula as the presenting manifestation of Hodgkin's lymphoma.

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    Alba, D.; Lobato, S. D.; Alvarez-Sala, R.; Villasante, C.; Echevarría, C.

    1994-01-01

    We present a patient with tracheoesophageal fistula as the initial manifestation of Hodgkin's disease with oesophageal involvement. To our knowledge, this has not been previously reported. The diagnosis of Hodgkin's lymphoma was made at autopsy.

  9. Tracheoesophageal fistula in utero: 22 cases

    International Nuclear Information System (INIS)

    A retrospective review of 22 infants born with tracheoesophageal fistula (TEF) detected on in utero US was performed. In addition, ten cases reported in the literature were reviewed. TEF or esophageal atresia should be considered when there is polydramnios and the stomach is not fluid filled; these findings were seen in 32% of the cases. Amniotic fluid flows freely through some TEFs, resulting in a normal amount of amniotic fluid and a fluid-filled stomach (6 of 22 cases), while in other cases the fluid does not traverse the fistula easily and polyhydramnios results. Polyhdramnios was present in 62% of the cases we reviewed and was the most common sonographic finding. The earliest age at which polyhdramnios was diagnosed was 24 weeks. Associated abnormalities are seen in 50%-70% of cases of TEF and are a major contributing factor to morbidity and mortality. Sonography will continue to miss many cases of TEF; however, when TEF is suspected from fetal US (i.e., polyhdramnios and no fluid-filled stomach, or polyhdramnios with no etiology identified), an improved outcome is expected

  10. Endoscopic Airway Evaluation in Congenital Tracheoesophageal Fistula

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    Bracci Paolo

    2014-06-01

    Full Text Available Introduction. The communication between the trachea and esophagus is called tracheoesophageal fistula (TEF. It can occurs as a congenital malformation (0.025-0.05% (in particular related to the esophageal atresia or can occurs as an acquired pathology. Endoscopic evaluation is the gold standard for the diagnosis of TEF and must be performed, in presence of symptoms such as choking, coughing, and cianosis at feeding. Materials and methods. The authors present 145 endoscopic airway evaluations, performed in 142 children for the suspected presence of TEF and for a diagnostic classification of esophageal atresia. The endoscopic airway procedure was performed with the rigid endoscopy technique, in general anesthesia and spontaneous ventilation, with topical anesthesia. Results. The use of the rigid endoscopy allows us to assure an open airway and assists operative management: in the presence of TEF the endoscopic procedure was infact diagnostic, and operative at surgery. The tracheobronchoscopic airway evaluation was able to identify the presence, the level and number of TEF in all patients, in order to classify the cases and plan the therapeutic strategy. Endoscopy showed the fovea of TEF in different positions, in the upper, medium and lower part of the trachea, in rare cases a double fistula or in some cases did not detect the presence of fistula. Discussion and Conclusions. The fovea located in the upper part of the trachea was always of small size, and difficult to diagnose, while the fovea located in the lower or medium part of the trachea was always of large size, and simple to identify. The identification of the precise anatomic position of the TEF guides the surgical planning but also permits to achieve the optimal ventilation and strategies to reduce potential complications during anesthesia.

  11. Congenital esophageal atresia with tracheo-esophageal fistula

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    Rhee, Chung Sik [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

    1970-10-15

    Three cases of esophageal atresia with tracheo-esophageal fistula. 1). Case 1: A female infant birth Wt. 1.95 kg , Apgar Score 10, Skeletal anomalies, was delivered after a pregnancy compeicated by hydroamnious on Aug. 17, 1970. The family history was not contributory. 2) Case 2: A male infant birth Wt. 2.8 kg , Apgar Score 8, was forcep delivered after a pregnancy on Feb. 8, 1970. This infant is twin. The family history was not contributory. 3) Case 3: A female infant birth Wt. 2.22 kg , Apgar Score 10, was C-section after a pregnancy on May, 16. 1970. The family history was not contributory. All cases: After 24 hours 5% glucose solution was given and immediately vomited and some of it regurgitating through the nose and mouth with associated cyanosis and dyspnea. A catheter was inserted through the nose into the esophagus under diagnosis of the esophageal atresia.

  12. Passage of nasogastric tube through tracheo-esophageal fistula into stomach: A rare event.

    Science.gov (United States)

    Kamble, Ravikiran Shankar; Gupta, Rahulkumar; Gupta, Abhaya; Kothari, Paras; Dikshit, K Vishesh; Kesan, Krishnakumar; Mudkhedkar, Kedar

    2014-07-16

    Esophageal atresia with tracheo-oesophageal fistula (TEF) occurs in 1 in 3500 live births. Anorectal malformation is found to be associated with 14% of TEF. Esophageal atresia with TEF is a congenital anomaly which classically presents as excessive frothing from the mouth and respiratory distress. Rarely gastric position of the feeding tube in a case of TEF can be obtained delaying the diagnosis of TEF. We had an uncommon situation where a nasogastric tube reached the stomach through the trachea and tracheo-esophageal fistula, leading to misdiagnosis in a case of esophageal atresia with tracheoesophageal fistula. By using a stiff rubber catheter instead of a soft feeding tube for the diagnosis of esophageal atresia and TEF, such situation can be avoided.

  13. Esophageal Atresia and Tracheoesophageal Fistula with Unilateral Pulmonary Agenesis - Hypoplasia

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    Katragadda Laxmi Narsimha Rao

    2013-04-01

    Full Text Available Association of unilateral severe pulmonary hypoplasia or agenesis and esophageal atresia (EA with or without tracheoesophageal fistula (TEF is an exceedingly rare and highly lethal combination. We report a case of full term male baby who had EA with TEF and right lung hypoplasia, managed at our centre. He is alive and doing well at 10 years of age.

  14. Acute gastric volvulus in operated cases of tracheoesophageal fistula

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    Joshi Milind

    2010-01-01

    Full Text Available A report of two neonates of esophageal atresia with tracheoesophageal fistula who had acute gastric volvulus in the postoperative period and required gastropexy after correction of the volvulus. Such postoperative complication has not been reported in the literature so far.

  15. Congenital tracheoesophageal fistula successfully diagnosed by CT esophagography

    Institute of Scientific and Technical Information of China (English)

    Koichi Nagata; Yoshito Kamio; Tamaki Ichikawa; Mitsutaka Kadokura; Akihiko Kitami; Shungo Endo; Haruhiro Inoue; Shin-Ei Kudo

    2006-01-01

    Tracheoesophageal fistula (TEF) or bronchoesophageal fistula may be congenital, inflammatory, neoplastic,or secondary to trauma. Congenital TEF or bronchoesophageal fistula is usually associated with esophageal atresia and is readily diagnosed in infancy.But if it is not associated with esophageal atresia, it may persist until adulthood. Some theories have been proposed to explain this delay in diagnosis. We present a case of a 70-year-old man with congenital TEF. The TEF was successfully diagnosed by multidetector-row CT esophagography.

  16. ESOPHAGEAL ATRESIA WITH RECURRENT TRACHEOESOPHAGEAL FISTULAS AND MICRODUPLICATION 22q11.23.

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    Puvabanditsin, S; Garrow, E; February, M; Yen, E; Mehta, R

    2015-01-01

    The microduplication 22q11.2 syndrome has a wide range of clinical manifestations. The phenotype ranges from normal to mental retardation and congenital anomalies. Esophageal atresia/tracheoesophageal fistula (EA/TEF) has recently been linked with the Tbx1 gene mutation located on the long arm of chromosome 22(22q11.21). We report a case with 1.4 Mb 22q11.23 duplication detected by array-CGH. The father of this infant has the same interstitial microduplication but with a normal phenotype. The phenotype seen in our case is type C (3B) esophageal atresia, tracheoesophageal fistula, and ventricular septal defect. Our patient underwent primary repair of OA/TEF malformations, which was later complicated by pneumonia and a recurrent TEF. PMID:26625662

  17. Hodgkin Lymphoma Untreated for Six Years Presenting with Tracheoesophageal Fistula

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    Jason R. Westin

    2012-01-01

    Full Text Available Hodgkin lymphoma is a highly curable cancer with modern therapy, with five-year survival rates in excess of 80%. However, the natural history of the untreated disease is largely unknown. We present the case of a patient with Hodgkin lymphoma who went untreated for over 5 years due to patient choice. Eventually, the patient developed hypoxemia, significant weight loss, and a tracheoesophageal fistula. After a placement of a gastrostomy tube and tracheal stent, treatment with standard chemotherapy was initiated. The patient achieved an excellent response, the fistula closed without further intervention, and there is no evidence of relapse six years later. Even in a patient with significant Hodgkin-lymphoma-related sequelae, standard therapy can result in excellent long-term outcomes.

  18. Hypertrophic Pyloric Stenosis Following Repair of Esophageal Atresia and Tracheo-Esophageal Fistula

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    Emmanuelle Seguier-Lipszyc; Baruch Klin

    2014-01-01

    Two cases of hypertrophic pyloric stenosis (HPS) developed after a few weeks of repair of an esophageal atresia and tracheo-esophageal fistula (EA&TEF). Both cases were dealt successfully with laparoscopic pyloromyotomy.

  19. Hypertrophic Pyloric Stenosis Following Repair of Esophageal Atresia and Tracheo-Esophageal Fistula

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    Emmanuelle Seguier-Lipszyc

    2014-07-01

    Full Text Available Two cases of hypertrophic pyloric stenosis (HPS developed after a few weeks of repair of an esophageal atresia and tracheo-esophageal fistula (EA&TEF. Both cases were dealt successfully with laparoscopic pyloromyotomy.

  20. Absent upper blind Pouch in a case of tracheo-esophageal fistula

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    Man Mohan Harjai

    2015-01-01

    Full Text Available A common upper airway and digestive tract is a rare congenital anomaly that is usually fatal and its exact incidence is not known. It is a diagnostic challenge as it requires high index of suspicion. It should be considered in a neonate with respiratory distress in a non-vigorous baby requiring endotracheal intubation, which is difficult even in expert hand. We present a newborn with suspected tracheo-esophageal fistula that was diagnosed intraoperatively to have absent upper blind pouch of the esophagus and on autopsy found to have laryngeal atresia with absent vocal cords and a common aerodigestive tract continuing distally with trachea. The neonate was ventilated with endotracheal tube (ETT placement which in retrospect we came to know that it was in the esophagus. The neonate also had associated multiple congenital anomalies of VACTERL association. The importance of teamwork between neonatologist, pediatric surgeon, anesthesiologist, and radiologist is highlighted for diagnosis and management of such rare cases.

  1. Tracheoesophageal fistula without esophageal atresia: are pull-back tube esophagograms needed for diagnosis?

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    Laffan, E.E.; Daneman, A.; Kerrigan, D.; Manson, D.E. [Univ. of Toronto (Canada). Dept. of Diagnostic Imaging; Ein, S.H. [Univ. of Toronto (Canada). Div. of General Surgery

    2006-11-15

    A pull-back tube esophagogram (PBTE) is widely accepted in the literature as the radiological investigation of choice for the diagnosis of tracheoesophageal fistula without esophageal atresia. However, PBTE is rarely performed in our institution, as we have been successful in confirming the presence of such fistulae with a contrast material swallow (CS). We hypothesized that PBTE is not the radiological investigation of choice for the diagnosis of the fistula in this condition. We sought to determine what proportion of patients with tracheoesophageal fistula without esophageal atresia can be diagnosed promptly by a CS and what the indications are for a PBTE. We retrospectively analyzed the clinical and radiological findings in patients with tracheoesophageal fistula without esophageal atresia to determine whether the fistula was diagnosed with a CS or PBTE. We identified 20 children (13 female and 7 male) with tracheoesophageal fistula without esophageal atresia. Their age at diagnosis ranged from 3 days to 168 months with a median of 9 days. The diagnosis was documented by CS in 12, PBTE in 7 and CT in 1. In three of the seven who had the fistula documented by PBTE, a previous CS had shown contrast material in the trachea, but no fistulous tract or aspiration was identified. We believe that CS should be the examination of choice in most patients suspected of having a tracheoesophageal fistula without esophageal atresia. A PBTE is indicated in patients who are intubated or are at significant risk of aspiration. Furthermore, a PBTE is also indicated in patients who are intubated or are at significant risk of aspiration. Furthermore, a PBTE is also indicated where contrast material is seen in the airway on CS and there is uncertainty whether this is due to aspiration or a fistula.

  2. Surgical Outcomes in Esophageal Atresia and Tracheoesophageal Fistula: A Comparison between Primary and Delayed Repair

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    H Davari

    2006-01-01

    Full Text Available Background: The purpose of this study was to investigate outcomes of surgical repair of esophageal atresia (EA or tracheoesophageal fistula (TEF in newborns, with respect to incidence of death and other complications in early or late operations. Methods: Charts of all 80 infants with EA/TEF, operated in Alzahra hospital (A tertiary hospital of Isfahan University of Medical Sciences from 2002 to 2004 were reviewed. Patients were designed in two groups as, primary and delayed repair groups. Patients demographics, frequency of associated anomalies, and details of management and outcomes were studied. Results: There were 48 male and 32 female patients with a frequency of 28(35% preterm infant and mean birth weight of 2473±595 g. Overall survival rate was 71.2%. Mortality rate in delayed repair group was significantly higher than the other one (22.5% vs. 6.3% but with matching, according to full term/preterm proportion, the significant differences were failed. Female sex and being preterm were the most powerful predictors of death (nearly odds ratio=7 for both. Conclusion: in this study mortality and complications rates are higher in delayed repair than early one, although our data proposed that in absence of sever life threatening anomalies the most important factor for death is gestational age and female sex, and primary repair is opposed to it. Although mortality rate and complications are equal in two strategies, with matching cases for being preterm, but primary repair stays the better choice due to economic considerations. Keywords: tracheoesophageal fistula, esophageal atresia, delayed repair, primary repair, outcome

  3. Congenital tracheoesophagel fistula with no esophageal atresia (H-type) in adult (a case report)

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    Byun, W. M.; Jung, K. H.; Cho, K. H.; Kim, S. Y.; Hwang, M. S.; Chang, J. C.; Chung, M. K.; Lee, C. J. [Yeungnam University College of Medicine, Gyengsan (Korea, Republic of)

    1986-08-15

    Congenital tracheoesophageal fistula with no esophageal atresia is considered a rate type anomaly, especially in adult age. We report a case of isolated tracheoesophageal fistula with no esophageal atresia with review of literature.

  4. Unilateral pulmonary agenesis associated with oesophageal atresia and tracheoesophageal fistula: A case report with prenatal diagnosis

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    Go Miyano

    2015-01-01

    Full Text Available We describe herein a case of unilateral pulmonary agenesis (PA with oesophageal atresia (EA/tracheoesophageal fistula (TEF that was diagnosed prenatally and repaired by esophagoesophagostomy with stable postoperative course. The patient was born at 34 weeks gestation, after ultrasonography at 22 weeks gestation showed possible right-sided diaphragmatic eventration or PA and EA was subsequently suspected due to hydramnios. The initial X-ray showed mediastinal shift to the right, and coil up sign of the nasogastric tube, without intracardiac anomaly. Immediately after the diagnosis of EA/TEF and unilateral PA on day 0, the patient was intubated in the operating room, and a gastrostomy tube was placed. After pulmonary status stabilized, at 4 days old, EA/TEF was repaired through a thoracotomy in the right 4 th intercostal space. The right main bronchus was noted to continue into the distal oesophagus; this fistula was ligated and divided, and a single-layer esophagoesophagostomy was performed under mild tension with one vertebral gap. The neonate was maintained on mechanical ventilation and gradually weaned to extubation at 7 days old. The postoperative course was uneventful, with the exception of prolonged jaundice that emerged at 3 months old. Laparoscopic cholangiography at that time excluded biliary atresia, and jaundice resolved spontaneously. The patient has not shown any respiratory symptoms or feeding difficulties as of the 12-month follow-up.

  5. Esophageal atresia and tracheoesophageal fistula in children of women exposed to diethylstilbestrol in utero

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    Felix, Janine F.; Steegers-Theunissen, Regine P. M.; de Walle, Hermien E. K.; de Klein, Annelies; Torfs, Claudine P.; Tibboel, Dick

    2007-01-01

    OBJECTIVE: This study was undertaken to study the possible risk to mothers exposed in utero to diethylstilbestrol for offspring with esophageal atresia/ tracheoesophageal fistula. STUDY DESIGN: Information on the mothers ' in utero exposure to diethylstilbestrol was obtained from 3 sources: question

  6. Tracheoesophageal fistula resulting from invasive aspergillosis in acute lymphoblastic leukemia: a case report

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    Kang, Si Won [Daejeon St. Mary' s Hospital, College of Medicine, Catholic University, Daejeon (Korea, Republic of)

    2006-04-15

    Tracheoesophageal fistula (TEF) in adult patients is an uncommon complication in leukemia. We present here on a case of TEF in a 46-year-old woman with ALL. The patient was asymptomatic and TEF is resulted from aspergillus bronchitis during the chemotherapy for acute lymphoblastic leukemia (ALL)

  7. Tracheoesophageal fistula resulting from invasive aspergillosis in acute lymphoblastic leukemia: a case report

    International Nuclear Information System (INIS)

    Tracheoesophageal fistula (TEF) in adult patients is an uncommon complication in leukemia. We present here on a case of TEF in a 46-year-old woman with ALL. The patient was asymptomatic and TEF is resulted from aspergillus bronchitis during the chemotherapy for acute lymphoblastic leukemia (ALL)

  8. Congenital tracheoesophageal fistula: A rare and late presentation in adult patient

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    Waseem M Hajjar

    2012-01-01

    Full Text Available Congenital H-type tracheoesophageal fistula (TEF in adults is a rare presentation and can test the diagnostic acumen of a surgeon, endoscopist, and the radiologist. These undetected fistulas may present as chronic lung disease of unknown origin because repeated aspirations can lead to recurrent lung infections and bronchiectasis. Congenital TEFs should be considered in the diagnosis of infants and young adults with recurrent respiratory distress and/or infections. Here, we present the successful management of this rare case in an adult patient.

  9. Comparison of neonatal tolerance to thoracoscopic and open repair of esophageal atresia with tracheoesophageal fistula

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    MA Li; LIU Yong-zhe; MA Ya-qun; ZHANG Sheng-suo; PAN Ning-ling

    2012-01-01

    Background Advances in minimally invasive surgical techniques and neonatal intensive care for neonates have allowed for repair of the neonatal esophageal atresia with tracheoesophageal fistula (EA/TEF) to be approached endoscopically.However,thoracoscopic surgery in children is still performed in only a few centers throughout the world.The aim of this study was to compare the neonatal tolerance to the thoracoscopic repair (TR) and the open repair (OR)and also to discuss anesthetic management in thoracoscopic procedure.Methods We performed a prospective study enrolling newborns diagnosed with EA with distal TEF (type C) receiving the repair surgery between June 2009 and January 2012 in our institution.Data collected included the newborns' gestational age and weight at the time of the operation,operative time,parameters of intraoperative mechanical ventilation,oxygenation,end-tidal carbon dioxide (ETCO2),and analysis of blood gases.Time to extubation and length of stay were also recorded.Results Intravenous induction with muscle paralysis followed by pressure-control ventilation and tracheal intubation regardless of the position of the fistula can be performed uneventfully in EA/TEF newborns with no additional airway anomalies and large,pericarinal fistulas in our experiences.The thoracoscopic approach appeared to take longer than the open approach.During the procedure of repair,hypercarbia and acidosis developed immediately 1 hour after pneumothorax in both groups.CO2 insufflation did have additional influence on the respiratory function of the newborns in the TR group; values of PaCO2 and ETCO2 were higher in the TR group but the difference did not reach statistical significance.By the end of the procedure,values of PaCO2 and ETCO2 returned to the baseline levels while pH did not,but all parameters made no difference in the two groups.Besides,time to extubation was shorter in the TR group.Conclusions Thoracoscopic repair of EA/TEF is comparable to the open repair

  10. Cervical approach for repair of congenital tracheo-esophageal fistula presenting in an adult.

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    Albuquerque K

    1993-10-01

    Full Text Available Congenital tracheo-esophageal fistula without esophageal atresia was diagnosed on barium swallow radiography and esophagoscopy findings in an adult patient presenting with difficult in swallowing. The fistulous opening seen on the anterior wall of the esophagus led to the trachea. On bronchoscopy, the tracheal opening was located posteriorly 5 cm below the vocal cords. Successful repair was undertaken via a left cervical approach. The anatomical and developmental basis for the preferred approach is discussed with a brief literature review on the subject.

  11. Genetic players in esophageal atresia and tracheoesophageal fistula.

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    Brunner, H.G.; Bokhoven, J.H.L.M. van

    2005-01-01

    Esophageal atresia is a common and serious developmental anomaly, of which the causes remain largely unknown. Studies in vertebrate models indicate the importance of the sonic hedgehog pathway in esophageal atresia, but its relevance to the human condition remains to be defined. Now, three genes hav

  12. Esophageal Anastomosis Medial to Preserved Azygos Vein in Esophageal Atresia with Tracheoesophageal Fistula: Restoration of Normal Mediastinal Anatomy

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    Kumar Abdul Rashid

    2012-09-01

    Full Text Available Objective: We intended to prospectively study the technical feasibility and advantages of esophageal anastomosis medial to the preserved azygos vein in neonates diagnosed with esophageal atresia with tracheoesophageal fistula (EA/TEF. The results were compared to the cases where azygos vein was either not preserved, or the anastomosis was done lateral to the arch of preserved azygos vein. Material and methods: A total of 134 patients with EA/TEF were admitted between January 2007 and July 2008 of which 116 underwent primary repair. Eleven patients with long gap esophageal atresia with or without tracheoesophageal fistula and 7 patients who expired before surgery were excluded. Patients were randomly divided in three groups comparable with respect to the gestational age, age at presentation, sex, birth weight, associated anomalies and the gap between the pouches after mobilization: Group A (azygos vein ligated and divided, Group B (azygos vein preserved with esophageal anastomosis lateral to the vein, and Group C azygos vein preserved with esophageal anastomosis medial to the vein. All the patients were operated by extra-pleural approach. The three groups were compared with respect to operative time and early postoperative complications like pneumonitis, anastomotic leaks and mortality. Odds ratio and Chi square test were used for the statistical analysis. Results: Group A, B and C had 35, 43 and 38 patients respectively. No significant difference was observed in average operative time in the 3 groups. Though incidence of postoperative pneumonitis was higher in group A (28% as compared to group B (13.95% and group C (11.62%, it was not statistically significant (p > 0.005. Anastomotic leak occurred in 7 patients in group A (20%, 6 patients in group B (13.95% and 4 patients (10.52% in group C (p > 0.005. Group A had 3 major and 4 minor anastomotic leaks; group B had 2 major and 4 minor leaks and group C had 1 major and 3 minor leaks. There were10

  13. Congenital esophageal stenosis associated with esophageal atresia/tracheoesophageal fistula: clinical and radiologic features

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    Yoo, Hye Jin; Kim, Woo Sun; Cheon, Jung-Eun; Shin, Su-Mi; Kim, In-One; Yeon, Kyung Mo [Seoul National University College of Medicine and the Institute of Radiation Medicine, Department of Radiology, Seoul (Korea); Yoo, So-Young [Seoul National University College of Medicine and the Institute of Radiation Medicine, Department of Radiology, Seoul (Korea); Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Seoul (Korea); Park, Kwi-Won; Jung, Sung-Eun [Seoul National University Children' s Hospital, Department of Pediatric Surgery, Seoul (Korea)

    2010-08-15

    Congenital esophageal stenosis (CES) can be associated with esophageal atresia/tracheoesophageal fistula (EA/TEF). Because there are a variety of degrees of obstruction and symptoms of CES, it is frequently difficult to make a pre- and post-operative diagnosis of the distal CES associated with EA/TEF. To evaluate the clinical and radiologic features of congenital esophageal stenosis associated with esophageal atresia/tracheoesophageal fistula. We retrospectively reviewed postoperative esophagograms and medical records of 187 children (107 boys, 80 girls) who had primary repair of EA/TEF from 1992 to 2009 at our institution. We evaluated the incidence of CES, clinical findings, radiologic features and management of CES in these children. CES was diagnosed in 22 of 187 EA/TEF children (12%); one child had double CES lesions, for a total of 23 lesions. Ten of those 22 children (45%) had presented with significant symptoms of esophageal obstruction. The diagnosis of CES was delayed in 10 children (45%) until 1-10 years of age. On esophagogram, CES (n = 23) was located in the distal esophagus (n = 20, 87%) or mid-esophagus (n = 3, 13%). The degree of stenosis was severe (n = 6, 26%), moderate (n = 10, 43%), or mild (n = 7, 30%). Eight children, including two with unsuccessful esophageal balloon dilatation of CES, were treated surgically. Histologic examination revealed tracheobronchial remnant (n = 7) or fibromuscular hyperplasia (n = 1). One child with surgically treated CES developed achalasia at the age of 3 years 9 months. Esophagography after EA/TEF repair should be performed with a high index of suspicion for the presence of distal CES, because the diagnosis and adequate management of CES can often be delayed. (orig.)

  14. Expanding the BP1-BP2 15q11.2 Microdeletion Phenotype: Tracheoesophageal Fistula and Congenital Cataracts

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    D. Wong

    2013-01-01

    Full Text Available The proximal q arm of chromosome 15 contains breakpoint regions BP1–BP5 with the classic deletion of BP1–BP3 best known to be associated with Prader-Willi and Angelman syndromes. The region is approximately 500 kb and microdeletions within the BP1-BP2 region have been reported in patients with developmental delay, behavioral abnormalities, and motor apraxia as well as dysmorphic features including hypertelorism, cleft or narrow palate, ear abnormalities, and recurrent upper airway infections. We report two patients with unique, never-before-reported 15q11.2 BP1-2 microdeletion syndrome findings, one with proximal esophageal atresia and distal tracheoesophageal fistula (type C and one with congenital cataracts. Cataracts have been described in Prader-Willi syndrome but we could not find any description of cataracts in Angelman syndrome. Esophageal atresia and tracheoesophageal fistula have not been reported to our knowledge in either syndrome. A chance exists that both cases are sporadic birth defects; however, the findings of the concomitant microdeletion cannot be overlooked as a possible cause. Based on our review of the literature and the presentation of our patients, we recommend that esophageal atresia and distal tracheoesophageal fistula as well as congenital cataracts be included in the phenotypic spectrum of 15q11.2 BP1-2 microdeletion syndrome.

  15. The role of genetic and environmental factors in the etiology of esophageal atresia and tracheo-esophageal fistula

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    Damian Bednarczyk

    2014-03-01

    Full Text Available Esophageal atresia and tracheo-esophageal fistula are severe congenital malformations, whose etiology is still poorly understood. So far, numerous genetic and environmental factors that may contribute to the occurrence of these defects have been described and the literature is dominated by the view of their common involvement in the etiology and pathogenesis of congenital esophageal atresia. In this review the authors present current knowledge on the embryogenesis of the esophagus and trachea, discuss environmental risk factors, and also list and describe genetic alterations identified so far in patients with congenital esophageal atresia.

  16. Determinants of gap length in esophageal atresia with tracheoesophageal fistula and the impact of gap length on outcome

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    Muffazzal Rassiwala; Subhasis Roy Choudhury; Partap Singh Yadav; Praveen Jhanwar; Raghu Prakash Agarwal; Rajiv Chadha; Pinaki Ranjan Debnath

    2016-01-01

    Aim: This study was aimed at identifying factors which may affect the gap length in cases of esophageal atresia with tracheoesophageal fistula (EA-TEF) and whether gap length plays any role in determining the outcome. Materials and Methods: All consecutive cases of EA-TEF were included and different patient parameters were recorded. Plain radiographs with a nasogastric tube in the upper esophagus were taken. Patients were grouped into T1-T2; T2-T3; T3-T4; and T4 depending on the thoracic vert...

  17. Thoracoscopic repair of esophageal atresia with tracheoesophageal fistula: Basics of technique and its nuances

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    Ravi Prakash Kanojia

    2016-01-01

    Full Text Available Aim: To review the technique of thoracoscopic repair of esophageal atresia with tracheoesophageal fistula (TREAT and results reported in literature and with authors′ experience. Patients and Methods: The technique of TREAT was reviewed in detail with evaluation in patients treated at authors′ institution. The patients were selected based on selection criteria and were followed postoperatively. The results available in literature were also reviewed. Results: A total of 29 patients (8 females were operated by TREAT. Mean age was 2.8 days (range 2-6 days. Mean weight was 2.6 kg (range 1.8-3.2 kg. There was a leak in four patients, and two patients had to be diverted. They are now awaiting definitive repair. Twenty-one patients have completed a mean follow-up of 1.5 years and are doing well except for two patients who had a stricture and underwent serial esophageal dilatations. The results from current literature are provided in tabulated form. Conclusions: TREAT is now a well-established procedure and currently is the preferred approach wherever feasible. The avoidance of thoracotomy is a major advantage to the newborn and is proven to benefit the recovery in the postoperative patient. The technique demonstrated, and the tweaks reported make the procedure easy and is helpful to beginners. The outcome is very much comparable to the open repair as proven by various series. Various parameters like leak rate, anastomotic stricture are the same. The outcome is comparable if you TREAT these babies well.

  18. Esophageal atresia and tracheoesophageal fistula: Effect of pleural cover on anastomotic dehiscence

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    Money Gupta

    2011-01-01

    Full Text Available Background: A significant number of esophageal atresia and tracheoesophageal fistula patients have long gaps and a high propensity to leak. Anastomotic leak in esophageal atresia is associated with a significant morbidity and mortality. Aim : In a prospective randomized trial, we analyzed the risk factors leading to anastomotic dehiscence and studied the effect of pleural wrap as an additional vascular cover around the esophageal anastomosis. Materials and Methods: Forty patients were divided into two groups A and B randomly. In 20 patients of group A, pleural wrap was utilized for covering the anastomosis and in 20 patients of group B, no such wrap was utilized. Results: Both the groups were comparable regarding age, sex, weight, gap length, tension at anastomosis and the hospital stay. The overall leak rate was 25% (10/40 in both the groups. The leak rate was not significantly different in two groups whenever a gap length was less than 2 cm or more than 3 cm. However, for a gap length of 2-3 cm, the leak rate in group A was 18% (2/11 and in group B was 50% (4/8 (P = 0.05. Thirty percent (3/10 of patients, whose anastomosis was under tension, leaked in group A as compared to 75% (6/8 in group B patients (P = 0.001. Conclusions: Use of pleural wrap was associated with less anastomotic dehiscence in patients with moderate gap esophageal atresia (2-3 cm especially when the anastomosis was under tension.

  19. Surgical treatment for vascular anomalies and tracheoesophageal compression

    Institute of Scientific and Technical Information of China (English)

    BAI Song; LI Xiao-feng; LIU Cai-xia; PENG Yun; YUAN Feng; GUO Jian; SONG Zhen-jiang; William M. Novick; LI Zhong-zhi

    2012-01-01

    Background Vascular rings are uncommon anomalies in which preferred strategies for diagnosis and management may vary among institutions.In this study,we reported our approach and a review of our 5-year experience.Methods From May 2006 to April 2011,45 children (31 boys) with vascular rings underwent surgical repair at Beijing Children's Hospital.Nineteen patients (26%) had associated heart anomalies.Results There were two hospital deaths.At follow-up,11 patients still had intermittent respiratory symptoms,but these symptoms had no effect on growth or physical activities.No patients required reoperation.Conclusions The rates of misdiagnosis and missed diagnosis of vascular rings are higher than those of other congenital heart diseases.A high index of clinical suspicion coupled with the use of computed tomography enables early diagnosis.Surgical repair can be performed successfully,although a number of patients will have persistent symptoms.

  20. The Harlequin phenomenon after thoracoscopic repair of esophageal atresia and tracheoesophageal fistula: Is there any coincidence?

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    Katarzyna A. Maścianica

    2015-11-01

    Full Text Available The experience and number of endoscopic surgery procedures applied in newborns are constantly growing, showing efficacy in many thoracic and abdominal conditions. However, there is an ongoing debate concerning the safety of this technique and the influence on the developing organism. Due to the relatively recent introduction of these methods in the therapy of congenital anomalies, we still have quite little knowledge about their long-term sequelae. The Harlequin phenomenon is a complex, little known and probably heterogeneous anomaly. It involves episodes of sharply demarcated erythema with the dividing line running exactly along the midline. We observe the appearance of episodes of unilateral flushing and sweating on the left half of the body in children who have been operated on using the thoracoscopic approach in the first days of life, due to esophageal atresia and distal tracheooesophageal fistula (EA/TEF, which are very similar to the Harlequin phenomenon. During long term follow-up visits, parents of 2 out of 55 children, who had been operated on during the period 2005–2011, turned our attention to these unusual symptoms. To our knowledge, this is the first report of the Harlequin phenomenon following esophageal surgery. The aim of the study is to analyze the possible pathogenesis of the observed anomaly, in the context of the existing congenital defect, and the operative technique used.

  1. Endoscopic Stenting and Clipping for Anastomotic Stricture and Persistent Tracheoesophageal Fistula after Surgical Repair of Esophageal Atresia in an Infant

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    Mohammed Amine Benatta

    2014-01-01

    Full Text Available Anastomotic stricture (AS and recurrent tracheoesophageal fistula (TEF are two complications of surgical repair of esophageal atresia (EA. Therapeutic endoscopic modalities include stenting, tissue glue, and clipping for TEF and endoscopic balloon dilation bougienage and stenting for esophageal strictures. We report herein a two-month infant with both EA and TEF who benefited from a surgical repair for EA, at the third day of life. Two months later he experienced deglutition disorders and recurrent chest infections. The esophagogram showed an AS and a TEF confirmed with blue methylene test at bronchoscopy. A partially covered self-expanding metal type biliary was endoscopically placed. Ten weeks later the stent was removed. This allows for easy passage of the endoscope in the gastric cavity but a persistent recurrent fistula was noted. Instillation of contrast demonstrated a fully dilated stricture but with a persistent TEF. Then we proceeded to placement of several endoclips at the fistula site. The esophagogram confirmed the TEF was obliterated. At 12 months of follow-up, he was asymptomatic. Stenting was effective to alleviate the stricture but failed to treat the TEF. At our knowledge this is the second case of successful use of endoclips placement to obliterate recurrent TEF after surgical repair of EA in children.

  2. Determinants of gap length in esophageal atresia with tracheoesophageal fistula and the impact of gap length on outcome

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    Muffazzal Rassiwala

    2016-01-01

    Full Text Available Aim: This study was aimed at identifying factors which may affect the gap length in cases of esophageal atresia with tracheoesophageal fistula (EA-TEF and whether gap length plays any role in determining the outcome. Materials and Methods: All consecutive cases of EA-TEF were included and different patient parameters were recorded. Plain radiographs with a nasogastric tube in the upper esophagus were taken. Patients were grouped into T1-T2; T2-T3; T3-T4; and T4 depending on the thoracic vertebral level of the arrest of the tube. During surgery, the gap length between the pouches was measured using a Vernier caliper and the patients were grouped into A, B, and C (gap length >2.1 cm; >1-≤2 cm and ≤1 cm. The operative gap groups were compared with the radiography groups and the other recorded parameters. Results: Total numbers of cases were 69. Birth weight was found to be significantly lower in Group A (mean = 2.14 kg as compared to Group B (mean = 2.38 kg and Group C patients (mean = 2.49 kg (P = 0.016. The radiographic groups compared favorably with the intraoperative gap length groups (P < 0.001. The need for postoperative ventilation (70.83% in Group A vs. 36.84% in Group C, P = 0.032 and mortality (62.5%, 26.9% and 15.8% in Group A, B, and C, respectively, P = 0.003 co-related significantly with the gap length. Conclusion: Birth weight had a direct reciprocal relationship with the gap length. Radiographic assessment correlated with intraoperative gap length. Higher gap length was associated with increased need for postoperative ventilation and poor outcome.

  3. ESOPHAGEAL ATRESIA WITH DISTAL TRACHEOESOPHAGEAL FISTULA: SURGERY TREATMENT AND A LONG TERM FOLLOW UP

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    E. Cerchia

    2012-12-01

    Full Text Available A study carried out at the Paediatric Surgery Units in Siena and Toulouse evaluated the long term follow-up of patients treated for esophageal atresia (EA, between 1988 and 2007. We analyzed the long term follow-up of 57 patients with III type EA. We evaluated the residual symptoms in three time intervals: in 1st years, between 2nd to 5th year and over 5th years from surgery. The considered parameters were: feeding difficulties, respiratory problems, gastro-esophageal reflux, growth impairment, chest anomalies. Feeding difficulty appeared in 26 patients in the 1st year of life, in 28 between the 2nd and 5th year and in 6 after the 5th year. Respiratory problems occurred in 35 children in 1st year, in 30 between the 2nd and 5th year and in 17 after the 5th year. Gastro-esophageal reflux occurred in 30 patients in 1st year, in 22 between the 2nd and 5th year and in 8 over the 5th year. Defects of growth were detected in 17 patients in 1st year of life, in 16 between the 2nd and 5th year and in 5 after the 5th year. Chest anomalies were diagnosed in 7 children. Our analysis established a time limit (5th year postoperatively over which an undeniable improvement of life quality can be expected.

  4. Fístula esôfago-traqueal após ingestão cáustica Tracheoesophageal fistula after caustic ingestion

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    Eduardo Crema

    2007-02-01

    Full Text Available As fístulas esôfago-traqueais são incomuns e apresentam diversas etiologias, entre elas, a queimadura química esofágica devida à ingestão cáustica. Relatamos o caso de um paciente de 27 anos com história de ingestão cáustica havia catorze dias, com dor retroesternal em queimação, fraqueza, tosse com escarro purulento e dispnéia associada à rouquidão no último dia. A endoscopia digestiva alta e a broncofibroscopia revelaram fístula esôfago-traqueal. O tratamento consistiu no suporte clínico, drenagem torácica bilateral, exclusão do transito esofágico com esofagostomia cervical terminal e gastrostomia. Houve cicatrização espontânea da fístula esôfago traqueal em seis semanas. Posteriormente, realizou-se a reconstrução do trânsito alimentar através de faringocoloplastia. A evolução pós-operatória foi satisfatória.Tracheoesophageal fistulas are uncommon and present diverse etiologies, among which is burning of the esophagus due to caustic ingestion. Herein, we report the case of a 27-year-old male patient having ingested a caustic substance 14 days prior and presenting burning retrosternal pain, weakness, productive cough with purulent sputum and dyspnea accompanied by hoarseness for the preceding 24 h. Endoscopy of the upper digestive tract revealed a tracheoesophageal fistula. Treatment consisted of cervical exclusion of the esophageal transit, together with gastrostomy. Subsequently, the nutrient transit was reconstructed through pharyngocoloplasty. The postoperative evolution was favorable.

  5. The use of a sternothyroid muscle flap to prevent the re-recurrence of a recurrent tracheoesophageal fistula found 10 years after the primary repair.

    Science.gov (United States)

    Takayasu, Hajime; Masumoto, Kouji; Ishikawa, Miki; Sasaki, Takato; Ono, Kentaro

    2016-12-01

    Recurrent tracheoesophageal fistula (TEF) is still difficult to diagnose and repair. In almost all cases, recurrence appears relatively soon after the primary surgery. We herein describe a case of recurrent TEF that appeared 10 years after the primary repair. At 2 years of age, the patient suffered from mental retardation due to encephalitis and developed a hiatus hernia with gastro-esophageal reflux. He underwent the repair of a hiatus hernia and fundoplication at 3 years of age. However, the hiatus hernia recurred 6 months after the operation. The patient suffered from recurrent pneumonia for 6 years after the appearance of the recurrent hiatus hernia. At 9 years of age, he was hospitalized frequently due to recurrent severe pneumonia. After admission at 9 years of age, an endoscopic study under general anesthesia was performed and revealed subglottic stenosis and a dilated esophagus with a recurrent hiatus hernia. Tracheotomy or laryngotracheal separation was first planned in order to improve his upper airway and facilitate the safer repair of the recurrent hiatus hernia. After laryngotracheal separation, the patient still suffered from severe pneumonia. In addition, a small volume of nutritional supplement was aspirated from the tracheostomy. Thus, recurrent TEF was suspected. Tests using dye under both esophagoscopy and bronchoscopy confirmed recurrent TEF. The fistula recurred in the cervical area because of the elevation of the esophagus due to the recurrent hiatus hernia. The fistula was surgically closed, with a sternothyroid muscle flap to prevent re-recurrence. At 4 months after this operation, the recurrent hiatus hernia was repaired. Thereafter, the patient's respiratory symptoms showed a dramatic improvement. The patient is now doing well and free from further recurrences of TEF and hiatus hernia at 2 years after the final operation. PMID:27589983

  6. Tracheal agenesis with broncho-esophageal fistula in VACTERL / TACRD association

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    Suresh R. S. Mandrekar

    2013-01-01

    Full Text Available Tracheal agenesis (TA is an extremely rare malformation. We report here autopsy findings in a case of TA with bronchoesophageal fistula of Floyd type III. The other malformations present included laryngeal atresia, Right lung hypolobulation, ventricular septal defect in membranous portion, bilateral cystic renal dysplasia, spleninculus, Meckel′s diverticulum, and imperforate anus. The constellations of malformations present in our case have overlapping features with Vertebral anomalies, Anal atresia, Cardiovascular anomalies, Tracheo-esophageal fistula, Esophageal atresia, Renal anomalies, Limb anomalies and Tracheal atresia or laryngo tracheal atresia, Cardiac anomalies, Renal anomalies, Duodenal atresia association described previously in the literature.

  7. 不同影像检查对新生儿食管闭锁与食管气管瘘的诊断应用%Application of different imaging diagnosis of esophageal atresia and tracheoesophageal fistula in infants

    Institute of Scientific and Technical Information of China (English)

    涂为建; 吴主强; 丁山

    2014-01-01

    Objective To investigate the diagnostic values of different imaging techniques in congenital esophageal atresia and tra-cheoesophageal fistula.Methods Imaging findinfs of 34 infants with congenital esophageal atresia and tracheoesophageal fistula were retrospectively analyzed.34 infants undertook X-ray and esophageal imaging,and 1 7 infants also undertook CT examination.Results Based on Gross classification,there were 2,32,9 and 23 cases for type I,Ⅲ,Ⅲa and Ⅲb,respectively.Coexistence of other de-formity was observed in 10 cases.Plain chest and abdomen X-ray film showed gastric pneumatosis in 32 cases,varied degrees of pneumonia in 25 cases and right upper pulmonary atelectasis in 3 cases.Esophagography showed a cecum in upper esophageal in 34 cases,distal tracheoesophageal fistula in one case.CT examination indicated distal tracheoesophageal fistula and orificium fistulae in 14 cases.Conclusion Combination of X-ray and CT imaging results with clinical symptoms can aid early detection and typing of con-genital esophageal atresia,furthermore provides guidance for operation and finally improves the survival rate of infants.%目的:探讨先天性食管闭锁(CEA)与食管气管瘘(TEF)的不同影像诊断价值。方法回顾性分析34例 CEA 与 TEF的影像检查表现,34例均行 X 线平片和食管造影,其中17例进行了 CT 检查。结果按照 Gross 分型:34例中 I 型2例;Ⅲ型32例,其中Ⅲa 型9例,Ⅲb 型23例。10例合并其他畸形。X 线胸腹平片显示胃肠积气32例,不同程度肺炎25例及右上肺不张3例;食管造影显示近端呈盲端34例,远端食管气管瘘1例;CT 检查显示远端 TEF 及瘘口14例。结论X 线、CT 检查与临床症状相结合能早期发现和诊断 CEA 及其分型,能够指导手术治疗提高患儿的存活率。

  8. Chylothorax after Primary Repair of Esophageal Atresia with Tracheo-esophageal Fistula: Successful Management by Biological Fibrin Glue

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    Anjan K Dhua

    2012-08-01

    Full Text Available A neonate, who had undergone primary repair of esophageal atresia with trachea-esophageal fistula, developed right pleural effusion in the postoperative period. It was initially misdiagnosed as an anastomotic leak, but later confirmed to be chylothorax. Conservative treatment failed. Application of biological fibrin glue (sealant on the mediastinum through a thoracotomy was curative.

  9. 先天性食管闭锁及气管食管瘘麻醉的临床观察%Anesthesia of congenital esphageal atresia and tracheoesophageal fistula

    Institute of Scientific and Technical Information of China (English)

    王云骥

    2011-01-01

    目的 探讨先天性食管闭锁及气管食管瘘的麻醉方法及术中管理.方法 回顾性分析徐州市儿童医院近2年的先天性食管闭锁及气管食管瘘麻醉方法及术中管理.结果 所有病例无一例术中死亡,术后随访3d无麻醉并发症发生.结论 充分的术前准备,严密的术中监测,细致的水电管理,协调的配合术者,有效的保暖措施,是先天性食管闭锁及气管食管瘘麻醉及术中管理的必要条件和有力保证.%Objective To investigate the anesthesia methods and intraoperative management of congenital esophageal atresia and tracheoesophageal fistula. Methods The anesthetic methods and intraoperative management of congenital esophageal atresia and tracheoesophageal fistula in our hospital for recent two years were retrospectively analyzed. Results All cases intraoperative no deaths,follow- up of three days without anesthesia complications.Conclusions Abandant perioprative preparation,strict intraoperative monitoring,meticulous of blood capacity and electrolyte management,coordinated with the performer,effective heat preservation measures is congenital esophageal atresia and tracheoesophageal fistula anesthesia and intraoperatie management of necessary conditions and a powerful guarantee.

  10. Tracheo-esophageal fistula in children: a diagnosis to keep in mind. Two case reports and review of the literature = Fístula traqueoesofágica en niños: un diagnóstico para tener en cuenta. Reporte de dos casos y revisión de la literatura

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    Olga Lucía Morales Múnera

    2013-07-01

    Full Text Available The tracheo-esophageal fistula without esophageal atresia is a rare type esophageal malformation. It has a multifactorial etiology including environmental and genetic factors. Common clinical manifestations are coughing and choking after meals, cyanosis and/or recurrent pneumonia. Diagnosis requires a high clinical suspicion index. Fistula confirmation is done with imaging studies including upper digestive series, video-fluoroscopy or with the use of bronchoscopy wich allows direct visualization of the fistula or methylene blue passage through the abnormal communication. Fistula closure can be done endoscopically or surgically, in both cases with good results.

  11. Isolated Vaginal Agenesis Associated with Multiple Gastrointestinal Anomalies: A Case Report

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    Rossella Angotti

    2016-07-01

    Full Text Available More than 50% of infants with esophageal atresia have associated anomalies. We present a case report of a 46XX neonate with long-gap esophageal atresia and tracheoesophageal fistula (EA/TEF, anorectal malformation, bowel duplication and vaginal agenesis. This is an unusual association of abnormalities which had not yet described in literature.

  12. Isolated Vaginal Agenesis Associated with Multiple Gastrointestinal Anomalies: A Case Report.

    Science.gov (United States)

    Angotti, R; Molinaro, F; Bulotta, A L; Ferrara, F; Sica, M; Bindi, E; Messina, M

    2016-01-01

    More than 50% of infants with esophageal atresia have associated anomalies. We present a case report of a 46XX neonate with long-gap esophageal atresia and tracheoesophageal fistula (EA/TEF), anorectal malformation, bowel duplication and vaginal agenesis. This is an unusual association of abnormalities which had not yet described in literature. PMID:27433450

  13. The Surgical Treatment Analysis of 18 Cases of Esophageal Atresia and Tracheoesophageal Fistula%食管闭锁与食管气管瘘18例手术治疗分析

    Institute of Scientific and Technical Information of China (English)

    安仲军

    2014-01-01

    目的:探讨食管闭锁与食管气管瘘的诊断及治疗。方法选取2012年6月~2014年2月收治的18例手术治疗的临床治疗资料进行分析。结果在收治的18例病儿中,手术治疗病儿治愈14例,其中2例术后持续胸膜外引流管引流自行愈合。吻合口狭窄3例,经食管扩张治愈,饮食正常、生长发育正常。结论手术治疗的目的是重建食管的连续并切断食管气管间的瘘管。%Objective The diagnosis and treatment of esophageal atresia and tracheoesophageal fistula to be investigated.Methods Analyzing the clinically surgical treatment data selected from 18 cases of patients with esophageal atresia and tracheoesophageal fistula who are treated in hospital from June 2012 to February 2014. Results Of al 18 cases, 14 cases of patients are cured, and 2 cases of patients get the postoperative extrapleural drainage tube healed. Conclusion And three cases with anastomotic stenosis are cured via esophageal dilatation;in addition, the patients’ diet, growth and development are normal again.

  14. Tracheoesophageal fistula associated with paracoccidioidomicosis

    OpenAIRE

    Antonio Carlos Nogueira; Daniel Soares de Sousa Dantas; Francisco Garcia Soriano; Simone Peres Pilli; João Epalanga Júnior Vidro; Edmar Tafner; Lincoln Tavares de Andrade; Luis Masuo Maruta; Hélio Minamoto; José Pinhata Otoch; João Augusto dos Santos Martines

    2011-01-01

    Paracoccidioidomycosis is a systemic fungal disease caused byParacoccidioides brasiliensis, agent geographically distributed to certainareas of Central and South America. The infection by P. brasiliensis hasbeen reported from north Mexico to south Argentina. Paracoccidioidomycosispresents similar clinical findings of many other diseases whatever in acute or chronic scenarios. Chronic pulmonary paracoccidioidomycosis is frequentlymisdiagnosed as malignancy or tuberculosis. The authors present ...

  15. Fistula

    Science.gov (United States)

    ... oxygen in the lungs) The navel and gut Inflammatory bowel disease, such as ulcerative colitis or Crohn disease, can lead to fistulas between one loop of intestine and another. Injury can cause fistulas to form ...

  16. RARE ANOMALY OF THE CORONARY VESSELS: CORONARY AND LEFT VENTRICULAR FISTULAS

    OpenAIRE

    L. V. Salamatina; Ye. Yu. Levchenko; A. A. Seitov; O. M. Zolotenkova; A. A. Burym

    2014-01-01

    Study objective: description of the case of diagnostics of rare anomaly of the coronary vessels: coronary and left ventricular fistulas.Materials and methods. Patient L., 45 y.o. (height 168 cm, weight 55 kg), male, complained of periodical burning pain behind the breastbone without connection with physical activity, often disturbing at night, stopped with intake of nitrates. The following examination of the patient was performed: clinical and biochemical blood tests, electrocardiography (ECG...

  17. A rare congenital anomaly, bridge-like appendiceal fistula to the terminal ileum, demonstrated by MDCT.

    Science.gov (United States)

    Takeuchi, Kayo; Kosaka, Nobuyuki; Kinoshita, Kazuyuki; Sakai, Toyohiko; Sawai, Katsuji; Imamura, Yoshiaki; Kimura, Hirohiko

    2013-08-01

    Although appendiceal anatomical anomalies are very rare, understanding of the anatomical details of these anomalies is important for surgery. In this case report, we present images from multi-detector row computed tomography (MDCT) and histological findings of a rare anatomical appendiceal anomaly originating from the cecum and opening into the terminal ileum like a bridge. These anatomical details were clearly depicted on MDCT with multi-planar reconstruction. MDCT demonstrated a communication between the appendix and terminal ileum. Histological analysis revealed that a normal mucosal layer was maintained from the appendix to the connected ileum, without any evidence of inflammatory or neoplastic changes, and only thickening of the muscular layer of the appendix was identified. Based on these histological findings, the appendix was considered to represent an anatomical anomaly rather than secondary fistula caused by inflammation or neoplasm, which has not yet been reported. PMID:23247734

  18. Neonate with VACTERL Association and a Branchial Arch Anomaly without Hydrocephalus.

    Science.gov (United States)

    Velazquez, Danitza; Pereira, Elaine; Havranek, Thomas

    2016-03-01

    VACTERL (vertebral anomalies, anal atresia, cardiac defect, tracheoesophageal fistula, renal anomaly, limb anomalies) is an association of anomalies with a wide spectrum of phenotypic expression. While the majority of cases are sporadic, there is evidence of an inherited component in a small number of patients as well as the potential influence of nongenetic risk factors (maternal diabetes mellitus). Presence of hydrocephalus has been reported in VACTERL patients (VACTERL-H) in the past, with some displaying branchial arch anomalies. We report the unique case of an infant of diabetic mother with VACTERL association and a branchial arch anomaly-in the absence of hydrocephalus.

  19. 电子支气管镜在Ⅲ型食管闭锁术后气管食管瘘复发诊断中的应用%Application of electronic bronchoscopy in diagnosis of recurrent tracheoesophageal fistula of type Ⅲ esophageal atresia

    Institute of Scientific and Technical Information of China (English)

    冯翠竹; 万灝; 陈快; 陶俊锋; 黄金狮

    2016-01-01

    目的 探讨电子支气管镜在Ⅲ型食管闭锁术后气管食管瘘复发诊断中的应用.方法 回顾分析江西省儿童医院自2010年1月-2014年8月收治的5例Ⅲ型食管闭锁术后怀疑气管食管瘘复发的病例,均采用电子支气管镜结合胃管注入美兰方法进行检查.其中,男4例,女1例,检查年龄为2~15个月,平均7.4个月.结果 5例患儿均在电子支气管镜下见到气管膜部瘘口,胃管内注入美兰后可见美兰自气管膜部瘘口溢出,气管食管瘘复发诊断成立.检查时间为3~7 min,平均为4.2 min.此5例患儿均通过手术证实.结论 使用电子支气管镜结合胃管注入美兰的检查方法,用来诊断食管闭锁术后气管食管瘘复发安全可行,检查时间短,确诊率高.%Objective To investigate the application of electronic bronchoscopy in diagnosis of recurrent tracheoe-sophageal fistula of type Ⅲ esophageal atresia. Methods 5 patients were reviewed who were suspected postopera-tive tracheoesophageal fistula recurrence of type Ⅲ esophageal atresia and examined through electronic bron-choscopy combined with injecting Methylene blue into stomach tube from Jan 2010 to Aug 2014. Male to female ra-tio was 4:1. The age was 2~15 months, median age was 7.4 months. Results The 5 cases were found trachea mem-brane fistula by electronic bronchoscope, recurrent tracheoesophageal fistula was diagnosed with Methylene blue in-jected into stomach tube and overflowed from trachea membrane fistula. Examination time is 3~7 minutes, the aver-age is 4.2 minutes. The 5 cases were confirmed by operation. Conclusion Electronic bronchoscopy combined with injecting Methylene blue into stomach tube to diagnose recurrent tracheoesophageal fistula is safe and feasible, the time is short and the diagnosis rate is high.

  20. RARE ANOMALY OF THE CORONARY VESSELS: CORONARY AND LEFT VENTRICULAR FISTULAS

    Directory of Open Access Journals (Sweden)

    L. V. Salamatina

    2014-01-01

    Full Text Available Study objective: description of the case of diagnostics of rare anomaly of the coronary vessels: coronary and left ventricular fistulas.Materials and methods. Patient L., 45 y.o. (height 168 cm, weight 55 kg, male, complained of periodical burning pain behind the breastbone without connection with physical activity, often disturbing at night, stopped with intake of nitrates. The following examination of the patient was performed: clinical and biochemical blood tests, electrocardiography (ECG, Holter ECG monitoring, bicycle ergometry, echocardiography, coronary angiography, computerized tomography.Results. The following clinical diagnosis was set on the basis of complaints. data of objective and instrumental examination: congenital heart disease. Abnormal end of the coronary arteries: multiple coronary and left ventricular fistulas, steal syndrome. Hypoplasia of the right coronary artery (Q 24.5 in accordance with the International Classification of Diseases, revision 10. Coronary angiography has become the main diagnostic method that allowed diagnosis verification: left type of coronary blood circulation. The trunk of the left coronary artery, the anterior interventricular branch,  he diagonal branch, the envelope branch, the obtuse marginal branch, the right coronary artery, the posterior interventricular branch have with irregular contours. Direct abnormal connection (dense grid of fistulas is observed in the medium and lower third of the anterior interventricular branch with the left ventricle cavity. The contrast agent practically completely comes into the left ventricular cavity. The parenchymal phase is very well expressed; the venous phase is not visualized. Conclusion. Congenital heart disease: multiple coronary and left ventricular fistulas. No angiographic evidence of hemodynamically significant stenotic coronary lesions.Conclusion. The practical interest of this observation is due to rarity of disease, analysis of modern

  1. RARE ANOMALY OF THE CORONARY VESSELS: CORONARY AND LEFT VENTRICULAR FISTULAS

    Directory of Open Access Journals (Sweden)

    L. V. Salamatina

    2015-01-01

    Full Text Available Study objective: description of the case of diagnostics of rare anomaly of the coronary vessels: coronary and left ventricular fistulas.Materials and methods. Patient L., 45 y.o. (height 168 cm, weight 55 kg, male, complained of periodical burning pain behind the breastbone without connection with physical activity, often disturbing at night, stopped with intake of nitrates. The following examination of the patient was performed: clinical and biochemical blood tests, electrocardiography (ECG, Holter ECG monitoring, bicycle ergometry, echocardiography, coronary angiography, computerized tomography.Results. The following clinical diagnosis was set on the basis of complaints. data of objective and instrumental examination: congenital heart disease. Abnormal end of the coronary arteries: multiple coronary and left ventricular fistulas, steal syndrome. Hypoplasia of the right coronary artery (Q 24.5 in accordance with the International Classification of Diseases, revision 10. Coronary angiography has become the main diagnostic method that allowed diagnosis verification: left type of coronary blood circulation. The trunk of the left coronary artery, the anterior interventricular branch,  he diagonal branch, the envelope branch, the obtuse marginal branch, the right coronary artery, the posterior interventricular branch have with irregular contours. Direct abnormal connection (dense grid of fistulas is observed in the medium and lower third of the anterior interventricular branch with the left ventricle cavity. The contrast agent practically completely comes into the left ventricular cavity. The parenchymal phase is very well expressed; the venous phase is not visualized. Conclusion. Congenital heart disease: multiple coronary and left ventricular fistulas. No angiographic evidence of hemodynamically significant stenotic coronary lesions.Conclusion. The practical interest of this observation is due to rarity of disease, analysis of modern

  2. Associated congenital anomalies: Vestibular fistula, duodenal atresia and obstructive refluxing megaureter

    Directory of Open Access Journals (Sweden)

    Bukarica Svetlana S.

    2004-01-01

    Full Text Available Congenital gastrointestinal anomalies include spectrum of malformations, simple ones as well as complex, which are associated with anomalies of other organs and systems of organs. Most infants (50-60% with imperforate anus also have genitourinary, cardiovascular, gastrointestinal and vertebral anomalies. This case report is of a female newborn with prenatally diagnosed duodenal atresia and right hydronephrosis. Clinical investigation revealed an imperforate anus with vestibular fistula. A plain abdominal x-ray showed a "double-bubble” sign, characteristic for duodenal atresia. Intraluminal membrane was excised and sigmoid colostomy was performed in general anesthesia on the first day of life. Ultrasound and intravenous pyelography confirmed a hydronephrotic right kidney and obstructive megaureter after Pena. In the fifth month of life, the ureter was tapered and reimplanted. Six months later, posterior sagittal anorectoplasty was performed. In the sewentheenth month of life the colostomy was closed. This child attained normal growth and development, normal bowel control, fecal continence without soiling, obstipation and urinary infections.

  3. Radiological evaluation congenital gastrointestinal tract anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Hee; Kim, Ock [Hanil Hospital, Seoul (Korea, Republic of); Jang, Jung Wha [Seoul Nationl Hospital, Seoul (Korea, Republic of)

    1983-06-15

    With the improvements, during recent years, in the control of the infections and nutritional diseases the subject of congenital malformation becomes of increasing importance. The radiologic signs are crucial for prompt diagnosis of anomalies of alimentary tract and with early identification of resulting complication, surgical therapy is usually life-saving. 30 cases of congenital anomalies of alimentary tract in infants were reviewed in respect of age, sex, incidence and radiological findings. The results are summarized as follows; 1, The most common lesion was hypertrophic pyloric stenosis, followed by congenital megacolon and anorectal anomaly, tracheoesophageal fistula, intestinal atresia. 2. Male outnumbered female in most congenital anomalies of alimentary tract. 25 cases were under the age of 1 month. 3. Common symptoms of upper gastrointestinal tract obstruction are vomiting and abdominal distension. In the obstruction of lower gastrointestinal tract, abdominal distension and failure of meconium passage were noted. 4. Roentgenologic findings were as follows, a. Chest A-P and lateral view: In tracheoesophageal fistula, saccular dilatation of upper esophagus and displacement of trachea anterolaterally were the most common finding. b. Simple abdomen: Obstructive pattern of proximal portion of duodenum shows in 11 cases, of distal bowel shows in 16 cases. Duodenal atresia showed 'double bubble' sign, hypertrophic pyloric stenosis showed marked gastric distension, paucity of air in small bowel and increases gastric peristalsis were the most common findings. Hirschsprung's disease showed absenced of rectal gas almostly. The variable length between blind hindgut to anus was seen in anorectal anomalies. c. Esophagogram: Blind sac of upper esophagus was seen at the 4th thoracic spinal level and displacement of trachea anterolaterally. 1 case of tracheoesophageal fistula had an intact esophageal lumen. d. Upper G-I series: In hypertrophic pyloric

  4. Bilateral congenital lacrimal fistulas in an adult as part of ectrodactyly-ectodermal dysplasia-clefting syndrome: A rare anomaly.

    Science.gov (United States)

    Ghosh, Debangshu; Saha, Somnath; Basu, Sumit Kumar

    2015-10-01

    Ectrodactyly-ectodermal dysplasia and clefting syndrome or "Lobster claw" deformity is a rare congenital anomaly that affects tissues of ectodermal and mesodermal origin. Nasolacrimal duct (NLD) obstruction with or without atresia of lacrimal passage is a common finding of such a syndrome. The authors report here even a rarer presentation of the syndrome which manifested as bilateral NLD obstruction and lacrimal fistula along with cleft lip and palate, syndactyly affecting all four limbs, mild mental retardation, otitis media, and sinusitis. Lacrimal duct obstruction and fistula were managed successfully with endoscopic dacryocystorhinostomy (DCR) which is a good alternative to lacrimal probing or open DCR in such a case. PMID:26655010

  5. Bilateral congenital lacrimal fistulas in an adult as part of ectrodactyly-ectodermal dysplasia-clefting syndrome: A rare anomaly

    Directory of Open Access Journals (Sweden)

    Debangshu Ghosh

    2015-01-01

    Full Text Available Ectrodactyly-ectodermal dysplasia and clefting syndrome or "Lobster claw" deformity is a rare congenital anomaly that affects tissues of ectodermal and mesodermal origin. Nasolacrimal duct (NLD obstruction with or without atresia of lacrimal passage is a common finding of such a syndrome. The authors report here even a rarer presentation of the syndrome which manifested as bilateral NLD obstruction and lacrimal fistula along with cleft lip and palate, syndactyly affecting all four limbs, mild mental retardation, otitis media, and sinusitis. Lacrimal duct obstruction and fistula were managed successfully with endoscopic dacryocystorhinostomy (DCR which is a good alternative to lacrimal probing or open DCR in such a case.

  6. Bilateral congenital lacrimal fistulas in an adult as part of ectrodactyly-ectodermal dysplasia-clefting syndrome: A rare anomaly

    OpenAIRE

    Debangshu Ghosh; Somnath Saha; Sumit Kumar Basu

    2015-01-01

    Ectrodactyly-ectodermal dysplasia and clefting syndrome or "Lobster claw" deformity is a rare congenital anomaly that affects tissues of ectodermal and mesodermal origin. Nasolacrimal duct (NLD) obstruction with or without atresia of lacrimal passage is a common finding of such a syndrome. The authors report here even a rarer presentation of the syndrome which manifested as bilateral NLD obstruction and lacrimal fistula along with cleft lip and palate, syndactyly affecting all four limbs, mil...

  7. Expanded spectrum of limb anomalies in the VATER association

    Energy Technology Data Exchange (ETDEWEB)

    Fernbach, S.K.; Glass, R.B.J.

    1988-04-01

    The radiographs of 230 children who had undergone neonatal surgery for imperforate anus and/or esophageal atresia/tracheoesophageal fistula were reviewed. Of the 31 children with limb anomalies thus detected, the 24 who had no radiologic or laboratory evidence of chromosomal abnormality form the basis of this report. In 16 children the limb anomalies fell within the commonly described spectrum of the VATER association. In the other 8 children and in 3 of the children with typical VATER limb anomalies additional anomalies were encountered: Sprengel deformity (2), hypoplasia of the humerus (3), radioulnar synostosis (1), midline anomalies of the hand (1), absence of the pubis, femur, tibia, and fibula and two rays of the foot (1), and other foot deformities. Subtle anomalies of the hand were common and included: clinodactyly, syndactyly, shortening of the middle phalanx of the fifth digit, and rotary malposition of the digits.

  8. Application of high-frequency ultrasound in esophageal atresia with tracheoesophageal fistula%高频超声在诊断先天性食管闭锁合并气管食管瘘中的价值

    Institute of Scientific and Technical Information of China (English)

    苏朋俊; 袁宇航; 张志波; 黄英; 王大佳

    2014-01-01

    Objective To evaluate the accuracy of preoperative ultrasonography (US) in depicting the structure of esophageal atresia with tracheoesophageal fistula (EA-TEF)and determine its role in planning surgical strategy by digitally measuring interpouch distance (ID).Methods A total of 1 8 neonates (10 males,8 females)with congenital EA-TEF were recruited.After obtaining chest radiographs with a coiled nasogastric tube in upper esophageal pouch,longitudinal esophageal high-frequency US was performed.The esophageal structures were displayed and the IDs measured on US images were compared with the surgical findings.The esophageal structures were displayed,and the IDs measured on US images were compared with the surgical findings.Results With the use of US, the structure of EA-TEF was accurately depicted.And the IDs detected by US correlated well with the surgical findings.Statistical analysis demonstrated no significant difference in the IDs as assessed by US and surgery (0.1-3.5 vs 0.1-3.6 cm)(R =0.99,P <0.01 ).Conclusions Preoperative US may provide more accurate information on the structure of EA-TEF and it plays a crucial role in planning surgical strategy.%目的:探讨高频超声在新生儿食管闭锁合并气管食管瘘诊断中的应用价值。方法应用 PhilipsIU22三维容积高频线阵探头,频率为5~12MHz,对18例(男10例,女8例)疑为食管闭锁气管食管瘘新生儿术前行胸部正侧位、插胃管及高频超声食管纵行扫描,观察食管闭锁超声图像表现,测量食管近远端盲端间距离,并与手术测量结果统计对照分析。结果所有患儿均获得满意的食管近远端超声图像:食管结构呈外低内高回声环,闭锁食管的上下段盲端显示清楚;上端食管盲端的位置与主动脉弓关系密切,下端食管沿左心房后方向近端延伸;所有患儿均可在同一屏幕内直接测量食管上下盲袋间的距离0.1~3.5 cm,术中测量距离为0.1~3.6 cm,两者对应差值小于0

  9. 先天性食管闭锁并气管食管瘘的早期胚胎学研究%The embryological changes of the esophagus and trachea in congenital esophageal atresia and tracheo-esophageal fistula

    Institute of Scientific and Technical Information of China (English)

    李樱子; 陈永卫; 曾晓蓓; 孙海梅; 徐元芹

    2007-01-01

    目的 利用阿霉素诱导制作食管闭锁并气管食管瘘(esophageal atresia and tracheoesophageal fistula,EA-TEF)大鼠模型,探讨胚胎发育中气管、食管分化异常的发生机制及可能的影响因素.方法 明确孕龄的SD雌性孕鼠9只,随机分为正常组2只及模型组7只,模型组于E6~E9d每日腹腔注射2 mg/kg阿霉素,正常组不注射.正常组于E11.5、E12.5 d,模型组于E11.5、E12.5、E13.5 d取材.进行HE及PAS染色,成纤维细胞生长因子7、10(fibroblast growth factor 7,FGF7,10)免疫组化染色.留1只模型组孕鼠于E21 d处死,体式镜下解剖.结果 ①正常对照组:HE染色可见到11.5 d肺芽萌出,12.5 d时可见气管、食管分离,在气管、食管分离处的前肠壁内有大量的凋亡小体.PAS染色及FGF7、10免疫组化染色可见前肠背侧半及食管为阴性,前肠腹侧半及气管部分为阳性;②模型组:HE染色11.5 d未见明显肺芽萌出,12.5 d可见瘘管与两侧支气管类似三分叉结构,在几乎相同水平发出.PAS染色及FGF7、10免疫组化染色可见瘘管组织阳性染色,近段前肠可见喉气管憩室以远的腹侧半为阳性.结论 对正常大鼠及阿霉素致畸动物模型早期胚胎学的观察得出以下结论:①正常气管、食管的分隔可能与局部细胞的凋亡有关;②气管、食管的正常分隔可能为前肠正常发育的必要条件;③FGF7、10在模型组TEF中表达,表明可能存在间充质细胞的异常,产生异常的信号因子导致TEF.

  10. Tracheoesophageal fistula and esophageal atresia repair

    Science.gov (United States)

    ... be admitted to the neonatal intensive care unit (NICU) as soon as the doctors diagnose either of ... child will be cared for in the hospital's NICU. Additional treatments after surgery usually include: Antibiotics as ...

  11. 先天性食管闭锁并气管食管瘘的大鼠胚胎学研究%Embryological study of the rat embryos developing congenital esophageal atresia and tracheoesophageal fistula

    Institute of Scientific and Technical Information of China (English)

    王伟; 陈永卫; 孙海梅

    2009-01-01

    Objective To investigate the embryological development and Sonic Hedgehogs (Shh) expression in an adriamycin rat model(ARM) of esophageal atresia and tracheoesophageal fistula(EA-TEF).Methods Twelve timed-pregnant.Sprague-Dawley rats were randomly divided into two groups:ARM group (n=8) and normal control group (n=4).The rats of ARM group were intraperitoneally administrated with adriamycin (2 mg/kg) on gestational days 6 to 9 (E6-E9).From El0.5 to El3.5,the embryos of 2 ARM rats and 1 normal control rat were harvested by caesarean section every day.The embryos were processed and serially sectioned in the transverse planes.The slides were stained with H&E staining.Shh was detected by immunofluorescence staining.ResultsThe ARM embryos displayed a reduction in cell proliferation and delayed embryological development compared to the normal control embryos.Most of the ARM embryos had ectopic notochord which approached to,attached to or even fused with foregut.In normal control embryos,the highest expression of Shh in foregut occurred on E10.5,then it decreased with the gestational age.Compared to the normal control embryos,the Shh expression in ARM embryos was lower,and it didn't show the tendency to decrease with the gestational age.The expression of Shh in ectopic notochord and foregut was prominent in ARM embryos.Conclusions The abnormal notochord development may contribute to the embryological development of EA-TEF.The ectopic expression and the absence of down-regulation of Shh may play an important role in the embryological development of EA-TEF.%目的 利用阿霉素诱导食管闭锁并气管食管瘘大鼠胚胎模型(adriamyein-induced rat model,ARM)与正常大鼠胚胎作比较,研究气管、食管的正常与异常分化过程.探讨产牛食管闭锁并气管食管瘘(esophageal atresia and traeheoesophageal fistula,EA-TEF)的可能影响因素.方法 SD孕鼠12只.随机分为模犁组8只及正常组4只.模型组于E6~9 d每Et腹腔注射阿霉素2

  12. Sonic hedgehog and Glis famliy expression in the human neonatal of congenital esophageal atresia and tracheoesophageal fistula%Sonic hedgehog基因及Gli家族在人类食管闭锁并气管食管瘘中的表达

    Institute of Scientific and Technical Information of China (English)

    陈璐璐; 陈永卫

    2012-01-01

    目的 研究Sonic hedgehog基因及Gli家族在人类先天性食管闭锁并气管食管瘘(esophageal atresia and tracheoesophageal fistula,EA-TEF)的表达特点,探讨EA-TEF病因及发病机制的可能影响因素.方法 食管吻合术中留取22例EA-TEF患儿近端食管盲端及远端气管食管瘘管组织,7例行HE染色,10例行real-time RT-PCR处理,5例行免疫荧光染色处理.观察食管盲端及气管食管瘘管形态上的变化及各指标的差异.结果 ①形态学:瘘管组织内皮下可见粘液腺体,肌层稀疏且肌肉组织结构紊乱;②Shh表达:食管盲端组织中可见表达,瘘管组织中未有表达;③Glis表达:Gli-1、Gli-3mRNA表达无差异,Gli-2mRNA表达差异有统计学意义(P<0.05),瘘管中表达低于食管盲袋.结论 气管食管瘘组织具有气管源性特征.EA-TEF的发生可能与Shh信号通路表达下调有关.Gli-2的功能缺失在EA-TEF的发生中可能发挥重要作用.%Objective To describe the differential expression of Shh and Gli family members between normal proximal esophageal pouch and distal tracheoesophageal fistula (EA-TEF).Methods Twenty twohuman proximal esophageal pouch and distal fistula samples were obtained at the time of standard repair of EA-TEF.Seven samples were processed for HE,ten for real-time reverse-transcriptase polymerase chain reaction (RT-PCR),and five for immunohistochemistry.Results Shh was confirmed to be present by immunohistochemistry in the proximal esophageal pouch,but was specifically absent in the distal fistula tract.Gli1and-3 mRNA expression showed no difference in the proximal pouch and distal esophagus using real-time RT-PCR.Gli-2 mRNA levels were much lower in the fistula tract than in the adjacent esophagus.Conclusions Abnomal expression of Shh may contribute to the malformation of EA-TEF.Gli2down-regulation may also play an important role in the mechanisms of EA-TEF malformation.These results support the conclusion that the fistula tract

  13. THORACOSCOPIC REPAIR OF ESOPHAGEAL ATRESIA WITH DISTAL FISTULA IN A NEW BORN: A TECHNICAL CASE REPORT

    Directory of Open Access Journals (Sweden)

    E. Brandigi

    2013-12-01

    Full Text Available Introduction. Esophageal atresia encompasses a group of congenital anomalies comprising of an interruption of the esophageal continuity with or without a persistent communication with the trachea. Esophageal atresia with tracheoesophageal fistula (type C accounts for 85% of all esophageal atresia. Minimally invasive approach to correct esophageal atresia with distal fistula is becoming more generally accepted. The outcome of these technique are critically analyzed and compared with results from open repair. We present one case of type IIIB esophageal atresia treated by a thoracoscopic approach. Case Report. The patient was a 2-days-old infant male, weight 3 kg with esophageal atresia and distal tracheoesophageal fistula without other associated disease. A polidramanios was detected in prenatal age by a prenatal ultrasound evaluation. He underwent to a thoracoscopic repair of the defect. The operation was approached through the right chest using a three-trocar technique (three 5-mm with the patient placed in a three-quarter prone position. The azygos vein was ligated by Ligature device. The fistula was ligated by two resorbable stiches suture and dissected, the proximal esophagus was opened and an anastomosis was made over a 6 Ch nasogastric tube with interrupted and resorbable stiches suture. On the postoperative day 7, gastrografin swallow was performed and oral feeding was started. The patient’s six month upper Gastrointestinal barium studies was normal. Discussion and conclusion. Thoracoscopic repair of esophageal atresia is considered to be one of the more advanced and most difficult pediatric surgical procedures and it undoubtely has necessary an elevated learning curve. The minimally invasive approach was larged accepted in the last ten years also for the well documented sequelae of traditional open repair of esophageal atresia. More experience is needed to determine the exact place of this approach.

  14. Usefulness of intraoperative bronchoscopy during surgical repair of a congenital cardiac anomaly with possible airway obstruction: three cases report.

    Science.gov (United States)

    Oh, JongEun; Kim, Jung-Won; Shin, Won-Jung; Gwak, Mijeung; Park, Pyung Hwan

    2016-02-01

    Compression of the airway is relatively common in pediatric patients, although it is often an unrecognized complication of congenital cardiac and aortic arch anomalies. Aortopexy has been established as a surgical treatment for tracheobronchial obstruction associated with vascular anomaly, aortic arch anomaly, esophageal atresia, and tracheoesophageal fistula. The tissue-to-tissue arch repair technique could result in severe airway complication such as compression of the left main bronchus which was not a problem before the correction. We report three cases of corrective open heart surgery monitored by intraoperative bronchoscopy performed during prebypass, and performed immediately before weaning from bypass, to evaluate tracheobronchial obstruction caused by congenital, complex cardiac anomalies in the operating room. PMID:26885306

  15. 1例先天性食管闭锁及气管食管瘘患儿的护理%Nursing Care of a Case With Congenital Esophageal Atresia and Tracheoesophageal Fistula

    Institute of Scientific and Technical Information of China (English)

    何锦平

    2000-01-01

    @@先天性食管闭锁及气管食管瘘 (congenital esophageal a treasia and tracheosophageal fistula, 简称食管闭锁-气管瘘)是 一种严重的胚胎发育畸形。根据国外的统计,约3 000个新生儿中就有1例此病患儿。但在我国,根据目前的资料发病率较国外为低[1,2]。本病的治愈率在国外已高达80%以上,在我国仅40%左右[2]。我院于1999年5月收治1例先天性食管闭锁及气管食管瘘合并吸入性肺炎、先天性心脏病的患儿,经急诊手术及精心护理,患儿痊愈出院。现将临床护理体会报告如下。

  16. Urethrorectal fistula in a horse.

    OpenAIRE

    Cruz, A. M.; Barber, S M; Kaestner, S B; Townsend, H G

    1999-01-01

    Anomalies of the urethra are uncommon. Urethrorectal fistula in horses has only been reported in foals and only in conjunction with other congenital anomalies. This report describes the diagnosis, surgical management, and possible etiologies of a unique case of urethrorectal fistula in a mature gelding.

  17. Esophageal atresia/tracheoesophageal fistula complicated by hypertrophic pyloric stenosis: a case report%食道闭锁气管食管瘘合并肥厚性幽门狭窄1例报道

    Institute of Scientific and Technical Information of China (English)

    张志波

    2010-01-01

    患儿,女,2 d.因出生后喂养困难,口鼻持续有泡沫样唾液流出2 d入院.患儿胎龄36周~(+2),出生体重2 510 g,身长46 cm,Apgar评分生后1 min和5 min均为10分,系剖腹产娩出.母健康,妊娠期间无异常,产前超声检查未提示有羊水异常.出生后发现喂养困难,口鼻持续有泡沫样唾液流出,其他未见异常.生后2 d就诊.就诊时发现口鼻内有泡沫样液体,上腹饱满,胃肠减压管插入受阻,疑诊为食道闭锁(esophageal atresia,EA),行胸腹平片检查诊断为EA.同时发现胃高度扩张,提示存在气管食管瘘(tracheo-esophageal fistula,TEF),而远端肠气缺失则提示高位肠梗阻;食道CT证实了EA合并TEF,CT同时提示了食道盲端距离.入院后2 d行右侧开胸胸膜外食道吻合术,同时结扎切断气管食管瘘.随后行开腹探查术,旨在探查、治疗高位肠梗阻.经仔细探查除了发现幽门肥厚水肿外并未发现其他高位肠梗阻,幽门管长2 cm,术中诊断为肥厚性幽门狭窄(hypertrophic pyloric stenosis,HPS),行幽门肌切开术,证实幽门肌厚达4mm.术后恢复过程顺利.经10 d全胃肠道外营养治疗后,食管造影证实吻合口通畅良好,无吻合口狭窄或吻合口瘘,随后给予母乳喂养,耐受良好.术后14 d出院.染色体核型为正常46,XY(GTG 500 bands).随访至今患儿已14个月,体重增长良好,进食正常,未出现术后并发症.

  18. Anomalies.

    Science.gov (United States)

    Online-Offline, 1999

    1999-01-01

    This theme issue on anomalies includes Web sites, CD-ROMs and software, videos, books, and additional resources for elementary and junior high school students. Pertinent activities are suggested, and sidebars discuss UFOs, animal anomalies, and anomalies from nature; and resources covering unexplained phenonmenas like crop circles, Easter Island,…

  19. A study of associated congenital anomalies with biliary atresia

    Directory of Open Access Journals (Sweden)

    Lucky Gupta

    2016-01-01

    Full Text Available Background/Purpose: This study aims to analyze the incidence and type of various associated anomalies among infants with extrahepatic biliary atresia (EHBA, compare their frequency with those quoted in the existing literature and assess their role in the overall management. Materials and Methods: A retrospective study was performed on 137 infants who underwent the Kasai procedure for EHBA during the past 12 years. The medical records were reviewed for the incidence and type of associated anomalies in addition to the details of the management of the EHBA. Results: Of the137 infants, 40 (29.2% were diagnosed as having 58 anomalies. The majority of patients had presented in the 3 rd month of life; mean age was 81 ± 33 days (range = 20-150 days. There were 32 males and 8 females; boys with EHBA had a higher incidence of associated anomalies. Of these 40 patients, 22 (37.9% had vascular anomalies, 13 patients (22.4% had hernias (umbilical-10, inguinal-3, 7 patients (12.1% had intestinal malrotation, 4 patients (6.8% had choledochal cyst, 1 patient (1.7% had Meckel′s diverticulum, 3 patients (5% had undergone prior treatment for jejunoileal atresias (jejunal-2, ileal-1, 2 patients (3.4% had undergone prior treatment for esophageal atresia and tracheoesophageal fistula, 2 patients (3.4% had spleniculi, and 2 patients (3.4% were diagnosed as having situs inversus. Conclusions: The most common associated anomalies in our study were related to the vascular variation at the porta hepatis and the digestive system. The existence of anomalies in distantly developing anatomic regions in patients with EHBA supports the possibility of a "generalized" insult during embryogenesis rather than a "localized" defect. In addition, male infants were observed to have significantly more associated anomalies as compared with the female infants in contrast to earlier reports.

  20. Aortoenteric Fistula

    Directory of Open Access Journals (Sweden)

    Shou-Jiang Tang

    2014-04-01

    Conclusions: Diagnosis of aortoenteric fistula requires a high index of suspicion and careful history-taking. Endoscopic findings include adherent clots or bleeding at the fistula opening and/or eroded vascular graft or stent into the bowel.

  1. Report of a complete second branchial fistula.

    LENUS (Irish Health Repository)

    Khan, Mohammad Habibullah

    2010-08-01

    We report a case of complete congenital branchial fistula with an internal opening near the tonsillar fossa. Cysts, fistulas, and sinuses of the second branchial cleft are the most common developmental anomalies arising from the branchial apparatus. In our case, a 43-year-old man presented with a several-year history of a discharging sinus from the right side of his neck, consistent with a branchial fistula. He underwent various investigations and finally was treated with a one-stage complete surgical excision of the fistula tract. We describe the general clinical presentation, investigations, and surgical outcome of this case.

  2. Cardiocutaneous fistula

    OpenAIRE

    Danias, P; Lehman, T; Kartis, T; Missri, J.

    1999-01-01

    Infection of the Teflon pledgets on the heart suture line after left ventricular aneurysm repair, presenting late with a fistulous tract connecting the heart with the skin (cardiocutaneous fistula) is an uncommon but potentially serious condition. The case is reported of a 73 year old man who developed a cardiocutaneous fistula extending through the left hemidiaphragm and draining at the abdominal wall, which developed six years after left ventricular aneurysmectomy. Following radiographic ev...

  3. Esophageal aerodynamics in an idealized experimental model of tracheoesophageal speech

    Science.gov (United States)

    Erath, Byron D.; Hemsing, Frank S.

    2016-03-01

    Flow behavior is investigated in the esophageal tract in an idealized experimental model of tracheoesophageal speech. The tracheoesophageal prosthesis is idealized as a first-order approximation using a straight, constant diameter tube. The flow is scaled according to Reynolds, Strouhal, and Euler numbers to ensure dynamic similarity. Flow pulsatility is produced by a driven orifice that approximates the kinematics of the pharyngoesophageal segment during tracheoesophageal speech. Particle image velocimetry data are acquired in three orthogonal planes as the flow exits the model prosthesis and enters the esophageal tract. Contrary to prior investigations performed in steady flow with the prosthesis oriented in-line with the flow direction, the fluid dynamics are shown to be highly unsteady, suggesting that the esophageal pressure field will be similarly complex. A large vortex ring is formed at the inception of each phonatory cycle, followed by the formation of a persistent jet. This vortex ring appears to remain throughout the entire cycle due to the continued production of vorticity resulting from entrainment between the prosthesis jet and the curved esophageal walls. Mean flow in the axial direction of the esophagus produces significant stretching of the vortex throughout the phonatory cycle. The stagnation point created by the jet impinging on the esophageal wall varies throughout the cycle due to fluctuations in the jet trajectory, which most likely arises due to flow separation within the model prosthesis. Applications to tracheoesophageal speech, including shortcomings of the model and proposed future plans, are discussed.

  4. An introduction to the assessment of intelligibility of tracheoesophageal speech

    NARCIS (Netherlands)

    P. Jongmans; C. van As; L. Pols; F. Hilgers

    2003-01-01

    In cases of laryngeal cancer, it is sometimes necessary to perform a total laryngectomy. This procedure changes the anatomy and physiology of the vocal tract, with the most noticeable effect on speech. By applying a voice prosthesis, enabling the patient to use tracheoesophageal speech, speech is of

  5. Physiology and prospects of bimanual tracheoesophageal brass instrument play

    NARCIS (Netherlands)

    F.J.M. Hilgers; R. Dirven; I. Jacobi; M.W.M. van den Brekel

    2015-01-01

    This study investigated whether trachea pressures during brass instrument play of laryngectomised patients are within the range of those measured during tracheoesophageal voicing, and whether application of an automatic speaking valve can ‘free’ both hands to play a brass instrument. Objective asses

  6. Physiology and prospects of bimanual tracheoesophageal brass instrument play

    OpenAIRE

    Hilgers, F.J.M.; Dirven, R.; JACOBI, I.; Brekel, van den, M.W.M.

    2015-01-01

    SUMMARY This study investigated whether trachea pressures during brass instrument play of laryngectomised patients are within the range of those measured during tracheoesophageal voicing, and whether application of an automatic speaking valve can 'free' both hands to play a brass instrument. Objective assessment of voicing and music playing parameters was carried out in 2 laryngectomised patients with a low-pressure indwelling voice-prosthesis able to play brass instruments (tenor horn and sl...

  7. Experimental results of the tracheoesophageal tissue connector for improved fixation of shunt valves in laryngectomized patients

    NARCIS (Netherlands)

    ten Hallers, E. J. Olivier; Marres, Henri A. M.; van der Houwen, Eduard B.; Jansen, John A.; Rakhorst, Gerhard; Schutte, Harm K.; van Kooten, Theo G.; van Loon, Jan-Paul; Verkerke, Gijsbertus J.

    2006-01-01

    Background, After total laryngectomy and voice rehabilitation using a tracheoesophageal shunt valve, patients often have valve-related complications such as leakage. To solve these problems, a tracheoesophageal tissue connector (TE-TC) was devised to serve as an interface between the patient's tissu

  8. ESOPHAGEAL ATRESIA WITH DISTAL TRACHEOESOPHAGEAL FISTULA: SURGERY TREATMENT AND A LONG TERM FOLLOW UP

    OpenAIRE

    E. Cerchia; F. Molinaro; M. Pavone; E Bindi; R. Angotti; Ferrara, F.; Messina, M.

    2012-01-01

    A study carried out at the Paediatric Surgery Units in Siena and Toulouse evaluated the long term follow-up of patients treated for esophageal atresia (EA), between 1988 and 2007. We analyzed the long term follow-up of 57 patients with III type EA. We evaluated the residual symptoms in three time intervals: in 1st years, between 2nd to 5th year and over 5th years from surgery. The considered parameters were: feeding difficulties, respiratory problems, gastro-esophageal reflux, growth impairme...

  9. A new approach for the management of esophageal atresia without tracheo-esophageal fistula.

    Science.gov (United States)

    Bedi, Nandini K; Grewal, Alka G; Rathore, Shubhra; George, Uttam

    2016-01-01

    Long gap esophageal atresia (OA) is a challenging condition. While discussing the various methods of management available to us, we report the use of magnetic resonance imaging in a case of pure OA to judge the gap between two ends of the esophagus. PMID:27365910

  10. A new approach for the management of esophageal atresia without tracheo-esophageal fistula

    Directory of Open Access Journals (Sweden)

    Nandini K Bedi

    2016-01-01

    Full Text Available Long gap esophageal atresia (OA is a challenging condition. While discussing the various methods of management available to us, we report the use of magnetic resonance imaging in a case of pure OA to judge the gap between two ends of the esophagus.

  11. Infantile Hypertrophic Pyloric Stenosis in Postoperative Esophageal Atresia with Tracheoesophageal Fistula

    Directory of Open Access Journals (Sweden)

    Hassan RAA

    2015-07-01

    Full Text Available Development of infantile hypertrophic pyloric stenosis during postoperative period in EA with TEF is rare. Postoperative vomiting or feeding intolerance in EA is more common which is due to esophageal stricture, gastroesophageal reflux and esophageal dysmotility. A typical case of IHPS also presents with non-bilious projectile vomiting at around 3-4 weeks of life. The diagnosis of infantile hypertrophic pyloric stenosis in this subset is usually delayed because of its rarity. We report a case of IHPS in postoperative EA and emphasize on high index of suspicion to avoid any delay in diagnosis with its metabolic consequences.

  12. A new approach for the management of esophageal atresia without tracheo-esophageal fistula

    OpenAIRE

    Nandini K Bedi; Alka G Grewal; Shubhra Rathore; Uttam George

    2016-01-01

    Long gap esophageal atresia (OA) is a challenging condition. While discussing the various methods of management available to us, we report the use of magnetic resonance imaging in a case of pure OA to judge the gap between two ends of the esophagus.

  13. Ureteroarterial Fistula

    Directory of Open Access Journals (Sweden)

    D. H. Kim

    2009-01-01

    Full Text Available Ureteral-iliac artery fistula (UIAF is a rare life threatening cause of hematuria. The increasing frequency is attributed to increasing use of ureteral stents. A 68-year-old female presented with gross hematuria. She had prior low anterior resection for rectal cancer and a retained ureteral stent. CT abdomen and pelvis showed a large recurrent pelvic mass and a retained stent. The patient underwent cystoscopy which showed a normal bladder. Upon removal of the stent, brisk bleeding was noted coming from the ureteral orifice. Antegrade pyelogram was done which revealed a UIAF. Angiography was done and a covered stent was placed. Multiple treatment options are available. All must consider management of the arterial and ureteral side. The arterial side may be addressed by primary open repair, embolization with extra-anatomic vascular reconstruction, or endovascular stenting. The ureter can be managed with nephroureterectomy, ureteral reconstruction, placement of a nephrostomy tube, or ureteral stenting. Being minimally invasive, we believe that endovascular stenting should be the preferred therapeutic option as it also corrects the source of bleeding while preserving distal blood flow.

  14. MRI in perianal fistulae

    International Nuclear Information System (INIS)

    MRI has become the method of choice for evaluating perianal fistulae due to its ability to display the anatomy of the sphincter muscles orthogonally, with good contrast resolution. In this article we give an outline of the classification of perianal fistulae and present a pictorial assay of sphincter anatomy and the MRI findings in perianal fistulae. This study is based on a retrospective analysis of 43 patients with a clinical diagnosis of perianal fistula. MRI revealed a total of 44 fistulae in 35 patients; eight patients had only perianal sinuses

  15. MRI in perianal fistulae

    Directory of Open Access Journals (Sweden)

    Khera Pushpinder

    2010-01-01

    Full Text Available MRI has become the method of choice for evaluating perianal fistulae due to its ability to display the anatomy of the sphincter muscles orthogonally, with good contrast resolution. In this article we give an outline of the classification of perianal fistulae and present a pictorial assay of sphincter anatomy and the MRI findings in perianal fistulae. This study is based on a retrospective analysis of 43 patients with a clinical diagnosis of perianal fistula. MRI revealed a total of 44 fistulae in 35 patients; eight patients had only perianal sinuses.

  16. Doppler findings in a rare Coronary Artery Fistula

    OpenAIRE

    Jorns Carl; Jung Christian; Huhta James

    2007-01-01

    Abstract One of the primary forms of congenital anomalies of the coronary arteries is coronary artery fistula (CAF). It is defined as a direct communication between the coronary artery and any surrounding cardiac chamber or vascular structure, which bypasses the myocardial capillary bed. We present a newborn baby with a large coronary artery fistula connecting the left anterior descending (LAD) artery to the left ventricular (LV) apex. Associated cardiac abnormalities were found: a ventricula...

  17. STUDY OF ENTEROCUTANEOUS FISTULA

    Directory of Open Access Journals (Sweden)

    Arti

    2015-03-01

    Full Text Available BACKGROUND: A fistula is defined as abnormal communication between two epithelial surfaces . 1 Enterocutaneous fistula is defined as abnormal communication between hollow organ and skin. They are classified as congenital or acquired. We have excluded congenital and internal fistulas. We have also excluded esophageal, urinary, p ancreatic and biliary fistulas as their management is complex and differs significantly from enterocutaneous fistulas. AIM: 1. Study of aetiology, pathophysiology and management of enterocutaneous fistula. To evaluate previously laid principles of management of enterocutaneous fistula. 2. To assess the feasibility of early intervention safety and outcome as the conservative long term treatment appears to be cost prohibitive. 3. To study morbidity and mortality related to enterocutaneous fistula. MATERIAL AND METHODS: In all, 50 cases of enterocutaneous fistula were studied during a period from June 2012 to N ovember 2014 at a Government tertiary care C entre. Both, patients referred from other centres with post - operative fistulas and fistulas developed in this institute after surgeries or spontaneously were included in the study after fulfilling the inclusion and exclusion criteria. RESULT S : The maximum numbers of cases were between 39 - 48 years of age group. Spontaneous closure was achieved in 72.7% and surgical closure in 76.7% of the patients Vacuum assisted closure was achieved in 66.66% of the patients in whom VAC was used. Of the patients in whom octreotide was used closure was achieved in 66.66% of the patients. The association between serum albumin levels and fistula healing and between fistula output and mortality were statistically significant. Overall mortality in this study was 26% with 44.44% among referred cases and 15.625% among institutional cases.

  18. Aphallia with urethrorectal fistula, bladder and urethral calculi

    Directory of Open Access Journals (Sweden)

    M Movarrekh

    2006-04-01

    Full Text Available Introduction: Aphallia is a very rare urogenital anomaly with incidence rate of 1 in 30,000,000. It usually coexists with other anomalies such as cardiovascular anomalies which are incompatible with normal life, and therefore infants are delivered stillbirth or live for a very short period of time. Methods: We present an 18 months old boy with aphallia associated with congenital urethrorectal fistula, bladder and urethral stones. All stones were removed endourologically, recto-urethral fistula was repaired and perincal urethrostomy was performed. Results: The stones were composed of calcium phosphate colonized by klebiella pneumonia and proteus mirabilis. Urethrorectal fistula repairment was confirmed by cystography. Patient was discharged without a urinary catheter. Conclusion: In developed countries, management of such patients is to raise them as females. However, we must consider socio-cultural conditions, parents preference and patients tendency in management of aphallia.

  19. [Surgery of anal fistulas].

    Science.gov (United States)

    Ricchi, E; Carriero, A; Spallanzani, A; Fundarò, S; Heydari, A; Piccoli, M; Gelmini, R

    1997-06-01

    The authors report a study on 120 patients with anal fistula (111 males and 9 females). The average age was 44.3 years (median 44, SD +/- 14.807). 64.1% of patients had an intersphincteric fistula, 23.3% hanal transphincteric fistula, 1.6% a suprasphincteric fistula, 7.5% a horseshoe fistula and the 3.3% an extrasphincteric fistula. We treated 14 patients (11.66%) with direct surgical treatment. The other 106 had various types of treatment depending on the localisation and the involvement of the anorectal sphincter. We had 11 cases (9.1%) of complications, such as recurrence in 5 patients (4.1%) transitory incontinence in 2 cases (1.6%) and finally postoperative bleeding in 3 patients (2.5%). PMID:9324655

  20. Physiology and prospects of bimanual tracheoesophageal brass instrument play.

    Science.gov (United States)

    Hilgers, F J M; Dirven, R; Jacobi, I; van den Brekel, M W M

    2015-06-01

    This study investigated whether trachea pressures during brass instrument play of laryngectomised patients are within the range of those measured during tracheoesophageal voicing, and whether application of an automatic speaking valve can 'free' both hands to play a brass instrument. Objective assessment of voicing and music playing parameters was carried out in 2 laryngectomised patients with a low-pressure indwelling voice-prosthesis able to play brass instruments (tenor horn and slide trombone): sound pressure levels in dB, maximum phonation time in seconds and trachea pressures in mmHg; videofluoroscopy, stroboscopy and digital high speed endoscopy to assess neoglottis vibration and opening. The dynamic range of the voice in the patients was 29 and 20 dB, and maximum phonation time was 22 and 19 sec, respectively; intratracheal pressures during voicing varied from 7 mmHg for the softest /a/ to 49 mmHg for the loudest /a/. For brass instrument play, the intratracheal pressures varied from 14 mmHg for the softest tone to 48 mmHg for the loudest tone. Imaging confirmed earlier findings that the neoglottis is closing and vibrating during voicing and remains 'open' without vibrations during music play, indicating good neoglottis control and innervation. From these objective measurements, we can conclude that trachea pressures during brass instrument play are within physiological ranges for tracheoesophageal voicing with a low-pressure indwelling voice-prosthesis. Furthermore, it was shown that application of a stable baseplate for retaining an automatic speaking valve and an additional customisable 'neck brace' makes bimanual play possible again. PMID:26246666

  1. Spontaneous aortocaval fistula.

    Directory of Open Access Journals (Sweden)

    Rajmohan B

    2002-07-01

    Full Text Available Spontaneous aortocaval fistula is rare, occurring only in 4% of all ruptured abdominal aortic aneurysms. The physical signs can be missed but the presence of low back pain, palpable abdominal aortic aneurysm, machinery abdominal murmur and high-output cardiac failure unresponsive to medical treatment should raise the suspicion. Pre-operative diagnosis is crucial, as adequate preparation has to be made for the massive bleeding expected at operation. Successful treatment depends on management of perioperative haemodynamics, control of bleeding from the fistula and prevention of deep vein thrombosis and pulmonary embolism. Surgical repair of an aortocaval fistula is now standardised--repair of the fistula from within the aneurysm (endoaneurysmorraphy followed by prosthetic graft replacement of the aneurysm. A case report of a 77-year-old woman, initially suspected to have unstable angina but subsequently diagnosed to have an aortocaval fistula and surgically treated successfully, is presented along with a review of literature.

  2. Congenital H-type anovestibuler fistula

    Institute of Scientific and Technical Information of China (English)

    Mesut Yazlcl; Barlas Etensel; Harun Gürsoy; Sezen Ozklsaclk

    2003-01-01

    The congenital H-type fistula between the anorectum and genital tract besides a normal anus is a rare entity in the spectrum of anorectal anomalies. We described a girl with an anovestibuler H-type fistula and left vulvar abscess. A 40-day-old girl presented symptoms after her parents noted the presence of stool at the vestibulum. On the physical examination, anus was in normal location and size, and had normal sphincter tone. A vestibuler opening was seen in the midline just below of the hymen. A fistulous communication was found between the vestibuler opening and the anus, just above the dentate line. There was a vulvar abscess which had a left lateral vulvar drainage opening 15 mm left lateral to the perineum. After the management of local inflammation and abscess, the patient was operated for primary repair of the fistula. A protective colostomy wasn′t performed prior the operation. A profuse diarrhea started after 5 hours of postoperation. After the diarrhea, a recurrent fistula was occurred on the second postoperative day. A divided sigmoid colostomy was performed. 2 months later, and anterior sagital anorectoplasty was reconstructed and colostomy was closed 1 month later. Various surgical techniques with or without protective colostomy have been described for double termination repair. But there is no consensus regarding surgical management of double termination.

  3. Spectral moments analysis of stops in tracheoesophageal speakers

    Science.gov (United States)

    Rosenbauer, Kimberly; Obert, Kerrie; Fox, Robert Allen

    2002-05-01

    Optimal speech intelligibility is naturally of primary concern for individuals who have had their larynxes removed due to cancer and are now using tracheoesophageal (TE) speech as their primary mode of communication. The current study examines the acoustic characteristics associated with the oral stops /pbtdkg/ produced by TE speakers as compared to normal speakers. Of particular interest are the acoustic differences between these two sets of speakers in oral stop bursts and in the aspiration frication for the voiceless stops. A set of utterances in which these six stops occur in both initial position (CV) and intervocalic position (VCV) before a wide range of English vowels were recorded for each set of speakers. Appropriate acoustic measurements were then made for each stop. These measurements included the spectral moments of the burst and aspiration, VOT, closure duration (for intervocalic stops), and the relative and normalized amplitude levels of the burst and aspiration. Acoustic differences obtained will be discussed as a function of speaker type, phonetic context and, in the case of the TE speaker, experience with the device.

  4. Management of Enterocutaneous Fistulas

    OpenAIRE

    Kaushal, Manish; Carlson, Gordon L.

    2004-01-01

    Despite advances in antimicrobial chemotherapy, nutritional support, and perioperative critical care, the development of an enterocutaneous fistula continues to represent a major therapeutic challenge, with appreciable morbidity and mortality. Specific problems that must be addressed for the successful management of patients with enterocutaneous fistulas are the control of sepsis, maintenance of adequate fluid and electrolyte balance, provision of adequate and complication-free nutritional su...

  5. Biofilm formation and design features of indwelling silicone rubber tracheoesophageal voice prostheses - An electron microscopical study

    NARCIS (Netherlands)

    Leunisse, C; van Weissenbruch, R; Busscher, HJ; van der Mei, HC; Dijk, F; Albers, FWJ

    2001-01-01

    After total laryngectomy, voice can be restored with a silicone rubber tracheoesophageal voice prosthesis. However, biofilm formation and subsequent deterioration of the silicone material of the prosthesis will limit device life by impairing valve function. To simulate the natural process of biofilm

  6. Effect of singing training on total laryngectomees wearing a tracheoesophageal voice prosthesis

    Directory of Open Access Journals (Sweden)

    Fernanda Onofre

    2013-02-01

    Full Text Available PURPOSE: To assess the effect of a program of singing training on the voice of total laryngectomees wearing tracheoesophageal voice prosthesis, considering the quality of alaryngeal phonation, vocal extension and the musical elements of tunning and legato. METHODS: Five laryngectomees wearing tracheoesophageal voice prosthesis completed the singing training program over a period of three months, with exploration of the strengthening of the respiratory muscles and vocalization and with evaluation of perceptive-auditory and singing voice being performed before and after 12 sessions of singing therapy. RESULTS: After the program of singing voice training, the quality of tracheoesophageal voice showed improvement or the persistence of the general degree of dysphonia for the emitted vowels and for the parameters of roughness and breathiness. For the vowel "a", the pitch was displaced to grave in two participants and to acute in one, and remained adequate in the others. A similar situation was observed also for the vowel "i". After the singing program, all participants presented tunning and most of them showed a greater presence of legato. The vocal extension improved in all participants. CONCLUSION: Singing training seems to have a favorable effect on the quality of tracheoesophageal phonation and on singing voice.

  7. Deterioration of the Provox(TM) silicone tracheoesophageal voice prosthesis : Microbial aspects and structural changes

    NARCIS (Netherlands)

    vanWeissenbruch, R; Albers, FWJ; Bouckaert, S; Nelis, HJ; Criel, G; Remon, JP; Sulter, AM

    1997-01-01

    Device life of tracheoesophageal voice prostheses is limited due to deterioration of the polymers. A group of 55 postlaryngectomy patients fitted with a Provox(TM) voice prosthesis have been studied prospectively during 6 months. Thirty-seven prostheses were replaced due to a dysfunctional valve mec

  8. Aerodynamic characteristics of the Nijdam voice prosthesis in relation to tracheo-esophageal wall thickness

    NARCIS (Netherlands)

    Veenstra, Aalze; van den Hoogen, F. J. A.; Schutte, H.K.; Nijdam, HF; Manni, JJ; Verkerke, GJ

    1997-01-01

    Tracheo-esophageal speech using various pros theses is currently the most successful form of voice and speech rehabilitation for laryngectomees. Main inter-device differences are durability and trans-device pressure loss during speech. The valveless indwelling Nijdam voice prosthesis is a new voice

  9. Diagnostic and therapeutic approach of congenital solitary coronary artery fistulas in adults : Dutch case series and review of literature

    NARCIS (Netherlands)

    Said, S. A. M.; Nijhuis, R. L. G.; op den Akker, J. W.; Kimman, G. P.; Van Houwelingen, K. G.; Gerrits, D.; Huisman, A. B.; Slart, R. H. J. A.; Nicastia, D. M.; Koomen, E. M.; Tans, A. C.; Al-Windy, N. Y. Y.; Sonker, U.; Slagboom, T.; Pronk, A. C. B.

    2011-01-01

    Background Coronary artery fistulas (CAFs) are infrequent anomalies, coincidentally detected during coronary angiography (CAG). Aim To elucidate the currently used diagnostic imaging modalities and applied therapeutic approaches. Materials and Methods Five Dutch patients were found to have CAFs. A t

  10. Fistula Vesiko Vaginalis

    Directory of Open Access Journals (Sweden)

    Luki Ertandri

    2016-08-01

    Full Text Available Abstrak          Latar belakang : fistula vesiko vaginalis merupakan bagian dari fistula vesiko urogenital merupakansuatu keadaan ditandai fistel antara kandung kemih dengan vagina yang menyebabkan rembesan urin keluar melalui vagina.           Kasus : wanita P3A0H3, 44 tahun, datang dengan keluhan terasa rembesan buang air kecil dari kemaluan sejak 3 bulan yang lalu. Keluhan muncul 7 hari setelah menajalani operasi histerektomi 3 bulan yang lalu. Histerektomi dilakukan atas indikasi mioma uteri dilakukan di Rumah Sakit Swasta. Tanda vital dalam batas normal. Pada pemeriksaan inspekulo tampak cairan urin menumpuk di fornix posterior. Dilakukan prosedur tes methylene blue didapatkan hasil positif di puncak vagina anterior 1 fistel dengan ukuran 1-1,5 cm. Pada pasien dilakukan fistulorraphy vesikovagina dengan teknik repair latzko dalam spinal anasthesi.           Pembahasan : Kasus fistula vesiko vaginalis biasa muncul di negara berkembang. Diantara faktor predisposisi adalah disebabkan operasi histerektomi, selain itu trauma persalinan dan komplikasi operasi daerah pelvik. Pemeriksaan Fisik dan pemeriksaan tambahan secara konvensional atau minimal invasif seperti sistoskopi, sistografi menggunakan zat kontras bisa membantu menegakan diagnosa, menentukan lokasi, ukuran dan jumlah fistel. Pembedahan adalah terapi andalan untuk fistula urogenital melalui transvagina atau trans abdomen. Pendekatan terapi tergantung ilmu, pengalaman dan kolaborasi dengan ahli lain bila dibutuhkan.Kata kunci: fistula vesiko vaginalis, histerektomi, latzkoAbstractBackground : Vesica vagina fistula is a part of urogenital fistula wich condition that present fistula between bladder and vagina and make urine mold through vagina.Case Report: Woman P3A0H3, 44 years old, admitted with complaining mold of urine from vagina since three months ago after seven days having surgery procedure. Complaint appeared seven days after histerctomi procedure. The

  11. Percutaneous closure of congenital aortocaval fistula with a coexisting secundum atrial septal defect

    DEFF Research Database (Denmark)

    Loh, Poay Huan; Jensen, Tim; Søndergaard, Lars

    2012-01-01

    Congenital aortocaval fistula is a very rare anomaly. Clinically, it resembles conditions that cause left-to-right shunt of blood. We report a case of such anomaly in combination with a secundum atrial septal defect in a 13-month-old girl who presented with failure to thrive and exertional respir...

  12. Congenital parotid fistula

    Directory of Open Access Journals (Sweden)

    Shiggaon Natasha

    2014-01-01

    Full Text Available Parotid fistula is a cause of great distress and embarrassment to the patient. Parotid fistula is most commonly a post-traumatic situation. Congenital parotid salivary fistulas are unusual entities that can arise from accessory parotid glands or even more infrequently, from normal parotid glands through an aberrant Stensen′s duct. The treatment of fistulous tract is usually surgical and can be successfully excised after making a skin incision along the skin tension line around the fistula opening. This report describes a case of right accessory parotid gland fistula of a 4-year-old boy with discharge of pus from right cheek. Computed tomography (CT fistulography and CT sialography demonstrated fistulous tract arising from accessory parotid gland. Both CT fistulography and CT sialography are very helpful in the diagnosis and surgical planning. In this case, superficial parotidectomy is the treatment of choice. A detailed history, clinical and functional examination, proper salivary gland investigations facilitates in correct diagnosis followed by immediate surgical intervention helps us to restore physical, psychological health of the child patient.

  13. Congenital parotid fistula.

    Science.gov (United States)

    Natasha, Shiggaon

    2014-01-01

    Parotid fistula is a cause of great distress and embarrassment to the patient. Parotid fistula is most commonly a post-traumatic situation. Congenital parotid salivary fistulas are unusual entities that can arise from accessory parotid glands or even more infrequently, from normal parotid glands through an aberrant Stensen's duct. The treatment of fistulous tract is usually surgical and can be successfully excised after making a skin incision along the skin tension line around the fistula opening. This report describes a case of right accessory parotid gland fistula of a 4-year-old boy with discharge of pus from right cheek. Computed tomography (CT) fistulography and CT sialography demonstrated fistulous tract arising from accessory parotid gland. Both CT fistulography and CT sialography are very helpful in the diagnosis and surgical planning. In this case, superficial parotidectomy is the treatment of choice. A detailed history, clinical and functional examination, proper salivary gland investigations facilitates in correct diagnosis followed by immediate surgical intervention helps us to restore physical, psychological health of the child patient. PMID:25231049

  14. Possible Waardenburg syndrome with gastrointestinal anomalies.

    OpenAIRE

    Nutman, J; Steinherz, R; Sivan, Y; Goodman, R M

    1986-01-01

    We describe a patient with possible Waardenburg syndrome associated with anal atresia and oesophageal atresia with tracheooesophageal fistula. Three other published cases with atretic gastrointestinal anomalies associated with the Waardenburg syndrome are reviewed. We conclude that the association between atretic lesions of the gastrointestinal tract and the Waardenburg syndrome may be a significant one.

  15. Treatment of non-IBD anal fistula

    DEFF Research Database (Denmark)

    Lundby, Lilli; Hagen, Kikke; Christensen, Peter;

    2015-01-01

    The course of the fistula tract in relation to the anal sphincter is identified by clinical examination under general anaesthesia using a fistula probe and injection of fluid into the external fistula opening. In the event of a complex fistula or in the case of fistula recurrence, this should be ...

  16. Transcatheter closure of a congenital coronary artery to right ventricle fistula: a case report

    OpenAIRE

    Gribaa, Rym; Slim, Mehdi; Ouali, Sana; Neffati, Elies; Boughzela, Essia

    2014-01-01

    Introduction Congenital coronary artery fistula is a rare anomaly that may cause angina, atrial fibrillation, endocarditis, aneurysmal dilation and myocardial infarction. Both spontaneous regression and life-threatening complications have been described. Treatment can be conservative, surgical or more recently through transcatheter closure. Case presentation We report the case of a 27-year-old Tunisian man with a large coronary artery fistula from the left anterior descending artery to the ri...

  17. Huge aneurysm and coronary-cameral fistula from right coronary branch: First case.

    Science.gov (United States)

    Ahmad, Tanveer; Pasarad, Ashwini Kumar; Kishore, Kolkebaile Sadanand; Maheshwarappa, Nandakumar Neralakere

    2016-02-01

    Coronary-cameral fistulas are rare cardiovascular anomalies. A giant coronary artery aneurysm associated with a coronary-cameral fistula is a very rare condition, with an estimated prevalence of 0.02%. We report the case of middle-aged woman who presented with a huge extracardiac aneurysmal mass and a coronary-cameral fistula from a right coronary artery branch. It was successfully repaired by ligation and excision plus marsupialization of the aneurysm. We believe this is the first such a case reported in literature.

  18. Associated congenital anomalies among cases with Down syndrome.

    Science.gov (United States)

    Stoll, Claude; Dott, Beatrice; Alembik, Yves; Roth, Marie-Paule

    2015-12-01

    Down syndrome (DS) is the most common congenital anomaly widely studied for at least 150 years. However, the type and the frequency of congenital anomalies associated with DS are still controversial. Despite prenatal diagnosis and elective termination of pregnancy for fetal anomalies, in Europe, from 2008 to 2012 the live birth prevalence of DS per 10,000 was 10. 2. The objectives of this study were to examine the major congenital anomalies occurring in infants and fetuses with Down syndrome. The material for this study came from 402,532 consecutive pregnancies of known outcome registered by our registry of congenital anomalies between 1979 and 2008. Four hundred sixty seven (64%) out of the 728 cases with DS registered had at least one major associated congenital anomaly. The most common associated anomalies were cardiac anomalies, 323 cases (44%), followed by digestive system anomalies, 42 cases (6%), musculoskeletal system anomalies, 35 cases (5%), urinary system anomalies, 28 cases (4%), respiratory system anomalies, 13 cases (2%), and other system anomalies, 26 cases (3.6%). Among the cases with DS with congenital heart defects, the most common cardiac anomaly was atrioventricular septal defect (30%) followed by atrial septum defect (25%), ventricular septal defect (22%), patent ductus arteriosus (5%), coarctation of aorta (5%), and tetralogy of Fallot (3%). Among the cases with DS with a digestive system anomaly recorded, duodenal atresia (67%), Hirschsprung disease (14%), and tracheo-esophageal atresia (10%) were the most common. Fourteen (2%) of the cases with DS had an obstructive anomaly of the renal pelvis, including hydronephrosis. The other most common anomalies associated with cases with DS were syndactyly, club foot, polydactyly, limb reduction, cataract, hydrocephaly, cleft palate, hypospadias and diaphragmatic hernia. Many studies to assess the anomalies associated with DS have reported various results. There is no agreement in the literature as to

  19. Associated congenital anomalies among cases with Down syndrome.

    Science.gov (United States)

    Stoll, Claude; Dott, Beatrice; Alembik, Yves; Roth, Marie-Paule

    2015-12-01

    Down syndrome (DS) is the most common congenital anomaly widely studied for at least 150 years. However, the type and the frequency of congenital anomalies associated with DS are still controversial. Despite prenatal diagnosis and elective termination of pregnancy for fetal anomalies, in Europe, from 2008 to 2012 the live birth prevalence of DS per 10,000 was 10. 2. The objectives of this study were to examine the major congenital anomalies occurring in infants and fetuses with Down syndrome. The material for this study came from 402,532 consecutive pregnancies of known outcome registered by our registry of congenital anomalies between 1979 and 2008. Four hundred sixty seven (64%) out of the 728 cases with DS registered had at least one major associated congenital anomaly. The most common associated anomalies were cardiac anomalies, 323 cases (44%), followed by digestive system anomalies, 42 cases (6%), musculoskeletal system anomalies, 35 cases (5%), urinary system anomalies, 28 cases (4%), respiratory system anomalies, 13 cases (2%), and other system anomalies, 26 cases (3.6%). Among the cases with DS with congenital heart defects, the most common cardiac anomaly was atrioventricular septal defect (30%) followed by atrial septum defect (25%), ventricular septal defect (22%), patent ductus arteriosus (5%), coarctation of aorta (5%), and tetralogy of Fallot (3%). Among the cases with DS with a digestive system anomaly recorded, duodenal atresia (67%), Hirschsprung disease (14%), and tracheo-esophageal atresia (10%) were the most common. Fourteen (2%) of the cases with DS had an obstructive anomaly of the renal pelvis, including hydronephrosis. The other most common anomalies associated with cases with DS were syndactyly, club foot, polydactyly, limb reduction, cataract, hydrocephaly, cleft palate, hypospadias and diaphragmatic hernia. Many studies to assess the anomalies associated with DS have reported various results. There is no agreement in the literature as to

  20. Surgical Management of Enterocutaneous Fistula

    International Nuclear Information System (INIS)

    Enterocutaneous (EC) fistula is an abnormal connection between the gastrointestinal (GI) tract and skin. The majority of EC fistulas result from surgery. About one third of fistulas close spontaneously with medical treatment and radiologic interventions. Surgical treatment should be reserved for use after sufficient time has passed from the previous laparotomy to allow lysis of the fibrous adhesion using full nutritional and medical treatment and until a complete understanding of the anatomy of the fistula has been achieved. The successful management of GI fistula requires a multi-disciplinary team approach including a gastroenterologist, interventional radiologist, enterostomal therapist, dietician, social worker and surgeons. With this coordinated approach, EC fistula can be controlled with acceptable morbidity and mortality.

  1. Tubercular fistula-in-ano

    International Nuclear Information System (INIS)

    To determine the frequency of tuberculosis in recurrent fistula-in-ano. The study included 100 cases of recurrent fistula-in-ano not responding to conventional surgery. Patients with other co-morbidities such as diabetes mellitus, bleeding disorders or with the evidence of pulmonary, abdominal or intestinal tuberculosis were excluded from this study. Fistulogram was performed in all patients. All the patients were subjected to fistulectomy followed by histopathology of the resected specimen. Thereafter, confirmation of the disease, anti-tuberculous treatment was immediately started and response to treatment was observed after 6 months. Out of the 100 studied patients, 11 cases had biopsy proven tuberculosis in the fistula. All the patients were male. The fistulae were low type, single and usually located posteriorly (n=9) with everted margins. Ten were located within 3 cm of anus. Fistulogram revealed single internal opening. Comparative statistics of tuberculous fistula-in-ano with fistulas due to specific inflammation revealed no major differences. The diagnosed patients of tubercular fistulae-in-ano were observed for at least 6 months after starting anti-tuberculous treatment. They all responded well to anti-tubercular treatment and the fistulae healed without any complication such as recurrence or anal stenosis within 6 months. Tuberculosis should be suspected in case of recurrent fistulae-in-ano, so as to avoid unusual delay in the treatment and miseries to the patient. Appropriate anti-tuberculous therapy leads to healing within 6 months. (author)

  2. Secondary aortoduodenal fistula

    Institute of Scientific and Technical Information of China (English)

    Girolamo Geraci; Franco Pisello; Francesco Li Volsi; Tiziana Facella; Lina Platia; Giuseppe Modica; Carmelo Sciumè

    2008-01-01

    Aorto-duodenal fistulae (ADF) are the most frequent aorto-enteric fistulae (80%), presenting with upper gastrointestinal bleeding. We report the first case of a man with a secondary aorto-duodenal fistula presenting with a history of persistent occlusive syndrome. A 59-year old man who underwent an aortic-bi-femoral bypass 5 years ago, presented with dyspepsia and biliary vomiting. Computed tomography scan showed in the third duodenal segment the presence of inflammatory tissue with air bubbles between the duodenum and prosthesis, adherent to the duodenum. The patient was submitted to surgery, during which the prosthesis was detached from the duodenum, the intestine failed to close and a gastro-jejunal anastomosis was performed. The post-operative course was simple, secondary ADF was a complication (0.3%-2%) of aortic surgery. Mechanical erosion of the prosthetic material into the bowel was due to the lack of interposed retroperitoneal tissue or the excessive pulsation of redundantly placed grafts or septic procedures. The third or fourth duodenal segment was most frequently involved. Diagnosis of ADF was difficult. Surgical treatment is always recommended by explorative laparotomy. ADF must be suspected whenever a patient with aortic prosthesis has digestive bleeding or unexplained obstructive syndrome. Rarely the clinical picture of ADF is subtle presenting as an obstructive syndrome and in these cases the principal goal is to effectively relieve the mechanical bowel obstruction.

  3. Modern management of anal fistula.

    Science.gov (United States)

    Limura, Elsa; Giordano, Pasquale

    2015-01-01

    Ideal surgical treatment for anal fistula should aim to eradicate sepsis and promote healing of the tract, whilst preserving the sphincters and the mechanism of continence. For the simple and most distal fistulae, conventional surgical options such as laying open of the fistula tract seem to be relatively safe and therefore, well accepted in clinical practise. However, for the more complex fistulae where a significant proportion of the anal sphincter is involved, great concern remains about damaging the sphincter and subsequent poor functional outcome, which is quite inevitable following conventional surgical treatment. For this reason, over the last two decades, many sphincter-preserving procedures for the treatment of anal fistula have been introduced with the common goal of minimising the injury to the anal sphincters and preserving optimal function. Among them, the ligation of intersphincteric fistula tract procedure appears to be safe and effective and may be routinely considered for complex anal fistula. Another technique, the anal fistula plug, derived from porcine small intestinal submucosa, is safe but modestly effective in long-term follow-up, with success rates varying from 24%-88%. The failure rate may be due to its extrusion from the fistula tract. To obviate that, a new designed plug (GORE BioA®) was introduced, but long term data regarding its efficacy are scant. Fibrin glue showed poor and variable healing rate (14%-74%). FiLaC and video-assisted anal fistula treatment procedures, respectively using laser and electrode energy, are expensive and yet to be thoroughly assessed in clinical practise. Recently, a therapy using autologous adipose-derived stem cells has been described. Their properties of regenerating tissues and suppressing inflammatory response must be better investigated on anal fistulae, and studies remain in progress. The aim of this present article is to review the pertinent literature, describing the advantages and limitations of

  4. Dutch survey of congenital coronary artery fistulas in adults: coronary artery-left ventricular multiple micro-fistulas multi-center observational survey in the Netherlands.

    NARCIS (Netherlands)

    Said, S.A.M.; Werf, T. van der

    2006-01-01

    BACKGROUND: Congenital coronary artery-left ventricular multiple micro-fistulas (CA-LVMMFs) in adults are rare anomalies. They may cause angina pectoris and myocardial infarction in association with normal coronary arteries. METHODS AND RESULTS: From the medical databases of a Dutch Survey of corona

  5. Surgery for Crohn's anal fistulas.

    Science.gov (United States)

    Sugita, A; Koganei, K; Harada, H; Yamazaki, Y; Fukushima, T; Shimada, H

    1995-11-01

    The aim of this study was to analyze the features of Crohn's anal fistulas and to evaluate the efficacy of seton treatment. In 119 patients with Crohn's disease, the incidence of anal fistula was 56% (67/119), with no significant difference in the incidence among patients with ileitis, colitis, and ileocolitis. "Intractable" anal fistulas were found in 17% of patients with ileitis, compared to 64% of those with colitis (P = 0.051) and 68% of those with ileocolitis (P = 0.014). Seton treatment, i.e., non-cutting, long-term seton drainage, was performed for 21 patients (5 with intersphincteric, and 16 with transsphincteric fistulas). In the 16-month follow up, 9 patients required redrainage for recurrent fistulous abscess, mainly because of progressive colorectal disease. Finally, a good result was obtained in 17 of the 21 patients (81%) and no recurrent fistulous abscess developed in the 8 patients in whom all setons were removed. Anal continence was preserved in all the patients. These results indicate that anal fistulas with Crohn's ileitis were cured more easily than those with colitis or ileocolitis, and that seton treatment was effective for intersphincteric fistula with multiple fistula openings and for transphincteric fistulas in patients exhibiting remission of intestinal Crohn's disease. PMID:8563879

  6. Renopleural fistula after percutaneous nephrolithotomy.

    Science.gov (United States)

    Palou Redorta, J; Banús Gassol, J M; Prera Vilaseca, A; Ramón Dalmau, M; Morote Robles, J; Ahmad Wahad, A

    1988-01-01

    We present here a 42-year-old female who developed a renopleural fistula after a percutaneous nephrolithotomy through the 11th intercostal space of a calculus of the upper calyces of the right kidney. The fistula was resolved with a chest tube and a double-J ureteral catheter. PMID:3388633

  7. Congenital bronchoesophageal fistula in adults

    Institute of Scientific and Technical Information of China (English)

    Bao-Shi Zhang; Nai-Kang Zhou; Chang-Hai Yu

    2011-01-01

    AIM: To study the clinical characteristics, diagnosis and surgical treatment of congenital bronchoesophageal fistulae in adults. METHODS: Eleven adult cases of congenital bronchoesophageal fistula diagnosed and treated in our hospital between May 1990 and August 2010 were reviewed. Its clinical presentations, diagnostic methods, anatomic type, treatment, and follow-up were recorded. RESULTS: Of the chief clinical presentations, nonspecific cough and sputum were found in 10 (90.9%), recurrent bouts of cough after drinking liquid food in 6 (54.6%), hemoptysis in 6 (54.6%), low fever in 4 (36.4%), and chest pain in 3 (27.3%) of the 11 cases, respectively. The duration of symptoms before diagnosis ranged 5-36.5 years. The diagnosis of congenital bronchoesophageal fistulae was established in 9 patients by barium esophagography, in 1 patient by esophagoscopy and in 1 patient by bronchoscopy, respectively. The congenital bronchoesophageal fistulae communicated with a segmental bronchus, a main bronchus, and an intermediate bronchus in 8, 2 and 1 patients, respectively. The treatment of congenital bronchoesophageal fistulae involved excision of the fistula in 10 patients or division and suturing in 1 patient. The associated lung lesion was removed in all patients. No long-term sequelae were found during the postoperative follow-up except in 1 patient with bronchial fistula who accepted reoperation before recovery. CONCLUSION: Congenital bronchoesophageal fistula is rare in adults. Its most useful diagnostic method is esophagography. It must be treated surgically as soon as the diagnosis is established.

  8. Fistula gastrocólica Gastrocolic fistula

    Directory of Open Access Journals (Sweden)

    Alexandre Cruz Henriques

    1999-08-01

    Full Text Available A case of gastrocolic fistula(GCF in a patient with duodenal stenosis who had previously undergone gastroenteric anastomosis is reported. The patient went through hemigastrectomy, partial colectomy and segmental enterectomy with bloc resection. Reconstruction was carried out through Billroth II gastrojejunostomy, jejunojejunostomy and end-to-end anastomosis of the colon. The patient had good post-operative evolution and was discharged from hospital seven days after surgery. GCF should be suspected in patients presenting weight loss, diarrhea and fecal vomiting, mainly with history of peptic ulcer surgery, gastric or colonic malignancy and use of steroidal and nonsteroidal antiinflamatory drugs. Barium enema is the choice test for diagnosis, however, the benign or malignant nature of the lesion should always be evaluated through high digestive endoscopy. Clinical treatment with oral H2-antagonists and discontinuing ulcerogenic medications might be indicated in some cases; surgical treatment is indicated in cases of malignant disease and might be indicated in cases of peptic disease as it treats GCF and also the baseline disease. Some advise upwards colostomy at first. The most used technique is bloc resection, including the fistulous tract, hemigastrectomy and partial colectomy. Gastrectomy, fistulous tract excision and colon suturing may be performed in some cases. The mortality rate is related to metabolic disorders and the recurrence with the use of antiinflammatory drugs.

  9. MRI in evaluation of perianal fistulae:

    OpenAIRE

    Sofic, Amela; Beslic, Serif; Sehovic, Nedzad; Caluk, Jasmin; Sofic, Damir

    2010-01-01

    Background Fistula is considered to be any abnormal passage which connects two epithelial surfaces. Parks’ fistulae classification demonstrates the biggest practical significance and divides fistulae into: intersphincteric, transsphincteric, suprasphincteric and extrasphincteric. Etiology of perianal fistulae is most commonly linked with the inflammation of anal glands in Crohn’s disease, tuberculosis, pelvic infections, pelvic malignant tumours, and with the radiotherapy. Diagnostic method o...

  10. Idiopathic fistula-in-ano

    Institute of Scientific and Technical Information of China (English)

    Sherief Shawki; Steven D Wexner

    2011-01-01

    Fistula-in-ano is the most common form of perineal sep- sis. Typically, a fistula includes an internal opening, a track, and an external opening. The external opening might acutely appear following infection and/or an abs-cess, or more insiduously in a chronic manner. Mana-gement includes control of infection, assessment of the fistulous track in relation to the anal sphincter muscle, and finally, definitive treatment of the fistula. Fistulo-tomy was the most commonly used mode of manage-ment, but concerns about post-fistulotomy incontinence prompted the use of sphincter preserving techniques such as advancement flaps, fibrin glue, collagen fistula plug, ligation of the intersphincteric fistula track, and stem cells. Many descriptive and comparative studies have evaluated these different techniques with variable outcomes. The lack of consistent results, level I eviden-ce, or long-term follow-up, as well as the heterogeneity of fistula pathology has prevented a definitive treatment algorithm. This article will review the most commonly available modalities and techniques for managing idio-pathic fistula-in-ano.

  11. Sonographic Diagnosis of Arterioportal Fistula

    Directory of Open Access Journals (Sweden)

    Canan Alkim

    2010-01-01

    Full Text Available Aim. We aimed to identify and describe characteristic and diagnostic ultrasonographic features of arterioportal fistula cases. Patients. In this case series we describe 3 patients with arterioportal fistula. By depending on shared sonographic features of these patients we describe a “sonographic pattern” for the sonographic diagnosis of arterioportal fistula. Conclusion. In summary; both of the artery and vein related with fistula were wider than normal and seen as adjacent anechoic circles, there was an aneurismatic dilation on vein which has turbulent flow within it, the communication between the artery and aneurism can be seen sonographically, both of the vessels have arterial flow, filling of the vein was retrograde and other branches of the artery and vein unrelated with aneurism were all normal in dimension.

  12. Operative considerations for rectovaginal fistulas

    Institute of Scientific and Technical Information of China (English)

    Kevin; R; Kniery; Eric; K; Johnson; Scott; R; Steele

    2015-01-01

    To describe the etiology, anatomy and pathophysiology of rectovaginal fistulas(RVFs); and to describe a systematic surgical approach to help achieve optimal outcomes. A current review of the literature was performed to identify the most up-to-date techniques and outcomes for repair of RVFs. RVFs present a difficult problem that is frustrating for patients and surgeons alike. Multiple trips to the operating room are generally needed to resolve the fistula, and the recurrence rate approaches40% when considering all of the surgical options. At present, surgical options range from collagen plugs and endorectal advancement flaps to sphincter repairs or resection with colo-anal reconstruction. There are general principles that will allow the best chance for resolution of the fistula with the least morbidity to the patient. These principles include: resolving the sepsis, identifying the anatomy, starting with least invasive surgical options, and interposing healthy tissue for complex or recurrent fistulas.

  13. Pancreaticopleural Fistula: Revisited

    Directory of Open Access Journals (Sweden)

    Norman Oneil Machado

    2012-01-01

    Full Text Available Pancreaticopleural fistula is a rare complication of acute and chronic pancreatitis. This usually presents with chest symptoms due to pleural effusion, pleural pseudocyst, or mediastinal pseudocyst. Diagnosis requires a high index of clinical suspicion in patients who develop alcohol-induced pancreatitis and present with pleural effusion which is recurrent or persistent. Analysis of pleural fluid for raised amylase will confirm the diagnosis and investigations like CT. Endoscopic retrograde cholangiopancreaticography (ECRP or magnetic resonance cholangiopancreaticography (MRCP may establish the fistulous communication between the pancreas and pleural cavity. The optimal treatment strategy has traditionally been medical management with exocrine suppression with octreotide and ERCP stenting of the fistulous pancreatic duct. Operative therapy considered in the event patient fails to respond to conservative management. There is, however, a lack of clarity regarding the management, and the literature is reviewed here to assess the present view on its pathogenesis, investigations, and management.

  14. Correlation of intraluminal esophageal pressure with the dynamic extension of tracheoesophageal voice in total laryngectomees

    Directory of Open Access Journals (Sweden)

    Nathália Reis

    2013-05-01

    Full Text Available PURPOSE: To evaluate and correlate the amplitude of esophageal contractions triggered by swallowing water with dynamic extension and habitual, strong and weak sound intensity in total laryngectomees wearing a tracheoesophageal prosthesis. METHODS: Thirty total laryngectomees using tracheoesophageal voice with a phonatory prosthesis were evaluated by measuring the amplitude of contractions in the proximal, middle and distal esophagus and the pressure of the pharyngoesophageal transition by manometry. In order to measure vocal intensity the subject was asked to emit phonation of the vowel /a/ at habitual, strong and weak intensity which was captured with a sound pressure meter. Dynamic extension was calculated by subtracting strong intensity from weak intensity. RESULTS: A positive correlation was observed between contraction amplitude and dynamic extension in the proximal (rho: 0.45; p=0.01 and distal (rho: 0.41; p=0.02 esophagus There was no correlation with other parameters.. Total laryngectomees wearing a phonatory prosthesis with a dynamic extension above 21 dBNPS had greater contraction amplitude than laryngectomees with a dynamic extension below this value. CONCLUSIONS: There was a positive correlation between pressure amplitude in the proximal and distal esophagus and increased dynamic extension. The individuals with normal dynamic extension had greater contraction amplitude in the proximal esophagus than individuals with dynamic extension lower than the expected values for age.

  15. Doppler findings in a rare Coronary Artery Fistula

    Directory of Open Access Journals (Sweden)

    Jorns Carl

    2007-03-01

    Full Text Available Abstract One of the primary forms of congenital anomalies of the coronary arteries is coronary artery fistula (CAF. It is defined as a direct communication between the coronary artery and any surrounding cardiac chamber or vascular structure, which bypasses the myocardial capillary bed. We present a newborn baby with a large coronary artery fistula connecting the left anterior descending (LAD artery to the left ventricular (LV apex. Associated cardiac abnormalities were found: a ventricular septal defect (diameter 4 mm, a patent foramen ovale as well as trivial tricuspid and mitral regurgitation. Here we demonstrate the echocardiograms of an extremely rare form of CAF diagnosed within the first days of postnatal life.

  16. Optimizing management of pancreaticopleural fistulas

    Institute of Scientific and Technical Information of China (English)

    Marek Wronski; Maciej Slodkowski; Wlodzimierz Cebulski; Daniel Moronczyk; Ireneusz W Krasnodebski

    2011-01-01

    AIM: To evaluate the management of pancreaticopleu ral fistulas involving early endoscopic instrumentation of the pancreatic duct.METHODS: Eight patients with a spontaneous pancre aticopleural fistula underwent endoscopic retrograde cholangiopancreatography (ERCP) with an intention to stent the site of a ductal disruption as the primary treatment. Imaging features and management were evaluated retrospectively and compared with outcome.RESULTS: In one case, the stent bridged the site of a ductal disruption. The fistula in this patient closed within 3 wk. The main pancreatic duct in this case appeared normal, except for a leak located in the body of the pancreas. In another patient, the papilla of Vater could not be found and cannulation of the pancreatic duct failed. This patient underwent surgical treatment. In the remaining 6 cases, it was impossible to insert a stent into the main pancreatic duct properly so as to cover the site of leakage or traverse a stenosis situated down stream to the fistula. The placement of the stent failedbecause intraductal stones (n = 2) and ductal strictures (n = 2) precluded its passage or the stent was too short to reach the fistula located in the distal part of the pan creas (n = 2). In 3 out of these 6 patients, the pancre aticopleural fistula closed on further medical treatment. In these cases, the main pancreatic duct was normal or only mildly dilated, and there was a leakage at the body/tail of the pancreas. In one of these 3 patients, additional percutaneous drainage of the peripancreatic fluid collections allowed better control of the leakage and facilitated resolution of the fistula. The remaining 3 patients had a tight stenosis of the main pancreatic duct resistible to dilatation and the stent could not be inserted across the stenosis. Subsequent conservative treatment proved unsuccessful in these patients. After a failed therapeutic ERCP, 3 patients in our series devel oped super infection of the pleural or peripancreatic

  17. Nonsurgical Management of Pancreaticopleural Fistula

    Directory of Open Access Journals (Sweden)

    Ferran N

    2005-03-01

    Full Text Available CONTEXT: Pancreaticopleural fistula is seen in acute and chronic pancreatitis or after traumatic or surgical disruption of the pancreatic duct. Surgery leads to healing in 80-90% of cases but carries a mortality of up to 10%. AIM: Our aim was to assess the management of pancreaticopleural fistula on a specialist pancreatic Unit. METHODS: Patients presenting with pancreaticopleural fistulae were identified from acute and chronic pancreatitis databases. Management and outcome were compared with previous studies identified in MEDLINE and EMBASE. RESULTS: Four patients presented with dyspnoea from large unilateral pleural effusions. Three had a history of alcohol abuse and one of asymptomatic gallstones. All were treated with chest drainage, octreotide and endoscopic retrograde cholangiopancreatography plus/minus pancreatic stent. Two had a pancreatic stent in situ for 5 and 8.5 months respectively. In the third sphincterotomy was performed; in the fourth the pancreatic duct could not be cannulated. The fistula healed in all cases, with no recurrence after 12-30 months, and no deaths. There are 14 reports including 16 cases treated with endoscopic retrograde cholangiopancreatography plus/minus pancreatic stent in the literature, with no recurrence after follow up ranging 4-30 months and no deaths in these 16 cases. CONCLUSIONS: A high index of suspicion is necessary to be aware of its presence. These data suggest that endoscopic management is preferable alternative to surgery for pancreaticopleural fistula.

  18. Arteriovenous fistula and pseudoaneurysm as complications of renal biopsy treated with percutaneous intervention

    Institute of Scientific and Technical Information of China (English)

    JIANG Wen-xia; WANG Hui-fang; MA Jun; HAN Hong-jie

    2010-01-01

    @@ Symptomatic arteriovenous fistula (AVF) with pseudoaneurysm after percutaneous renal biopsy is an uncommon anomaly, occurring from 0.34% to 6.3%.1Most of these vascular lesions are of little clinical importance. However, severe bleeding,2 persistent hematuria, or acute urinary retention may occur, requiring treatment. Here we report a case of gross hematuria and acute urinary retention after renal biopsy in a male patient.An arteriovenous fistula with pseudoaneurysm was detected by renal ultrasound, confirmed by angiography and then successfully treated by transcatheter arterial embolization3 without damage to renal parenchyma.

  19. Gastrocolic Fistula: A Shortcut through the Gut

    Directory of Open Access Journals (Sweden)

    Nauzer Forbes

    2016-01-01

    Full Text Available Gastrocolic fistulas are observed in association with several conditions. Traditionally, peptic ulcer disease was commonly implicated in the formation of gastrocolic fistulas; however, this is now a rare etiology. Here, we present a case of gastrocolic fistula secondary to peptic ulcer disease alone, in addition to reviewing the literature and providing options for diagnosis and treatment.

  20. A simple novel technique for enteroatmospheric fistulae: silicone fistula plug.

    Science.gov (United States)

    Ozer, M Tahir; Sinan, Hüseyin; Zeybek, Nazif; Peker, Yusuf

    2014-06-01

    Enteroatmospheric fistulae (EAFs), a rare condition that develops in patients treated with an open abdomen, present serious problems for the surgeon. There are no fixed algorithms for treatment of EAF, and treatment options are determined based on the experience of the surgeon and status of the patient. We developed a 'suspended silicone fistula plug' for treating a patient who developed an EAF after undergoing multiple operations in a short period of time. Used in conjunction with negative pressure wound therapy, application of this novel therapy resulted in EAF closure and patient discharge.

  1. Posterior cranial fossa arteriovenous fistula with presenting as caroticocavernous fistula

    Energy Technology Data Exchange (ETDEWEB)

    Liu, H.M.; Shih, H.C.; Huang, Y.C.; Wang, Y.H. [Dept. of Medical Imaging, National Taiwan University Hospital, Taipei (Taiwan)

    2001-05-01

    We report cases of posterior cranial fossa arteriovenous fistula (AVF) with presenting with exophthalmos, chemosis and tinnitus in 26- and 66-year-old men. The final diagnoses was vertebral artery AVF and AVF of the marginal sinus, respectively. The dominant venous drainage was the cause of the unusual presentation: both drained from the jugular bulb or marginal sinus, via the inferior petrosal and cavernous sinuses and superior ophthalmic vein. We used endovascular techniques, with coils and liquid adhesives to occlude the fistulae, with resolution of the symptoms and signs. (orig.)

  2. Trans-Fistula Anorectoplasty (TFARP: Our Experience in the Management of Anorectovestibular Fistula in Neonates

    Directory of Open Access Journals (Sweden)

    Ashrarur Rahman Mitul

    2012-07-01

    Full Text Available Aim: The purpose of the study was to observe the outcome of trans-fistula anorectoplasty (TFARP in treating female neonates with anorectovestibular fistula (ARVF. Methods: A prospective study was carried out on female neonates with vestibular fistula, admitted into the surgical department of a tertiary level children hospital during the period from January 2009 to June 2011. TFARP without a covering colostomy was performed for definitive correction in the neonatal period in all. Data regarding demographics, clinical presentation, associated anomalies, preoperative findings, preoperative preparations, operative technique, difficulties faced during surgery, duration of surgery, postoperative course including complications, hospital stay, bowel habits and continence was prospectively compiled and analyzed. Anorectal function was measured by the modified Wingspread scoring as, “excellent”, “good”, “fair” and “poor”. Results: Thirty-nine neonates with vestibular fistula underwent single stage TFARP. Mean operation time was 81 minutes and mean hospital stay was 6 days. Three (7.7% patients suffered vaginal tear during separation from the rectal wall. Two patients (5.1% developed wound infection at neoanal site that resulted in anal stenosis. Eight (20.51% children in the series are more than 3 years of age and are continent; all have attained “excellent” fecal continence score. None had constipation or soiling. Other 31 (79.5% children less than 3 years of age have satisfactory anocutaneous reflex and anal grip on per rectal digital examination, though occasional soiling was observed in 4 patients. Conclusion: Primary repair of ARVF in female neonates by TFARP without dividing the perineum is a feasible procedure with good cosmetic appearance and good anal continence. Separation of the rectum from the posterior wall of vagina is the most delicate step of the operation, takes place under direct vision. It is very important to keep

  3. COMPLETE BRANCHIAL FISTULAS MANAGED BY COMBINED ‘TRANSCERVICAL’, ‘TRANSORAL’ APPROACH IN A MEDICAL COLLEGE HOSPITAL.

    Directory of Open Access Journals (Sweden)

    Ravishankar B

    2015-04-01

    Full Text Available Background/ objectives: Branchial arch anomalies form 20% of the congenital head and neck lesions and differ in their management depending on the arch involved. As all these anomalies are managed surgically accurate surgical anatomy is essential as it should be tailored to the lesion involved like it being a cyst, sinus or a fistula. Materials and methods: 11 cases of complete branchial fistula were excised by the combined approach. 6 were females and 5 males, with average age group of 9.09 years and 3 were left sided and 8 right sided. Classical transcervical approach with double incisions at the fistula and hyoid and transoral avulsion of fistula with tonsillectomy done under general anaesthesia in all cases. Results:The average length of the fistula was 7.27 cms. The patients were followed up monthly for six months and later 6 monthly for 2 years. No recurrence were seen on 6-94 months of follow-up with an average follow-up of 43 months. Conclusion:Combined transcervical transoral approach is the conventional procedure of choice for complete branchial fistulas. This approach with no recurrence rates can be made scarless with meticulous tensionless dermal suturing and best skin approximation.

  4. Diagnosis and Surgical Management of Uroenteric Fistula.

    Science.gov (United States)

    Gill, Harcharan S

    2016-06-01

    Uroenteric fistulae can occur between any part of the urinary tract and the small and large bowel. Classification is generally based on the organ of origin in the urinary tract and the termination of the fistula in the segment of the gastrointestinal tract. Surgery is often necessary. Congenital fistulae are rare, with most being acquired. Uroenteric fistulae most frequently occur in a setting of inflammatory bowel disease. Imaging often helps in the diagnosis. Management of urinary fistulae includes adequate nutrition, diversion of the urinary tract, diversion of the gastrointestinal tract, treatment of underling inflammatory process or malignancy, and surgery. PMID:27261796

  5. Enigma of primary aortoduodenal fistula

    Institute of Scientific and Technical Information of China (English)

    Miklosh Bala; Jacob Sosna; Liat Appelbaum; Eran Israeli; Avraham I Rivkind

    2009-01-01

    A diagnosis of primary aortoenteric fistula is difficult to make despite a high level of clinical suspicion. It should be considered in any elderly patient who presents with upper gastrointestinal bleeding in the context of a known abdominal aortic aneurysm. We present the case of young man with no history of abdominal aortic aneurysm who presented with massive upper gastrointestinal bleeding. Initial misdiagnosis led to a delay in treatment and the patient succumbing to the illness. This case is unique in that the fistula formed as a result of complex atherosclerotic disease of the abdominal aorta, and not from an aneurysm.

  6. MRI of congenital urethroperineal fistula

    Energy Technology Data Exchange (ETDEWEB)

    Ghadimi-Mahani, Maryam; Dillman, Jonathan R.; Pai, Deepa; DiPietro, Michael [C. S. Mott Children' s Hospital, Department of Radiology, Section of Pediatric Radiology, University of Michigan Health System, Ann Arbor, MI (United States); Park, John [C. S. Mott Children' s Hospital, Department of Pediatric Urology, University of Michigan Health System, Ann Arbor, MI (United States)

    2010-12-15

    We present the MRI features of a congenital urethroperineal fistula diagnosed in a 12-year-old boy being evaluated after a single urinary tract infection. This diagnosis was initially suggested by voiding cystourethrogram and confirmed by MRI. Imaging revealed an abnormal fluid-filled tract arising from the posterior urethra and tracking to the perineal skin surface that increased in size during micturition. Surgical resection and histopathological evaluation of the abnormal tract confirmed the diagnosis of congenital urethroperineal fistula. MRI played important roles in confirming the diagnosis and assisting surgical planning. (orig.)

  7. Branchial cleft anomalies: a pictorial review of embryological development and spectrum of imaging findings

    OpenAIRE

    Adams, Ashok; Mankad, Kshitij; Offiah, Curtis; Childs, Lucy

    2015-01-01

    Abstract The branchial arches are the embryological precursors of the face, neck and pharynx. Anomalies of the branchial arches are the second most common congenital lesions of the head and neck in children, with second branchial arch anomalies by far the most common. Clinically, these congenital anomalies may present as cysts, sinus tracts, fistulae or cartilaginous remnants with typical clinical and radiological findings. We review the normal embryological development of the branchial arche...

  8. Gastropulmonary Fistula after Bariatric Surgery

    Directory of Open Access Journals (Sweden)

    Maya Doumit

    2009-01-01

    Full Text Available The Roux-en-Y gastric bypass is one of the most common operations for morbid obesity. Although rare, gastropulmonary fistulas are an important complication of this procedure. There is only one recently reported case of this complication. The present report describes the serious nature of this complication in a patient after an uneventful laparoscopic gastric bypass surgery.

  9. Vesicouterine fistula and blind vagina

    International Nuclear Information System (INIS)

    A case of vesicouterine fistula with blind vagina following cesarean section for obstructed labor is presented. It was surgically treated by fistulectomy, cervicoplasty and maintenance of bladder and cervical potency by catheterization. Intrauterine synechiae formation was prevented by copper T insertion and oral contraceptive pills. The patient is making uneventful a symptomatic progress planning to conceive. (author)

  10. Management of Postpneumonectomy Bronchopleural Fistulae

    Directory of Open Access Journals (Sweden)

    Kemal Karapinar

    2016-04-01

    Full Text Available Aim: Postpneumonectomy bronchopleural fistula (PPBPF is a hard-to-treat complication that may develop after pneumonectomy. It follows a persistent course. Although there is no commonly adopted method, closure of the fistula with flaps is the general principle. The use of the omental flap may provide higher success rates in the treatment. Material and Method: PPBPF developed in 12 out of 162 pneumonectomies performed at the department of thoracic surgery between 2011 and 2014. The demographic characteristics, fistula management strategies, morbidity, and mortalities were retrospectively studied by analysis of operative reports and a digital database. Results: The rate of PPBPF was 7.4%. The bronchopleural fistulae could be closed by various treatments in 10 patients; omentopexy constituted the basis of treatment in 8 of them. In the other patients with successful results, resuturing with staplers and vacuum assisted closure were performed during the early period. One of the patients who failed treatment died due to ARDS; therefore, it was not possible to apply all the treatment alternatives. In the other patient, despite the use of all treatment alternatives (eloesser flap, tracheal stent, omentopexy, thoracomyoplasty, vacuum assisted closure, the treatment failed. Discussion: PPBPF is one of the most significant causes of morbidity and mortality in thoracic surgery units. Because its treatment may be long, a good plan and its execution by experienced units are necessary. The omental flap is increasingly popular due to good perfusion. We believe that omentopexy and j type tracheal stent performed by experienced teams will provide successful results in fistula treatment.

  11. Vitellointestinal Duct Anomalies in Infancy

    Science.gov (United States)

    Kadian, Yogender Singh; Verma, Anjali; Rattan, Kamal Nain; Kajal, Pardeep

    2016-01-01

    Background: Vitellointestinal duct (VID) or omphalomesenteric duct anomalies are secondary to the persistence of the embryonic vitelline duct, which normally obliterates by weeks 5–9 of intrauterine life. Methods: This is a retrospective analysis of a total of 16 patients of symptomatic remnants of vitellointestinal duct from period of Jan 2009 to May 2013. Results: Male to female ratio (M:F) was 4.3:1 and mean age of presentation was 2 months and their mode of presentation was: patent VID in 9 (56.25%) patients, umbilical cyst in 2(12.25%), umbilical granuloma in 2 (12.25%), and Meckel diverticulum as content of hernia sac in obstructed umbilical hernia in 1 (6.25%) patient. Two patients with umbilical fistula had severe electrolyte disturbance and died without surgical intervention. Conclusion: Persistent VID may have varied presentations in infancy. High output umbilical fistula and excessive bowel prolapse demand urgent surgical intervention to avoid morbidity and mortality. PMID:27433448

  12. Identifying, characterizing, and classifying congenital anomalies of the coronary arteries.

    Science.gov (United States)

    Shriki, Jabi E; Shinbane, Jerold S; Rashid, Mollie A; Hindoyan, Antereas; Withey, James G; DeFrance, Anthony; Cunningham, Mark; Oliveira, George R; Warren, Bill H; Wilcox, Alison

    2012-01-01

    The clinical manifestations of coronary artery anomalies vary in severity, with some anomalies causing severe symptoms and cardiovascular sequelae and others being benign. Cardiovascular computed tomography (CT) has emerged as the standard of reference for identification and characterization of coronary artery anomalies. Therefore, it is important for the reader of cardiovascular CT images to be thoroughly familiar with the spectrum of coronary artery anomalies. Hemodynamically significant anomalies include atresia, origin from the pulmonary artery, interarterial course, and congenital fistula. Non-hemodynamically significant anomalies include duplication; high origin; a prepulmonic, transseptal, or retroaortic course; shepherd's crook right coronary artery; and systemic termination. In general, coronary arteries with an interarterial course are associated with an increased risk of sudden cardiac death. Coronary artery anomalies that result in shunting, including congenital fistula and origin from the pulmonary artery, are also commonly symptomatic and may cause steal of blood from the myocardium. Radiologists should be familiar with each specific variant and its specific constellation of potential implications. PMID:22411942

  13. [Pediatric case of congenital coronary artery fistula; surgical result and late changes in coronary artery aneurysm].

    Science.gov (United States)

    Sugawara, Masaaki; Oguma, Fumiaki; Hirahara, Hiroyuki

    2014-07-01

    Congenital coronary artery fistula is an uncommon heart anomaly involving the coronary arteries. We report here a case of a 4-year-old boy who had a coronary fistula from the right coronary artery to the right ventricle, with a coronary aneurysm. He was asymptomatic, but the calculated ratio of pulmonary blood flow to systemic blood flow was shown to be high [pulmonary flow (Qp)/systemic flow(Qs)=1.78]. The coronary angiography showed that the right coronary artery was dilated beginning at the ostium and had an aneurysm at the acute marginal portion. A large spherical aneurysm approximately 20 mm in diameter was found to have been connected with coronary fistula opening into the right ventricle. Surgical repair by closure of the fistula under direct vision, partial resection and suture closure of the aneurysm was performed. Plication of the proximal portion of the right coronary artery was not performed, and the diffusely dilated artery was left untouched. After this operation, he recovered well under anticoagulant treatment with warfarin and aspirin. Postoperative angiography was performed 17 months after the surgery to evaluate morphological changes in the coronary artery. The angiography confirmed the closure of the fistula and the regression of coronary artery dilatation.

  14. Our experience with Russian voice prostheses long used in patents after laryngectomy with tracheoesophageal shunting and endoprosthesis replacement

    Directory of Open Access Journals (Sweden)

    L. G. Kozhanov

    2015-01-01

    Full Text Available Despite broad current diagnostic capabilities, most (60–70 % patients with larynx cancer seek medical advice only when they have stages III and IV. Until the present time, laryngectomy has remained the most common treatment option for cancer of the larynx and laryngopharynx. Tracheoesophageal shunting with endoprosthesis replacement is one of the most important surgical vocal rehabilitation techniques after laryngectomy. According to different authors» data, the mean lifetime of voice prostheses is 6–12 months. The long-term use of voice prostheses in patients after laryngectomy with tracheoesophageal shunting with endoprosthesis replacement was the object of our investigation.Patient G., aged 34 years was admitted to the Department of Head and Neck Tumors, Oncology Clinical Dispensary (OCD One, Moscow Healthcare Department, with a diagnosis of larynx cancer spreading to lymph nodes (LN (T3N1M0 in the left neck on September 16, 2010. Surgery involving laryngectomy with tracheoesophageal shunting and implantation of a Russian voice prosthesis, as well as radical fascial excision of LN and fat in the neck on the left side were performed on September 21, 2010. During the 4-year use of the voice prosthesis, his voice was sonorous and good. The voice prosthesis was removed in November 2014. Antifungal therapy was used; a new voice prosthesis was implanted. His speech was fluent and his voice was sonorous and good.Patient M., aged 54 years was admitted to the Department of Head and Neck Tumors, OCD One, Moscow Healthcare Department, with a clinical diagnosis of laryngopharynx cancer (T4N1M0 and an aftereffect of gamma-therapy with a summary focal dose of 42 Gy on November 18, 2003. Surgery involving laryngectomy with laryngopharyngeal resection, tracheoesophageal shunting, and endoprosthesis replacement with implantation of a Russian voice prosthesis, as well as radical fascial excision of LN and fat in the neck on the right side were performed

  15. A life-threatening association of coronary anomalies

    Directory of Open Access Journals (Sweden)

    Devasia T

    2016-10-01

    Full Text Available Anomalous origin of the left coronary artery from the right sinus of Valsalva, even though rare, has been documented well in literature. However the association of this anomaly with coronary fistulae has been rarely reported so far. We report the case of a 76-year-old female who presented to us with exertional dyspnoea. General physical and cardiovascular examination revealed no significant abnormalities. All laboratory investigations were normal. Chest radiograph was normal. Electrocardiogram showed left bundle branch block. Echocardiogram revealed a globally hypokinetic left ventricle with reduced ejection fraction. Coronary angiogram showed anomalous origin of left coronary artery from right coronary sinus along with a small coronary-cameral fistula connecting obtuse marginal artery to left ventricle, there was no significant stenosis of epicardial coronaries. This case report, documents the rare association of an anomalous coronary origin of left coronary artery with coronary fistula.

  16. Fistula-in-ano. A manometric study.

    Science.gov (United States)

    Belliveau, P; Thomson, J P; Parks, A G

    1983-03-01

    The functional outcome of fistula surgery can be quantitated by anal manometry. A closed, water-filled microballoon (0.5 X 1.0 cm) system was used to measure resting anal pressure and maximal squeeze pressure in 47 patients with anal fistulas at St. Mark's Hospital. After treatment of intersphincteric fistulas, there was a significant reduction in resting pressure in the distal 2 cm. In treated transphincteric fistulas and suprasphincteric fistulas, anal pressure was reduced in the distal 3 cm. A significant lower pressure was measured in patients having the external sphincter divided, compared with those having the muscle preserved. Disturbance of continence was related to abnormally low resting pressure in six patients. This study supports attempts at sphincter preservation in fistula surgery. PMID:6825520

  17. Management of Complex Perineal Fistula Disease.

    Science.gov (United States)

    Akiba, Ricardo Tadayoshi; Rodrigues, Fabio Gontijo; da Silva, Giovanna

    2016-06-01

    Management of complex perineal fistulas such as high perianal, rectovaginal, pouch-vaginal, rectourethral, or pouch-urethral fistulas requires a systematic approach. The first step is to control any sepsis with drainage of abscess and/or seton placement. Patients with large, recurrent, irradiated fistulas benefit from stoma diversion. In patients with Crohn's disease, it is essential to induce remission prior to any repair. There are different approaches to repair complex fistulas, from local repairs to transperineal and transabdominal approaches. Simpler fistulas are amenable to local repair. More complex fistulas, such as those secondary to irradiation, require interposition of healthy, well-vascularized tissue. The most common flap used for this treatment is the gracilis muscle with good outcomes reported. Once healing is confirmed by imaging and endoscopy, the stoma is reversed. PMID:27247533

  18. Lacrimal gland fistula after upper eyelid blepharoplasty

    Directory of Open Access Journals (Sweden)

    Mohsen Bahmani Kashkouli

    2011-01-01

    Full Text Available To report the first case of lacrimal gland fistula after upper eyelid blepharoplasty for blepharochalasis. Standard upper blepharoplasty and the hooding excision were performed in a female with blepharochalasis. The patient developed a fistulous tract with tearing from the incision few days after hooding excision. Fistula excision and lacrimal gland repositioning were performed. There were no complications after the repositioning procedure (6 months follow up. Prolapsed lacrimal gland and fistula formation can occur after upper blepharoplasty hooding excision.

  19. Spontaneous enterocutaneous fistula due to femoral hernia

    OpenAIRE

    Kumar, Awanish; Pahwa, Harvinder Singh; Pandey, Anand; Kumar, Suresh

    2012-01-01

    Spontaneous enterocutaneous fistula is a rare entity. We encountered a case of spontaneous enterocutaneous fistula in the groin region due to femoral hernia. A 60-year-old man presented with spontaneous enterocutaneous fistula in the left groin region without signs of peritonitis. He was kept on conservative treatment, but on third postadmission day, he developed a swelling in his right groin, which became firm and irreducible with signs of intestinal obstruction. On exploratory laparotomy, b...

  20. ANTIMICROBIAL ACTIVITY OF CASSIA FISTULA LINN. LEGUMES

    OpenAIRE

    Chauhan Neelam; Bairwa Ranjan; Sharma Komal; Chauhan Nootan

    2011-01-01

    Cassia fistula Linn. (Leguminoseae), commonly known as the Golden Shower, Indian Laburnum. Cassia fistula trees as leguminous plants are popularly grown in Thailand. It is native to India, the Amazon and Sri Lanka and diffused in various countries including Mexico, China, Mauritius, South Africa, East Africa, and West Indies. The antibacterial activities of the petroleum ether, chloroform, ethyle acetate, methanolic and 50% (v/v) hydro alcoholic successive extracts of Cassia fistula (L) fruit...

  1. Tracheal agenesis with broncho-esophageal fistula in VACTERL / TACRD association

    OpenAIRE

    Mandrekar, Suresh R. S.; Sangeeta Amoncar; R. G. W. Pinto

    2013-01-01

    Tracheal agenesis (TA) is an extremely rare malformation. We report here autopsy findings in a case of TA with bronchoesophageal fistula of Floyd type III. The other malformations present included laryngeal atresia, Right lung hypolobulation, ventricular septal defect in membranous portion, bilateral cystic renal dysplasia, spleninculus, Meckel's diverticulum, and imperforate anus. The constellations of malformations present in our case have overlapping features with Vertebral anomalies, Anal...

  2. Emphysematous prostatic abscess with rectoprostatic fistula

    Directory of Open Access Journals (Sweden)

    Po-Cheng Chen

    2014-12-01

    Full Text Available Emphysematous prostatic abscess is a rare but relatively serious infectious disease, and its association with rectoprostatic fistula is extremely unusual. The reported risk factors for this condition include diabetes mellitus, immunosuppression, and prostate surgery. We report a rare case of emphysematous prostatic abscess successfully treated by transurethral drainage. Nonetheless, a rectoprostatic fistula was found postoperatively. The fistula healed spontaneously without fasting or fecal diversion after suprapubic cystostomy and placement of a urethral catheter. This case highlights the importance of surgical drainage for the treatment of an emphysematous prostatic abscess and that conservative treatment can be a safe and effective approach for an associated rectoprostatic fistula.

  3. Concomitant slide tracheoplasty and cardiac operation for congenital tracheal stenosis associated with VACTERL.

    Science.gov (United States)

    Wu, En-Ting; Wang, Ching-Chia; Lin, Ming-Tai; Huang, Pei-Ming; Chen, Shyh-Jye; Huang, Chi-Hsiang; Hwang, Haw-Kwei; Chen, Ming-Ren; Huang, Shu-Chien

    2013-10-01

    The association of congenital tracheal stenosis and tracheoesophageal (TE) fistula is rare. Here, we report 2 patients with tracheobronchial stenosis (complete cartilage ring) involving the lower trachea and right bronchus. Both patients had associated VACTERL (vertebral anomalies, anal atresia, cardiovascular anomalies, TE, renal, and limb defects) congenital cardiac defects and tracheal diverticula after repair of the TE fistula in type C esophageal atresia. The stenotic segment began at the orifice of the TE fistula, which became diverticula after the TE fistula was repaired. Concomitant repair of congenital cardiac defects and a slide tracheoplasty with elimination of the diverticula were performed successfully. PMID:24088476

  4. Choledochoduodenal fistula of ulcer etiology

    Directory of Open Access Journals (Sweden)

    Čolović Radoje

    2010-01-01

    Full Text Available Introduction Choledochoduodenal fistulas are very rare and in most cases are caused by a long-lasting and poorly treated chronic duodenal ulcer. They may be asymptomatic or followed by symptoms of ulcer disease, by attacks of cholangitis or bleeding or vomiting in cases of ductoduodenal stenosis. The diagnosis is simple and safe, however treatment is still controversial. If surgery is the choice of treatment, local findings should be taken into consideration. As a rule, intervention involving closure of fistula is not recommended. Case Outline The authors present a 60-year-old woman with a long history of ulcer disease who developed attacks of cholangitis over the last three years. Ultrasonography and CT showed masive pneumobilia due to a choledochoduodenal fistula. . As there was no duodenal stenosis or bleeding, at operation the common bile duct was transected and end-to-side choledochojejunostomy was performed using a Roux-en Y jejunal limb. From the common bile duct, multiple foreign bodies of herbal origin causing biliary obstruction and cholangitis were removed. After uneventful recovery the patient stayed symptom free for four years now. Conclusion The performed operation was a simple and good surgical solution which resulted in complication-free and rapid recovery with a long-term good outcome. .

  5. The Patency Rate of Arteriovenous Fistulas

    Directory of Open Access Journals (Sweden)

    Aşkın Ender Topal

    2004-01-01

    Full Text Available The purpose of this investigation is to determine the patency of thearteriovenous (A-V fistulas, created in patients with chronic renal failure, inthe early and late periods according to sex.The A-V fistulas created for hemodialisis were investigated retrospectively.Of 238 patients, there were 130 male.269 operations were made to 238 patients. Of these, 198 (73.6 % wereradiochephalic, 56 (20.8 % were brachiochephalic, 8 (3 % were brachiobasilicA-V fistulas. In 3 (1.1 % patients loop graft between brachial artery and vein,in 1 (0.37 % patient graft between radial artery and brachial vein, in 1 patientgraft between brachial artery and basilic vein, in 1 patient graft betweensuperficial femoral artery and saphenous vein were placed. Of 198radiochephalic A-V fistulas 24 (12.1 % in early period and 3 (1.5 % in lateperiod became inactive. Of 56 brachiochephalic A-V fistulas 4 (7.1 % and of 8brachiobasilic A-V fistulas 2 (25 % became unsuccessful in early period. 1 of 6A-V fistulas with prosthetic graft failed in late period because of thrombosis. Inradial level patency rate of A-V fistulas in females were lower than in males(82.3 %-89.8 %.The patency rate of A-V fistulas in radial and brachial levels were similar,but in radial level rate of successful of A-V fistulas decreased in femalesaccording to males. Use of graft in A-V fistula didn’t give superiority to A-Vfistulas without graft.

  6. Minimal Invasive Coronary Artery Fistula Ligation

    OpenAIRE

    Mitropoulos, Fotios A.; Kanakis, Meletios A.; Chatzis, Andrew; Contrafouris, Constantinos; Sofianidou, Ioanna A.; Lioulias, Achilleas G.

    2014-01-01

    A coronary artery fistula was surgically ligated in a 38-year-old woman via a left anterior mini-thoracotomy without the use of cardiopulmonary bypass. In selected cases, this surgical approach can provide an excellent surgical exposure for coronary artery fistula ligation. It also offers an excellent cosmetic result and shorter hospital stay.

  7. Vector Volume Flow in Arteriovenous Fistulas

    DEFF Research Database (Denmark)

    Hansen, Peter Møller; Heerwagen, Søren; Pedersen, Mads Møller;

    2013-01-01

    , but is very challenging due to the angle dependency of the Doppler technique and the anatomy of the fistula. The angle independent vector ultrasound technique Transverse Oscillation provides a new and more intuitive way to measure volume flow in an arteriovenous fistula. In this paper the Transverse...

  8. Gastro-peritoneo-cutaneous fistula following splenectomy

    OpenAIRE

    BAYRAKÇI, Berna; ORUÇ, Nevin; TEKİN, Fatih; Elmas, Nevra; ÖZÜTEMİZ, A. Ömer

    2009-01-01

    Splenectomy operation is usually indicated for treatment of hematological disorders or splenic trauma. Splenectomy complications including gastric injury and peritoneal abscess formation were rarely reported. Forty seven years old male patient diagnosed with immune thrombocytopenic purpura and had splenectomy operation. Abdominal pain and cutaneous fistula was developed after the operation. Further investigations revealed gastric fistula opening endoscopically and presence of intraabdominal a...

  9. Ventriculomegaly with non-CNS anomalies

    International Nuclear Information System (INIS)

    We correlated fetal magnetic resonance (MR) imaging findings with postnatal clinical findings to assess ventriculomegaly with non-CNS anomalies. From 2002 to 2010, 52 fetuses underwent a MRI for evaluation of ventriculomegaly after ultrasonography (US). Ten of the 52 demonstrated anomalies outside the central nervous system (CNS), including trisomy 8, trisomy 18, X-linked hydrocephalus, CHARGE/Potter sequences, VATER association, oral-facial-digital syndrome, esophageal atresia type C, or external auditory canal stenosis. Examinations were performed between 24 and 35 weeks' gestation. MR imaging was performed in a 1.5-tesla unit using a phased-array coil without preparation. Fetal MR imaging showed abnormalities of the kidney, bladder, duodenum, and thumbs but did not permit diagnosis of esophageal atresia type C or craniofacial, anorectal, or skeletal anomalies. Cardiac anomaly was most frequent, but fetal MR imaging did not allow final diagnosis of congenital heart disease. On both US and MR imaging, esophageal atresia type C and anorectal anomaly were undetected; normal rectal signal in a case of anorectal anomaly without urorectal fistula did not lead to suspicion of anomaly. Observation of adducted thumbs on MR imaging is an important sign of X-linked hydrocephalus. The slice area used in this study did not cover polydactyly, which accompanies oral-facial-digital syndrome. US and MR imaging are complementary imaging methods used to evaluate ventriculomegaly. Fetal MR imaging should cover the kidney, bladder, and fingers. Further work is needed to determine the anomalies that can be clearly detected by fetal MR imaging. (author)

  10. Physiologic assessment of coronary artery fistula

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, N.C.; Beauvais, J. (Creighton Univ., Omaha, NE (USA))

    1991-01-01

    Coronary artery fistula is an uncommon clinical entity. The most common coronary artery fistula is from the right coronary artery to the right side of the heart, and it is less frequent to the pulmonary artery. The effect of a coronary artery fistula may be physiologically significant because of the steal phenomenon resulting in coronary ischemia. Based on published reports, it is recommended that patients with congenital coronary artery fistulas be considered candidates for elective surgical correction to prevent complications including development of congestive heart failure, angina, subacute bacterial endocarditis, myocardial infarction, and coronary aneurysm formation with rupture or embolization. A patient is presented in whom treadmill-exercise thallium imaging was effective in determining the degree of coronary steal from a coronary artery fistula, leading to successful corrective surgery.

  11. MDCT Findings of Tracheal Agenesis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Yu Mi; Kim, Jee Eun; Son, Dong Woo; Kim, Ha Na; Hwang, Hee Young [Gachon University, Gil Hospital, Incheon (Korea, Republic of)

    2009-01-15

    Tracheal agenesis is an extremely rare congenital anomaly with fatal consequences. We report a case of tracheal agenesis in a newborn infant who presented with no self-respiration and cyanosis that was confirmed by the use of 64-slice multidetector CT. Coronal and sagittal multiplanar reconstruction images clearly delineated the aberrant anatomy of tracheal agenesis and demonstrated the presence of a tracheoesophageal fistula.

  12. [Laryngotracheal separation and tracheoesophageal diversion for intractable aspiration in ALS--usefulness and indication].

    Science.gov (United States)

    Mita, Shuji

    2007-10-01

    To evaluate the usefulness of laryngotracheal separation or tracheoesophageal diversion (LTS/TED), we investigated changes in medical management after LTS/TED. We performed LTS/TED for intractable aspiration in patients with amyotrophic lateral sclerosis (ALS) and patients with other neurological diseases. Most of the subjects had already received a tracheostomy, and all the patients with ALS had tracheostomy positive pressure ventilation. However, they remained at risk of intractable aspiration, had experienced frequent suctioning of aspiration material, and could not eat. In all cases, LTS/TED was performed safely within 3 hours and without any complications. After LTS/TED, there was no aspiration of saliva in any of the patients. In most subjects, the frequency of suctioning by medical staff and caregivers was much reduced. The frequency of aspiration pneumonia was also extremely lowered. Follow-up study demonstrated that complete control over aspiration was achieved in all of the patients. Some of them were completely self-sufficient in their ability to eat. Some of the other patients were at least able to enjoy taste. Nutritional status was significantly improved. All the patients, family caregivers, and medical staff involved in this study were satisfied with the outcome. These results indicate that LTS/TED is a very useful procedure in several aspects: it benefits patients who have a fear of aspiration; it reduces the burden on patients and family caregivers; it promotes their quality of life; and it limits the aspiration-associated demands on medical staff. Based on the results, we have proposed an indication of LTS/TED for dysphasia in ALS.

  13. Aortoesophageal fistula in a child

    Directory of Open Access Journals (Sweden)

    Shasanka Shekhar Panda

    2013-01-01

    Full Text Available Aortoesophageal fistulae (AEF are rare and are associated with very high mortality. Foreign body ingestions remain the commonest cause of AEF seen in children. However in a clinical setting of tuberculosis and massive upper GI bleed, an AEF secondary to tuberculosis should be kept in mind. An early strong clinical suspicion with good quality imaging and endoscopic evaluation and timely aggressive surgical intervention helps offer the best possible management for this life threatening disorder. Our case is a 10-year-old boy who presented to the pediatric emergency with massive bouts of haemetemesis and was investigated and managed by multidisciplinary team effort in the emergency setting.

  14. Radiologic recognition of bronchopleural fistula.

    Science.gov (United States)

    Friedman, P J; Hellekant, C A

    1977-08-01

    Examination of more than 30 cases of bronchopleural fistula (BPF), of diverse causes, including 6 following resectional surgery, revealed a distinctive configuration of air/fluid collections in the pleural space. Maler in 1940 independently observed that loculated BPF pockets conform in shape to the adjacent chest wall. With the most common posterior costophrenic angle location, there is a wide air-fluid level in the frontal view, but on lateral films the anteroposterior diameter is narrow. In contrast, abscess cavities tend to be spherical and farther from the ribs. Use of these plain film criteria permits earlier and more confident diagnosis.

  15. A tiny dural arteriovenous fistula

    Institute of Scientific and Technical Information of China (English)

    ZHANG Peng 张 鹏; ZHU Fengshui 朱风水; LING Feng 凌 锋; Christophe COGNARD

    2003-01-01

    @@ Pulsatile tinnitus is commonly encountered in approximately 10% of a given population.1 Since causes of the disease vary, selecting appropriate protocols of imaging strategies is quite challenging.2 Vascular anormalies or diseases including anormalies of the carotid arteries and jugular veins, intracranial arteriovenous malformation and dural arteriovenous fistula (DAVF) are major causative factors of the disease. Before imaging studies, history inquiry and physical examination are important for detect the possible causes of pulsatile tinnitus. Different imaging examinations are depended on histories and clinical signs of different patients.

  16. Fístula esôfago-traqueal após ingestão cáustica Tracheoesophageal fistula after caustic ingestion

    OpenAIRE

    Eduardo Crema; Marcelo Cunha Fatureto; Marcel Noronha Gonzaga; Ricardo Pastore; Alex Augusto da Silva

    2007-01-01

    As fístulas esôfago-traqueais são incomuns e apresentam diversas etiologias, entre elas, a queimadura química esofágica devida à ingestão cáustica. Relatamos o caso de um paciente de 27 anos com história de ingestão cáustica havia catorze dias, com dor retroesternal em queimação, fraqueza, tosse com escarro purulento e dispnéia associada à rouquidão no último dia. A endoscopia digestiva alta e a broncofibroscopia revelaram fístula esôfago-traqueal. O tratamento consistiu no suporte clínico, d...

  17. Three Distinct Urethral Fistulae 35 Years After Pelvic Radiation

    OpenAIRE

    Sharma, Arindam; Kurtz, Michael P.; Jairam R. Eswara

    2014-01-01

    Introduction: While the development of fistulae is a well-known complication of radiotherapy, such fistulae can often be challenging to manage. Case Presentation: We describe the case of a 37 year old male who developed in succession a urethrocutaneous fistula to the thigh, a rectourethral fistula and a peritoneo-urethral fistula 35 years after radiotherapy for pediatric pelvic rhabdomyosarcoma. These complications were managed successfully after multiple surgical procedures. Discussion: We s...

  18. Coronary Artery Fistula-Associated Endocarditis: Report of Two Cases and a Review of the Literature.

    Science.gov (United States)

    Wang, Fang; Cranston-D'Amato, Hope; Pearson, Anthony

    2015-12-01

    Coronary artery fistulae (CAF) are rare congenital anomalies and reported to have an incidence of 0.1-0.2% of all coronary angiograms. An association between fistulae and nonatherosclerotic coronary artery aneurysms is even more rare. In childhood, patients are mostly asymptomatic; however, patients older than 20 years old may present with signs of infective endocarditis, myocardial ischemia, congestive heart failure, and aneurysm rupture. CAF are typically identified by coronary angiography; however, there are some limited studies showing that transesophageal echocardiography (TEE) can also be useful in identifying CAF. Here we report two cases of endocarditis secondary to congenital coronary artery fistulae draining into either a cardiac cavity or a coronary sinus, which were detected by TEE. Vegetations were found at the site of the fistulae drainage. Management for young patients is either percutaneous or surgical intervention. For elderly patients with multiple comorbidities, conservative treatment is another option. In these two cases, treating endocarditis with proper antibiotics and supportive treatment, the patients' conditions improved significantly.

  19. Enterovesical Fistulae: Aetiology, Imaging, and Management

    Directory of Open Access Journals (Sweden)

    Tomasz Golabek

    2013-01-01

    Full Text Available Background and Study Objectives. Enterovesical fistula (EVF is a devastating complication of a variety of inflammatory and neoplastic diseases. Radiological imaging plays a vital role in the diagnosis of EVF and is indispensable to gastroenterologists and surgeons for choosing the correct therapeutic option. This paper provides an overview of the diagnosis of enterovesical fistulae. The treatment of fistulae is also briefly discussed. Material and Methods. We performed a literature review by searching the Medline database for articles published from its inception until September 2013 based on clinical relevance. Electronic searches were limited to the keywords: “enterovesical fistula,” “colovesical fistula” (CVF, “pelvic fistula”, and “urinary fistula”. Results. EVF is a rare pathology. Diverticulitis is the commonest aetiology. Over two-thirds of affected patients describe pathognomonic features of pneumaturia, fecaluria, and recurrent urinary tract infections. Computed tomography is the modality of choice for the diagnosis of enterovesical fistulae as not only does it detect a fistula, but it also provides information about the surrounding anatomical structures. Conclusions. In the vast majority of cases, this condition is diagnosed because of unremitting urinary symptoms after gastroenterologist follow-up procedures for a diverticulitis or bowel inflammatory disease. Computed tomography is the most sensitive test for enterovesical fistula.

  20. Voice restoration following total laryngectomy by tracheoesophageal prosthesis: Effect on patients' quality of life and voice handicap in Jordan

    Directory of Open Access Journals (Sweden)

    Wreikat Mahmoud M

    2008-03-01

    Full Text Available Abstract Background Little has been reported about the impact of tracheoesophageal (TE speech on individuals in the Middle East where the procedure has been gaining in popularity. After total laryngectomy, individuals in Europe and North America have rated their quality of life as being lower than non-laryngectomized individuals. The purpose of this study was to evaluate changes in quality of life and degree of voice handicap reported by laryngectomized speakers from Jordan before and after establishment of TE speech. Methods Twelve male Jordanian laryngectomees completed the University of Michigan Head & Neck Quality of Life instrument and the Voice Handicap Index pre- and post-TE puncture. Results All subjects showed significant improvements in their quality of life following successful prosthetic voice restoration. In addition, voice handicap scores were significantly reduced from pre- to post-TE puncture. Conclusion Tracheoesophageal speech significantly improved the quality of life and limited the voice handicap imposed by total laryngectomy. This method of voice restoration has been used for a number of years in other countries and now appears to be a viable alternative within Jordan.

  1. Anomaly Structure of Supergravity and Anomaly Cancellation

    CERN Document Server

    Butter, Daniel

    2009-01-01

    We display the full anomaly structure of supergravity, including new D-term contributions to the conformal anomaly. This expression has the super-Weyl and chiral U(1)_K transformation properties that are required for implementation of the Green-Schwarz mechanism for anomaly cancellation. We outline the procedure for full anomaly cancellation. Our results have implications for effective supergravity theories from the weakly coupled heterotic string theory.

  2. Post-traumatic recto-spinal fistula

    Energy Technology Data Exchange (ETDEWEB)

    Lantsberg, L.; Greenberg, G. [Department of Surgery A, Soroka University Medical Center, Beer-Sheva (Israel); Laufer, L.; Hertzanu, Y. [Department of Diagnostic Radiology, Soroka University Medical Center, Beer-Sheva (Israel)

    2000-01-01

    Acquired recto-spinal fistula has been described elsewhere as a rare complication of colorectal malignancy and Crohn's enterocolitis. We treated a young man who developed a recto-spinal fistula as a result of a high fall injury. The patient presented with meningeal signs, sepsis and perianal laceration. Computerized axial tomography revealed air in the supersellar cistern. Gastrografin enema showed that contrast material was leaking from the rectum into the spinal canal. Surgical management included a diverting sigmoid colostomy, sacral bone curettage and wide presacral drainage. To the best of our knowledge, rectospinal fistula of traumatic origin has not been previously reported in the English literature. (orig.)

  3. The changing face of obstetric fistula surgery in Ethiopia

    Science.gov (United States)

    Wright, Jeremy; Ayenachew, Fekade; Ballard, Karen D

    2016-01-01

    Objective To examine the incidence and type of obstetric fistula presenting to Hamlin Fistula Ethiopia over a 4-year period. Study design This is a 4-year retrospective survey of obstetric fistula treated at three Hamlin Fistula Hospitals in Ethiopia, where approximately half of all women in the country are treated. The operation logbook was reviewed to identify all new cases of obstetric fistula presenting from 2011 to 2015. New cases of urinary fistula were classified by fistula type (high or low), age, and parity of the woman. Results In total, 2,593 new cases of urinary fistulae were identified in the study period. The number of new cases fell by 20% per year over the 4 years (P<0.001). A total of 1,845 cases (71.1%) were low (ischemic) fistulae, and 804 cases (43.6%) of these had an extreme form of low circumferential fistula. A total of 638 (24.6%) women had a high bladder fistula, which predominantly occurs following surgery, specifically cesarean section or emergency hysterectomy, and 110 (4.2%) women had a ureteric fistula. The incidence of high fistulae increased over the study period from 26.9% to 36.2% (P<0.001). A greater proportion of multiparous women had a high bladder fistula (70.3%) compared with primigravid women (29.7%) (P<0.001). Conversely, a greater proportion of primiparous women experienced a low circumferential fistulae (68.6%) compared with multiparous women (31.4%) (P<0.001). Conclusion There appears to be a decline in the number of Ethiopian women being treated for new obstetric urinary fistulae. However, the type of fistula being presented for treatment is changing, with a rise in high fistulae that very likely occurred following cesarean section and a decline in the classic low fistulae that arise following obstructed childbirth. PMID:27445505

  4. First Branchial Cleft Fistula Associated with External Auditory Canal Stenosis and Middle Ear Cholesteatoma

    Directory of Open Access Journals (Sweden)

    shahin abdollahi fakhim

    2014-10-01

    Full Text Available Introduction: First branchial cleft anomalies manifest with duplication of the external auditory canal.   Case Report: This report features a rare case of microtia and congenital middle ear and canal cholesteatoma with first branchial fistula. External auditory canal stenosis was complicated by middle ear and external canal cholesteatoma, but branchial fistula, opening in the zygomatic root and a sinus in the helical root, may explain this feature. A canal wall down mastoidectomy with canaloplasty and wide meatoplasty was performed. The branchial cleft was excised through parotidectomy and facial nerve dissection.   Conclusion:  It should be considered that canal stenosis in such cases can induce cholesteatoma formation in the auditory canal and middle ear.

  5. Pharyngocutaneous fistula after anterior cervical spine surgery

    OpenAIRE

    Sansur, Charles A.; Early, Stephen; Reibel, James; Arlet, Vincent

    2009-01-01

    Pharyngocutaneous fistulae are rare complications of anterior spine surgery occurring in less than 0.1% of all anterior surgery cases. We report a case of a 19 year old female who sustained a C6 burst fracture with complete quadriplegia. She was treated urgently with a C6 corpectomy with anterior cage and plating followed by posterior cervical stabilization at another institution. Post operatively she developed a pharyngocutaneous fistula that failed to heal despite several attempts of closu...

  6. Bronchobiliary Fistula Evaluated with Magnetic Resonance Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Ragozzino, A.; Rosa, R. De; Galdiero, R.; Maio, A.; Manes, G. [Aorn Cardarelli Napoli (Italy). Dept. di Gastroenterologia

    2005-08-01

    Bronchobiliary fistula (BBF) is a rare disorder consisting of a passageway between the biliary ducts and the bronchial tree. Many conditions may give rise to this development. Management of these fistulas is often difficult and can be associated with high morbidity and mortality rates. We present a case of BBF developing after hemihepatectomy in a 74-year-old man treated with endoscopic biliary drainage and illustrate MRCP findings.

  7. Radiology in cutaneous sinuses and fistulae

    International Nuclear Information System (INIS)

    In patients with cutaneous openings, sinograph and fistulography an usually performed. Fistulae in the head/neck region and perineum are seldom life-threatening while enterocutaneous fistulae involving the small bowel can be a serious threat due to loss of fluid. Radiology contributes to the preoperative examination of these patients. Fistulography outlines communications to the gastrointestinal tract, pleura, joints and other underlying crucial structures. Involved bowel segments are further demonstrated with barium examination. (orig.)

  8. Radiology in cutaneous sinuses and fistulae

    Energy Technology Data Exchange (ETDEWEB)

    Sundgren-Borgstroem, P.; Ekberg, O.; Lasson, A.

    1988-12-01

    In patients with cutaneous openings, sinograph and fistulography an usually performed. Fistulae in the head/neck region and perineum are seldom life-threatening while enterocutaneous fistulae involving the small bowel can be a serious threat due to loss of fluid. Radiology contributes to the preoperative examination of these patients. Fistulography outlines communications to the gastrointestinal tract, pleura, joints and other underlying crucial structures. Involved bowel segments are further demonstrated with barium examination.

  9. MRI IN THE EVALUATION OF PERIANAL FISTULAS

    Directory of Open Access Journals (Sweden)

    Gururaj

    2015-05-01

    Full Text Available Perianal fistulae though uncommon , can be quite distressing to the patient. Correct surgical management requires accurate pre - operative assessment and grading of this condition. MRI is now considered the modality of choice in the pre - operative assessment of perianal fistulae. We did a retrospective analysis of patients who underwent MR imaging for perianal fistulae in our institution , and compared it with the surg ical findings. The purpose of the study was to evaluate the accuracy of MRI in the pre - operative grading of perianal fistulae. A total of 32 patients were included in this study. Of these , 12(37% had type 1 intersphincteric , 8(25% had type 2 intersphincteric , 6(18% had type 3 transsphincteric , 4(12% had type 4 transphincteric , and 2(6% showed supra - levator extension. MRI was able to correctly grade the fistulous tract in 30 of these 32 patients , giving an accuracy of 94%. MRI was found to b e extremely useful in the pre - operative assessment of perianal fistulae. It helps in correctly classifying the fistulae and to detect hidden or deep seated tracts or abscesses which would have been otherwise missed. Thus , it is useful in selecting the most appropriate surgical procedure , thereby reducing the chances of recurrence and to avoid complications such as fecal incontinence from occurring.

  10. Chiral anomalies and differential geometry

    Energy Technology Data Exchange (ETDEWEB)

    Zumino, B.

    1983-10-01

    Some properties of chiral anomalies are described from a geometric point of view. Topics include chiral anomalies and differential forms, transformation properties of the anomalies, identification and use of the anomalies, and normalization of the anomalies. 22 references. (WHK)

  11. Endovascular Management of Acute Bleeding Arterioenteric Fistulas

    International Nuclear Information System (INIS)

    The objective of this study was to review the outcome of endovascular transcatheter repair of emergent arterioenteric fistulas. Cases of abdominal arterioenteric fistulas (defined as a fistula between a major artery and the small intestine or colon, thus not the esophagus or stomach), diagnosed over the 3-year period between December 2002 and December 2005 at our institution, were retrospectively reviewed. Five patients with severe enteric bleeding underwent angiography and endovascular repair. Four presented primary arterioenteric fistulas, and one presented a secondary aortoenteric fistula. All had massive persistent bleeding with hypotension despite volume substitution and transfusion by the time of endovascular management. Outcome after treatment of these patients was investigated for major procedure-related complications, recurrence, reintervention, morbidity, and mortality. Mean follow-up time was 3 months (range, 1-6 months). All massive bleeding was controlled by occlusive balloon catheters. Four fistulas were successfully sealed with stent-grafts, resulting in a technical success rate of 80%. One patient was circulatory stabilized by endovascular management but needed immediate further open surgery. There were no procedure-related major complications. Mean hospital stay after the initial endovascular intervention was 19 days. Rebleeding occurred in four patients (80%) after a free interval of 2 weeks or longer. During the follow-up period three patients needed reintervention. The in-hospital mortality was 20% and the 30-day mortality was 40%. The midterm outcome was poor, due to comorbidities or rebleeding, with a mortality of 80% within 6 months. In conclusion, endovascular repair is an efficient and safe method to stabilize patients with life-threatening bleeding arterioenteric fistulas in the emergent episode. However, in this group of patients with severe comorbidities, the risk of rebleeding is high and further intervention must be considered

  12. Modified prosthesis for the treatment of malignant esophagotracheal fistula

    International Nuclear Information System (INIS)

    Esophagotracheal fistula is usually a sequela of irradiation or laser treatment of advanced carcinoma of the esophagus or the tracheobronchial tree. Resection of the tumor in these cases is not possible, and palliative bypass surgery is highly risky. The peroral placement of a prosthesis is less invasive, but conventional prostheses often fail to occlude the fistula. The authors regularly use an endoscopic multiple-diameter bougie for dilation. After dilation, a specially designed prosthesis is pushed through the tumor stenosis to block the fistula. This procedure can be done without general anesthesia. The funnels of conventional prostheses cannot cover the fistula when there is either a wide, proximal esophagus above the fistula or a high fistula. To cope with this particular situation, a special fistula funnel was developed. It perfectly occludes the fistulas in all patients. Of 21 patients, 19 were discharged without further aspiration

  13. Imaging diagnosis of dural and direct cavernous carotid fistulae

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Daniela dos; Monsignore, Lucas Moretti; Nakiri, Guilherme Seizem; Cruz, Antonio Augusto Velasco e; Colli, Benedicto Oscar; Abud, Daniel Giansante, E-mail: danisantos2404@gmail.com [Universidade de Sao Paulo (HCFMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Hospital das Clinicas

    2014-07-15

    Arteriovenous fistulae of the cavernous sinus are rare and difficult to diagnose. They are classified into dural cavernous sinus fistulae or direct carotid-cavernous fistulae. Despite the similarity of symptoms between both types, a precise diagnosis is essential since the treatment is specific for each type of fistula. Imaging findings are remarkably similar in both dural cavernous sinus fistulae and carotid-cavernous fistulae, but it is possible to differentiate one type from the other. Amongst the available imaging methods (Doppler ultrasonography, computed tomography, magnetic resonance imaging and digital subtraction angiography), angiography is considered the gold standard for the diagnosis and classification of cavernous sinus arteriovenous fistulae. The present essay is aimed at didactically presenting the classification and imaging findings of cavernous sinus arteriovenous fistulae. (author)

  14. The pattern of non-obstetric fistula: A Cameroonian experience

    Directory of Open Access Journals (Sweden)

    Pierre-Marie Tebeu

    2014-09-01

    Conclusion: UGF fistula is the main type of NOGF in Cameroonian context, with hysterectomy being the leading cause. Proper knowledge on NOGF will enable better strategies to fight against genital fistula.

  15. Changes in aetiological determinants of urinary fistula

    Institute of Scientific and Technical Information of China (English)

    Prosper E. Gharoro; Chukwunwendu A. Okonkwo

    2009-01-01

    Objective: Objective: To investigate the localization and aetiological factors associated with urinary fistulae at the University Teaching Hospital in Benin-City, Nigeria. Methods: Records on 96 patients treated by the authors at the gynaecological ward of the University of Benin Teaching Hospital, Benin-City, Nigeria between January 1997 and December 2006 were analyzed. Information extracted and analyzed included data on socio-biological, demographic, and obstetric event of the antecedent pregnancy. Results: The average age of patients with vesico-vaginal fistula(VVF) was 34 years with a mean parity of 3. The various mean values for patients' height, weight and body mass index (BMI) were 1.58m, 58.29kg and 24.13 respectively. The majority (92.7%) of fistulas are obstetric in origin. While 5.21% were due to total abdominal hysterectomy and 2.08% due to post irradiation for advanced gynecological malignancy. 53(55.21%) patients had obstetric operative interventions (Forceps or vacuum extraction, and or caesarean section). Caesarean section contributed 23.96% to the total figure. Juxta-cervical fistula was the most frequent, next mid vagina and followed by vesico-uterine (32. 98%, 24.4% and 19.15% respectively).Conclusion: Obstetric surgical intervention by care providers is a major cause of VVF formation with particular reference to Caesarean section. Vesico-uterine fistulas are on the increase.

  16. Effects of arteriovenous fistulas on cardiac oxygen supply and demand

    NARCIS (Netherlands)

    Bos, W.J.W.; Zietse, R.; Wesseling, K.H.; Westerhof, N.

    1999-01-01

    Background. Arteriovenous (AV) fistulas used for hemodialysis access may affect cardiac load by increasing the preload while decreasing the afterload. In dogs, AV fistulas have also been shown to affect coronary perfusion negatively. We investigated the net effect of AV fistulas on cardiac oxygen su

  17. Formation of a vesicovaginal fistula in a pig model

    DEFF Research Database (Denmark)

    Lindberg, Jennifer; Rickardsson, Emilie; Andersen, Margrethe;

    2015-01-01

    the bladder and the vagina was made, and the mucosa between them was sutured together with absorbable sutures. A durometer ureteral stent was introduced into the fistula, secured with sutures to the bladder wall, allowing for the formation of a persistent fistula tract. Six weeks postoperatively cysto...... be an effective and cheap way to create a fistula between the bladder and vagina....

  18. Transarterial detachable coil embolization combined with ipsilateral intermittent carotid oppression for traumatic carotid-cavernous fistula with small fistula

    Institute of Scientific and Technical Information of China (English)

    Qing Huang; Hongbing Zhang; Gang Wang; Jun Yang; Yanlong Hu; Jianxin Liu

    2015-01-01

    One case of traumatic carotid-cavernous fistula (TCCF) with small fistula treated by transarterial detachable coil embolization was reported.The intermittent ipsilateral carotid compression was used to identify the final blocking of the residual fistula.The follow-up digital subtraction angiography showed that the TCCF was cured finally, From this case, we conclude that this method may be an effective way to treat TCCF with small fistula.

  19. Speech Rehabilitation For 10 Alaryngeal Patients Using Tracheoesophageal Puncture And Prosthesis Insertion In Amir Alam And Imam Khomeini Hospitals 2002-2003

    OpenAIRE

    M.T. Khorsi Ashtiani; Gh.A. Dashti Khavidaki S.H. Samimi Ardestani

    2006-01-01

    Background and Aim: Total laryngectomy following laryngeal cancer has many sequelae , that loss of voice is the most important of them. Tracheoesophageal puncture (TEP) and prosthesis insertion has evolved into the most widely used and accepted technique for vocal rehabilitation. Materials and Methods: 10 patients that underwent TEP in Amir Alam and Imam Khomeini hospitals from Feb. 2002 through Nov. 2003; were included in this study. Prosthesis insertion in 4 patients is primary and in 6 pat...

  20. Vesicovaginal Fistula-A-5 Year Review

    Directory of Open Access Journals (Sweden)

    Vineet Kaur

    2002-01-01

    Full Text Available A rctrospective analysis of 25 patients who underwent surgery for vesicovaginal fistula is herebyreported. The mean age ofpatients was 38.48 ± 10.72 years. Gynaecological surgery was the leadingfactor in etiology in 60% cases followed by obstetrical trauma in 32% and road traffic accident in8%. The primary presenting complaint was leaking of urine per vagina and the mean duration ofsymptoms was 41.81 months ± 9.90. Fistulas due to gynaecological surgical trauma were seen onthe vault. while anterior vaginal wall was involved in obstetrical trauma. 84% of patients had singlefistula, in remaining 16% two to three fistulas were demonstrated. In 20 patients. transvaginal repairwas done, remaining 5 patients underwent repair via abdominal route. Success rate of 80% wasreported in Ollr series.

  1. Successful tubes treatment of esophageal fistula

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Aim: To discuss the merits of "tubes treatment" for esophageal fistula (EF). Methods: A 66-year-old female who suffered from a bronchoesophageal and esophagothoratic fistula underwent a successful "three tubes treatment" (close chest drainage, negative pressure suction at the leak, and nasojejunal feeding tube), combination of antibiotics, antacid drugs and nutritional support. Another 55-year-old male patient developed an esophagopleural fistula (EPF) after esophageal carcinoma operation. He too was treated conservatively with the three tubes strategy as mentioned above towards a favorable outcome. Results:The two patients recovered with the tubes treatment, felt well and became able to eat and drink, presenting no complaint. Conclusion: Tubes treatment is an effective basic way for EF. It may be an alternative treatment option.

  2. Endovascular management of acute bleeding arterioenteric fistulas

    DEFF Research Database (Denmark)

    Leonhardt, H.; Mellander, S.; Snygg, J.;

    2008-01-01

    The objective of this study was to review the outcome of endovascular transcatheter repair of emergent arterioenteric fistulas. Cases of abdominal arterioenteric fistulas (defined as a fistula between a major artery and the small intestine or colon, thus not the esophagus or stomach), diagnosed....... All had massive persistent bleeding with hypotension despite volume substitution and transfusion by the time of endovascular management. Outcome after treatment of these patients was investigated for major procedure-related complications, recurrence, reintervention, morbidity, and mortality. Mean...... reintervention. The in-hospital mortality was 20% and the 30-day mortality was 40%. The midterm outcome was poor, due to comorbidities or rebleeding, with a mortality of 80% within 6 months. In conclusion, endovascular repair is an efficient and safe method to stabilize patients with life-threatening bleeding...

  3. Eyelid liquoric fistula secondary to orbital meningocele

    Directory of Open Access Journals (Sweden)

    Renato Antunes Schiave Germano

    2015-02-01

    Full Text Available Liquoric fistula (LF is defined as the communication of the subarachnoid space with the external environment, which main complication is the development of infection in the central nervous system. We reported the case of a patient with non-traumatic eyelid liquoric fistula secondary to orbital meningocele (congenital lesion, which main clinical manifestation was unilateral eyelid edema. Her symptoms and clinical signs appeared in adulthood, which is uncommon. The patient received surgical treatment, with complete resolution of the eyelid swelling. In conclusion, eyelid cerebrospinal fluid (CSF fistula is a rare condition but with great potential deleterious to the patient. It should be considered in the differential diagnosis of unilateral eyelid edema, and surgical treatment is almost always mandatory.

  4. Pancreatic Pseudocyst Pleural Fistula in Gallstone Pancreatitis

    Directory of Open Access Journals (Sweden)

    Sala Abdalla

    2016-01-01

    Full Text Available Extra-abdominal complications of pancreatitis such as pancreaticopleural fistulae are rare. A pancreaticopleural fistula occurs when inflammation of the pancreas and pancreatic ductal disruption lead to leakage of secretions through a fistulous tract into the thorax. The underlying aetiology in the majority of cases is alcohol-induced chronic pancreatitis. The diagnosis is often delayed given that the majority of patients present with pulmonary symptoms and frequently have large, persistent pleural effusions. The diagnosis is confirmed through imaging and the detection of significantly elevated amylase levels in the pleural exudate. Treatment options include somatostatin analogues, thoracocentesis, endoscopic retrograde cholangiopancreatography (ERCP with pancreatic duct stenting, and surgery. The authors present a case of pancreatic pseudocyst pleural fistula in a woman with gallstone pancreatitis presenting with recurrent pneumonias and bilateral pleural effusions.

  5. Eguchipsammia fistula Microsatellite Development and Population Analysis

    KAUST Repository

    Mughal, Mehreen

    2012-12-01

    Deep water corals are an understudied yet biologically important and fragile ecosystem under threat from recent increasing temperatures and high carbon dioxide emissions. Using 454 sequencing, we develop 14 new microsatellite markers for the deep water coral Eguchipsammia fistula, collected from the Red Sea but found in deep water coral ecosystems globally. We tested these microsatellite primers on 26 samples of this coral collected from a single population. Results show that these corals are highly clonal within this population stemming from a high level of asexual reproduction. Mitochondrial studies back up microsatellite findings of high levels of genetic similarity. CO1, ND1 and ATP6 mitochondrial sequences of E. fistula and 11 other coral species were used to build phylogenetic trees which grouped E. fistula with shallow water coral Porites rather than deep sea L. Petusa.

  6. Benign Duodenocolic Fistula: a Case Report

    Directory of Open Access Journals (Sweden)

    Marzieh Soheili

    2015-10-01

    Full Text Available Benign duodenocolic fistula (DCF, known as a fistula between the duodenum and colon with orwithout cecum of nonmalignant origin, is an unusual complication of different gastrointestinal diseases. Thepresent paper records a case in which the patient presented with chronic diarrhea, abdominal pain, weight lossas well as having a history of gastric ulcer. Most frequently the condition presents with signs ofmalabsorption such as weight loss and diarrhea, but other symptoms include nausea, vomiting (sometimeswith fecal, and abdominal pain. Gastrointestinal inflammatory conditions are the usual causes. The mostcommon ones are perforated duodenal ulcer and Crohn’s disease. Barium enemas are usually diagnostic.Treatment consists of excising the fistula and repairing the duodenal and colonic defects. Closure of thefistula provides quick relief.

  7. [The systemic approach to the rehabilitation of the patients presenting with laryngeal cancer after the resection of the organ and laryngectomy with tracheoesophageal by-pass and endoprosthetics].

    Science.gov (United States)

    Kryukov, A I; Reshetov, I V; Kozhanov, L G; Sdvizhkov, A M; Kozhanov, A L

    2016-01-01

    The objective of the present study was to enhance the effectiveness of rehabilitation of the patients presenting with laryngeal cancer after the resection of the organ and laryngotomy with tracheoesophageal by-pass and endoprosthetics. Our experience in this field is based on the treatment of 102 patients. They were distributed by the nosological forms as follows: primary laryngeal cancer in 97 patients including T1NoMo - 8 (8.2%), T2NoMo - 63 (65%), T3NoMo - 18 (17.6%), T2N1Mo - 1 (0.9%), T4NoMo - 3 (2.9%), and T4N1M0 - 4 (3.9%), root of the tongue cancer spreading over the vestibular part of the larynx in one patient, laryngeal sarcoma in one patient, relapse of cancer following the full-dose radiotherapy and organ-sparing surgery in 3 patients. Laryngeal resection was performed in 83 patients; 19 patients underwent laryngectomy with tracheoesophageal by-pass and endoprosthetics using a domestically manufactured voice prosthesis. The systemic approach to the rehabilitation of the patients and the use of the proposed treatment algorithm made it possible to restore the function of the larynx by means of organ-sparing surgery in 79 (95.1%) of the 83 patients. The vocal function in the patients following laryngectomy with tracheoesophageal by-pass and endoprosthetics was restored in 18 (94.7%) of the 19 patients. PMID:27500581

  8. Tracheobronchial Branching Anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Min Ji; Kim, Young Tong; Jou, Sung Shick [Soonchunhyang University, Cheonan Hospital, Cheonan (Korea, Republic of); Park, A Young [Soonchunhyang University College of Medicine, Asan (Korea, Republic of)

    2010-04-15

    There are various congenital anomalies with respect to the number, length, diameter, and location of tracheobronchial branching patterns. The tracheobronchial anomalies are classified into two groups. The first one, anomalies of division, includes tracheal bronchus, cardiac bronchus, tracheal diverticulum, pulmonary isomerism, and minor variations. The second one, dysmorphic lung, includes lung agenesis-hypoplasia complex and lobar agenesis-aplasia complex

  9. Aortocaval Fistula in a Behcet's Disease Patient

    Directory of Open Access Journals (Sweden)

    Yusuf Ata

    2009-01-01

    Full Text Available Behcet's disease (BD is a chronic, recurrent, systemic disease that is characterized by oral and genital ulcers and oculocutaneous inflammatory lesions. Cardiovascular involvement especially large artery involvement is a serious and vital complication of BD. Pseudoaneurysms in the major arteries may be the cause of sudden death in BD. In our case a pulsatile abdominal mass was determined to be an aortic pseudoaneurysm associated with BD and an aortocaval fistula. Here we report this case and a short review of literature because this is the first reported aortocaval fistula in a BD patient in English literature.

  10. CAROTID CAVERNOUS FISTULA: A RARE CASE REPORT

    Directory of Open Access Journals (Sweden)

    Satish Prasad

    2015-01-01

    Full Text Available Carotico - cavernous fistula represent abnormal communication between the carotid circulation and the cavernous sinus. They can be classified as direct or indirect which are separate conditions with different aetiologies. Direct Carotico - cavernous fistulas ( CCFs are often secondary to trauma, and as such the demographics reflect the distribution of head trauma, most commonly seen in the young male patients. Presentation is acute and symptoms develop rapidly. In contrast, indirect CCFs have a predilection for the postmenopausal female patient a nd the onset of symptoms is often insiduous. Other conditions that predispose to increased risk include . Ehlers - Danlos syndrome . Fibromuscular dysplasia .

  11. Laparoscopic repair for vesicouterine fistulae

    Directory of Open Access Journals (Sweden)

    Rafael A. Maioli

    2015-10-01

    Full Text Available ABSTRACT Objective: The purpose of this video is to present the laparoscopic repair of a VUF in a 42-year-old woman, with gross hematuria, in the immediate postoperative phase following a cesarean delivery. The obstetric team implemented conservative management, including Foley catheter insertion, for 2 weeks. She subsequently developed intermittent hematuria and cystitis. The urology team was consulted 15 days after cesarean delivery. Cystoscopy indicated an ulcerated lesion in the bladder dome of approximately 1.0cm in size. Hysterosalpingography and a pelvic computed tomography scan indicated a fistula. Materials and Methods: Laparoscopic repair was performed 30 days after the cesarean delivery. The patient was placed in the lithotomy position while also in an extreme Trendelenburg position. Pneumoperitoneum was established using a Veress needle in the midline infra-umbilical region, and a primary 11-mm port was inserted. Another 11-mm port was inserted exactly between the left superior iliac spine and the umbilicus. Two other 5-mm ports were established under laparoscopic guidance in the iliac fossa on both sides. The omental adhesions in the pelvis were carefully released and the peritoneum between the bladder and uterus was incised via cautery. Limited cystotomy was performed, and the specific sites of the fistula and the ureteral meatus were identified; thereafter, the posterior bladder wall was adequately mobilized away from the uterus. The uterine rent was then closed using single 3/0Vicryl sutures and two-layer watertight closure of the urinary bladder was achieved by using 3/0Vicryl sutures. An omental flap was mobilized and inserted between the uterus and the urinary bladder, and was fixed using two 3/0Vicryl sutures, followed by tube drain insertion. Results: The operative time was 140 min, whereas the blood loss was 100ml. The patient was discharged 3 days after surgery, and the catheter was removed 12 days after surgery

  12. Evaluation of hemodynamic significance of coronary fistulae. Diagnostic integration between coronary angiography and stress/rest myocardial scintigraphy

    International Nuclear Information System (INIS)

    It is here reported on the importance of the integration of data obtained from digital coronary angiography and stress/rest 99mTc sestamibi myocardial perfusion single photon emission tomography in evaluationing the hemodynamic significance of coronary arteriovenous fistulae. Coronary fistulae were detected with coronary angiography in 9 patients. All patients underwent clinical examination, trans thoracic echocardiography, stress electrocardiogram and stress/rest 99mTc sestamibi myocardial perfusion single photon emission tomography. Stress/rest 99mTc sestamibi myocardial perfusion single photon tomography and stress electrocardiogram showed stress-induced myocardial ischemia in 2 patients. The first patient with familial predisposition and risk factors for ischemic heart disease presented a mesocardic heart murmur on clinical examination. At stress ECG (125 Watt, 153 b/m max frequency 93%, arterial pressure 230 mmHg, max frequency pressure product 35200) ischemic alterations were recorded at the first minute of the second stage of the Bruce protocol. Coronary angiography detected a circumflex artery fistula in the coronary sinus. Stress/rest 99mTc sestamibi myocardial perfusion single photon emission tomography for the evaluation of stress/rest perfusion detected a reversible perfusion defect of the proximal portion of the posterolateral and lateral walls, thus confirming the hemodynamic importance of the flow through the fistula during stress cycloergometric testing. In the second patient familial predisposition to ischemic heart disease and previous inferior wall myocardial infarction and non-significant stress ECG, coronary angiography identified a seclusive stenosis of the right coronary artery and anomaly between the anterior interventricular artery and the left pulmonary artery. The presence of the contrast medium in the left pulmonary artery identified a flow from the left ventricle to the left pulmonary artery. Good angiographic results were obtained

  13. A Surviving Child With Complete Proximal Tracheal Atresia

    OpenAIRE

    Haight, Ken; Sankaran, Koravangattu; Shokeir, Mohamed

    1984-01-01

    An infant was born with an unusual combination of primitive foregut anomalies consisting of complete proximal tracheal atresia, proximal esophageal atresia and distal tracheoesophageal fistula. Before the birth, the family physician suspected an anomaly of the upper airway or esophageal occlusion on the basis of hydramnios evident at the thirty-third to thirty-fourth week of gestation, and earlier amniocentesis which indicated a normal level of α-fetoprotein. He consulted the hospital obstetr...

  14. Secondary Iliac-Enteric Fistula to the Sigmoid Colon Complicated with Entero-Grafto-Cutaneous Fistula

    Directory of Open Access Journals (Sweden)

    Gábor Bognár

    2008-04-01

    Full Text Available We report the case of a 67-year-old man who was admitted to our department with acute rectal bleeding. The patient had had previous aortoiliac surgery with the utilization of an aortobifemoral vascular prosthesis. Diagnosis of aortoenteric fistula was made between the distal suture line of the right graft leg and the sigmoid colon. This fistula had an enterocutaneous component. After exploratory laparotomy, primary resection of the sigmoid colon, exstirpation of the enterocutaneous fistula, excision of the right graft leg and extraanatomical crossover bypass were successfully performed. This study reports a rare type of aorto/ilac-enteric fistula to the left colon complicated with an entero-grafto-cutaneous component and describes an unusual and successful surgical treatment method.

  15. Coronary to pulmonary fistula as the primary source of pulmonary blood supply in pulmonary atresia with ventricular septal defect

    Directory of Open Access Journals (Sweden)

    Isman Firdaus

    2004-12-01

    Full Text Available A communication between the coronary and pulmonary arteries, so called coronary to pulmonary fistula, is a rare source of pulmonary supply in pulmonary atresia (PA with ventricular septal defect (VSD. A 4 year old girl referred to National Cardiovascular Center Harapan Kita, Jakarta with symptoms and signs of increased pulmonary blood flow since infancy and was confirmed by the chest x-rays. Heart examination revealed normal first heart sound with single loud second heart sound and an ejection systolic murmur at the pulmonary area. ECG demonstrated sinus rhythm with normal axis and biventricular hypertrophy. Echocardiography was performed and truncus arteriosus (TA type I was suspected with perimembranus VSD, overriding of the aorta, and dilated main pulmonary artery. But on cardiac catheterization studies, a non obstructive fistula was found between the left coronary and main pulmonary artery coexisted with PA and VSD. A successful surgery was performed subsequently and confirmed the above diagnosis. Although there were episodes of pulmonary hypertension crisis during early post operative course, she was then discharge from the hospital in a good condition. Since irreversible pulmonary vascular disease may develop in a non restrictive coronary to pulmonary fistula, early recognition of this anomaly is very important for better surgical result. (Med J Indones 2004; 13: 237-40Keywords: coronary to pulmonary fistula, pulmonary atresia, ventricular septal defect

  16. Coronary Arteriovenous Fistula Causing Hydrops Fetalis

    Directory of Open Access Journals (Sweden)

    Nilüfer Çetiner

    2014-01-01

    Full Text Available Fetal heart failure and hydrops fetalis may occur due to systemic arteriovenous fistula because of increased cardiac output. Arteriovenous fistula of the central nervous system, liver, bone or vascular tumors such as sacrococcygeal teratoma were previously reported to be causes of intrauterine heart failure. However, coronary arteriovenous fistula was not reported as a cause of fetal heart failure previously. It is a rare pathology comprising 0.2–0.4% of all congenital heart diseases even during postnatal life. Some may remain asymptomatic for many years and diagnosed by auscultation of a continuous murmur during a routine examination, while a larger fistulous coronary artery opening to a low pressure cardiac chamber may cause ischemia of the affected myocardial region due to steal phenomenon and may present with cardiomyopathy or congestive heart failure during childhood. We herein report a neonate with coronary arteriovenous fistula between the left main coronary artery and the right ventricular apex, who presented with hydrops fetalis during the third trimester of pregnancy.

  17. Scimitar syndrome with pulmonary arteriovenous fistulas.

    Science.gov (United States)

    Le Rochais, J P; Icard, P; Davani, S; Abouz, D; Evrard, C

    1999-10-01

    Right abnormal pulmonary venous return into the inferior vena cava associated with abnormal fissure, dextrocardia, and systemic arterial supply of a variable degree, are the characteristics of the scimitar syndrome. We report on a patient in whom this rare syndrome was associated with pulmonary arteriovenous fistulas within the involved lung.

  18. CT demonstration of an aortoesophageal fistula.

    Science.gov (United States)

    Longo, J M; Lopez-Rasines, G; Ortega, E; Pagola, M A

    1987-01-01

    A case of aortoesophageal fistula (AEF) is reported in a patient with esophageal bleeding resulting from ingestion of a foreign body. CT showed a saccular aneurysm in close proximity to the esophageal lumen at the level of the bleeding site. AEF has not previously been described on CT. PMID:3107831

  19. Endovascular treatment of hemodialysis arteriovenous fistulas

    DEFF Research Database (Denmark)

    Heerwagen, Søren T; Hansen, Marc A; Schroeder, Torben V;

    2012-01-01

    Purpose: The purpose of this study was to investigate if the immediate hemodynamic outcome of an endovascular intervention on a dysfunctional hemodialysis arteriovenous fistula is a prognostic factor for primary patency. Methods: This was a prospective observational study including 61 consecutive...

  20. Arteriovenous fistula: An evidence based practice in nursing care

    Directory of Open Access Journals (Sweden)

    Evangelia Prevyzi

    2013-01-01

    Full Text Available The arteriovenous fistula (AVF is the most frequent form of vascular access for patients undergoing haemodialysis because it ensures good quality of dialysis and reduce haemodialysis mortality. For this reason, the nephrology nurse plays an important role in the appropriate care of fistula with a view to promoting the longevity and prevention of complications. Purpose: The purpose of this review was to investigate the role of Nephrology nurse in the appropriate care of fistula, promoting longevity and reducing complications, based on scientific data and international guidelines. Material-Method: The methodology followed in this review relied on literatures reviews and investigative studies, which were carried out during the period 2000-2012 and international (Medline, PubMed, Cinahl and Greek databases (Iatrotek on the care and management of fistula in people undergoing chronic haemodialysis. Key-words were used: Arteriovenous fistula, cannulation techniques fistula, guidelines, vascular access, role of nurse. Results: The arteriovenous fistula (AVF is the life line for patients undergoing haemodialysis. For this reason, the appropriate care of fistula and its maintenance in a good condition plays an important role for patient΄s life. Conclusions: Nephrology nurse has a major role in the proper management of the fistula and the education of the patient. Additionally, there is a need for cooperation between all the members of the multidisciplinary team, which includes dialysis nurse, nefrologist, access surgeon, and radiologist, for the broader assessment of fistula and the prevention and timely treatment of any complications.

  1. Endovascular therapy of arteriovenous fistulae with electrolytically detachable coils

    Energy Technology Data Exchange (ETDEWEB)

    Jansen, O.; Doerfler, A.; Forsting, M.; Hartmann, M.; Kummer, R. von; Tronnier, V.; Sartor, K. [Dept. of Neuroradiology, University of Heidelberg Medical School (Germany)

    1999-12-01

    We report our experience in using Guglielmi electrolytically detachable coils (GDC) alone or in combination with other materials in the treatment of intracranial or cervical high-flow fistulae. We treated 14 patients with arteriovenous fistulae on brain-supplying vessels - three involving the external carotid or the vertebral artery, five the cavernous sinus and six the dural sinuses - by endovascular occlusion using electrolytically detachable platinum coils. The fistula was caused by trauma in six cases. In one case Ehlers-Danlos syndrome was the underlying disease, and in the remaining seven cases no aetiology could be found. Fistulae of the external carotid and vertebral arteries and caroticocavernous fistulae were reached via the transarterial route, while in all dural fistulae a combined transarterial-transvenous approach was chosen. All fistulae were treated using electrolytically detachable coils. While small fistulae could be occluded with electrolytically detachable coils alone, large fistulae were treated by using coils to build a stable basket for other types of coil or balloons. In 11 of the 14 patients, endovascular treatment resulted in complete occlusion of the fistula; in the remaining three occlusion was subtotal. Symptoms and signs were completely abolished by this treatment in 12 patients and reduced in 2. On clinical and neuroradiological follow-up (mean 16 months) no reappearance of symptoms was recorded. (orig.)

  2. Malignant transformation of perianal and enterocutaneous fistulas is rare: results of 17 years of follow-up from The Netherlands

    NARCIS (Netherlands)

    J.E. Baars; E.J. Kuipers; G. Dijkstra; D.W. Hommes; D.J. de Jong; P.C.F. Stokkers; B. Oldenburg; M. Pierik; P.J. Wahab; A.A. van Bodegraven; C.J. van der Woude

    2011-01-01

    Objective. Malignant transformation of fistulas has been observed, particularly in perianal fistulas in Crohn's disease (CD) patients. The prevalence of adenocarcinoma in enterocutaneous fistulas and non-CD-related fistulas, however, is unknown. We investigated adenocarcinoma originating from perian

  3. Malignant transformation of perianal and enterocutaneous fistulas is rare : results of 17 years of follow-up from The Netherlands

    NARCIS (Netherlands)

    Baars, Judith E.; Kuipers, Ernst J.; Dijkstra, Gerard; Hommes, Daniel W.; de Jong, Dirk J.; Stokkers, Pieter C. F.; Oldenburg, Bas; Pierik, Marieke; Wahab, Peter J.; van Bodegraven, Adriaan A.; van der Woude, Christien J.

    2011-01-01

    Objective. Malignant transformation of fistulas has been observed, particularly in perianal fistulas in Crohn's disease (CD) patients. The prevalence of adenocarcinoma in enterocutaneous fistulas and non-CD-related fistulas, however, is unknown. We investigated adenocarcinoma originating from perian

  4. Malignant transformation of perianal and enterocutaneous fistulas is rare: results of 17 years of follow-up from The Netherlands

    NARCIS (Netherlands)

    Baars, J.E.; Kuipers, E.J.; Dijkstra, G.; Hommes, D.W.; Jong, D.J. de; Stokkers, P.C.; Oldenburg, B.; Pierik, M.; Wahab, P.J.; Bodegraven, A.A. van; Woude, C.J. van der

    2011-01-01

    OBJECTIVE: Malignant transformation of fistulas has been observed, particularly in perianal fistulas in Crohn's disease (CD) patients. The prevalence of adenocarcinoma in enterocutaneous fistulas and non-CD-related fistulas, however, is unknown. We investigated adenocarcinoma originating from perian

  5. Familial Poland anomaly.

    OpenAIRE

    David, T J

    1982-01-01

    The Poland anomaly is usually a non-genetic malformation syndrome. This paper reports two second cousins who both had a typical left sided Poland anomaly, and this constitutes the first recorded case of this condition affecting more than one member of a family. Despite this, for the purposes of genetic counselling, the Poland anomaly can be regarded as a sporadic condition with an extremely low recurrence risk.

  6. Tentorial artery embolization in tentorial dural arteriovenous fistulas

    Energy Technology Data Exchange (ETDEWEB)

    Rooij, Willem Jan van; Sluzewski, Menno [St. Elisabeth Ziekenhuis, Department of Radiology, Tilburg (Netherlands); Beute, Guus N. [St. Elisabeth Ziekenhuis, Department of Neurosurgery, Tilburg (Netherlands)

    2006-10-15

    The tentorial artery is often involved in arterial supply to tentorial dural fistulas. The hypertrophied tentorial artery is accessible to embolization, either with glue or with particles. Six patients are presented with tentorial dural fistulas, mainly supplied by the tentorial artery. Two patients presented with intracranial hemorrhage, two with pulsatile tinnitus and one with progressive tetraparesis, and in one patient the tentorial dural fistula was an incidental finding. Different endovascular techniques were used to embolize the tentorial artery in the process of endovascular occlusion of the fistulas. All six tentorial dural fistulas were completely occluded by endovascular techniques, confirmed at follow-up angiography. There were no complications. When direct catheterization of the tentorial artery was possible, glue injection with temporary balloon occlusion of the internal carotid artery at the level of the tentorial artery origin was effective and safe. Different endovascular techniques may be successfully applied to embolize the tentorial artery in the treatment of tentorial dural fistulas. (orig.)

  7. Asymptomatic Cholecystocolonic Fistula: A Diagnostic and Therapeutic Dilemma

    Directory of Open Access Journals (Sweden)

    Nicola Antonacci

    2013-01-01

    Full Text Available Cholecystocolonic fistulas (CCF are rare complications of gallstones with a variable clinical presentation. Despite modern diagnostic tools, cholecystocolonic fistulas are often asymptomatic and it is difficult to diagnose them preoperatively. Biliary-enteric fistulae have been found in 0.9% of patients undergoing biliary tract surgery. The most common site of communication of the fistula is the cholecystoduodenal (70%, followed by the cholecystocolic (10–20%, and the least common is the cholecystogastric fistula. Herein, we report a case of female patient with multiple episodes of acute recurrent cholangitis due to common bile duct and gallbladder stones in which preoperative imaging studies were negative for cholecystocolonic fistula that was incidentally discovered and treated during surgery and was appropriately treated. A review of the literature is reported too.

  8. Genitourinary Fistula - An Experience from Tertiary Care Hospital

    Directory of Open Access Journals (Sweden)

    Kallol K. Roy, Neena Malhotra, Sunesh Kumar, Amlesh Seth*, Bonilla Nayar

    2006-07-01

    Full Text Available Genito urinary fistula remains a frustrating condition for patients in the developing world. Weretrospectively analysed twenty three women who underwent fistula repair over the last 5 years in oneunit at Department of Obstetric and Gynaecology, All India Institute of Medical Sciences. Twenty-sevenfistulae were repaired in 23 women of which 78.2% were vesecovaginal fistula. Majority of these fistula(73.9% were obstetric in origin, as a result of neglected, mismanaged labour. Surgical repair was themainstay with 100% success for those undergoing primary repair and an overall success rate of 83.3% forvesico vaginal fistula. Though principles of fistula repair were adhered to by the operating surgeon, eachpatient was unique. Surgeons trained in such repair can individually vary approach and technique to suiteach patient giving high success rate.

  9. Temporary mushroom like covered stent placement with transnasal esophageal fistula abscess drainage for gastroesophageal anastomotic fistula

    International Nuclear Information System (INIS)

    Objective: To investigate the therapeutic effects on gastroesophageal anastomotic fistula with temporary placing covered stent of mushroom shape and transnasal drainage of gastroesophageal anastomotic abscess. Methods: For 8 patients with gastroesophageal anastomotic fistula, under fluoroscopic guidance, the drainage tube was put into the abscess cavity through nasal cavity and esophageal fistula, then stent was implanted within the esophagus. The abscess cavity was aspirated and esophagogram was taken in suitable time. Retaining the drainage tube about one month and then the stent was withdrawn after one week of the taken out of the former. Results: The drainage of abscess and stent placement was successful. The drainage tube was pulled out during 14-21 days after placement. The stent should be removed within one month. All fistulas were closed up and the abscesses disappeared. Conclusions: It is a safe, efficient, complicationless, non-invasive method to treat gastroesophageal anastomotic fistula with temporary placing covered stent with mushroom shape and drainage of abscess through nasal cavity and esophagus. Temporary mushroom-like covered stent placement with transnasal gastroesophageal anastomotic abscess drainage is a safe efficient, complication-less non-invasive method used interventionally. (authors)

  10. Fistulotomy and marsupialisation for simple fistula-in-ano.

    Science.gov (United States)

    Yang, C Y

    1992-06-01

    Nineteen consecutive cases of simple fistula-in-ano treated with fistulotomy and marsupialisation were retrospectively reviewed. Fourteen cases were simple intersphincteric and the remaining 5 cases were uncomplicated transphincteric fistulae. The cases were followed up for between 3 to 10 months (mean 6.9 months). There were no reports of bowel incontinence or recurrence of fistula. The advantages of this 'tissue conserving' procedure are discussed in the paper. PMID:1631585

  11. Oronasal Fistula and Complete Edentulism: What to Do?

    OpenAIRE

    Pushappreet Kaur; Jaspinder Kaur

    2014-01-01

    Oronasal fistula is an internal fistula which represents an abnormal epitheliazed tract between oral and nasal cavity, thus impairing associated functions of deglutition and speech by nasal regurgitation of fluid and nasal speech respectively, besides risk of nasal infection resulting from food lodgement. This paper provides a brief yet definitive insight on the etiology, diagnosis and surgical closure of oronasal fistula along with a case report and discussion on prosthodontic rehabilitation...

  12. Arteriovenous fistula: An evidence based practice in nursing care

    OpenAIRE

    Evangelia Prevyzi

    2013-01-01

    The arteriovenous fistula (AVF) is the most frequent form of vascular access for patients undergoing haemodialysis because it ensures good quality of dialysis and reduce haemodialysis mortality. For this reason, the nephrology nurse plays an important role in the appropriate care of fistula with a view to promoting the longevity and prevention of complications. Purpose: The purpose of this review was to investigate the role of Nephrology nurse in the appropriate care of fistula, promoting lon...

  13. Chylous Fistula following Axillary Lymphadenectomy: Benefit of Octreotide Treatment

    Directory of Open Access Journals (Sweden)

    Elena González-Sánchez-Migallón

    2016-01-01

    Full Text Available Chyle leak following axillary lymph node clearance is a rare yet important complication. The treatment of postoperative chyle fistula still remains unclear. Conservative management is the first line of treatment. It includes axillary drains on continuous suction, pressure dressings, bed rest, and nutritional modifications. The use of somatostatin analogue is well documented as a treatment for chylous fistulas after neck surgery. We present a case of chylous fistula after axillary surgery resolved with the use of octreotide.

  14. Pharyngocutaneous fistula onset after total laryngectomy: scintigraphic analysis

    OpenAIRE

    Galli, J; VALENZA V; Parrilla, C; Galla, S; Marchese, MR; P. Castaldi; ALMADORI, G.; Paludetti, G

    2009-01-01

    Pharyngocutaneous fistula is the most common non-fatal complication following total laryngectomy. To start oral feeding and exclude the presence of a pharyngocutaneous fistula, a subjective test and instrumental assessments using videofluoroscopy, have been described. The aim of this study was to evaluate the effectiveness of oral-pharyngo-oesophageal scintigraphy as an objective and non-invasive tool to establish presence, site and dimensions of the fistula. Observations were performed on 3 ...

  15. Three-dimensional ultrasound imaging for diagnosis of urethrovaginal fistula.

    Science.gov (United States)

    Quiroz, Lieschen H; Shobeiri, S Abbas; Nihira, Mikio A

    2010-08-01

    We present a novel technique for visualization of a urethrovaginal fistula. A 52-year-old patient presented with persistent urinary incontinence, after having three mid-urethral sling procedures performed within the past year. The diagnosis of a urethrovaginal fistula was made by endovaginal 3-D endovaginal ultrasound and confirmed intraoperatively. We have described a novel technique that may benefit patients with urethrovaginal fistulas that are difficult to visualize.

  16. Treatment of tracheopharyngeal and tracheo-oesophageal fistulas following laryngectomy and fistula classification based on individual silicone casts.

    Science.gov (United States)

    Herzog, Michael; Lorenz, Kai J; Glien, Alexander; Greiner, Ingo; Plontke, Stefan; Plößl, Sebastian

    2015-10-01

    Persistent tracheopharyngeal (TPF) and tracheo-oesophageal (TEF) fistulas after laryngectomy create a therapeutic challenge. The current classification of TPFs and TEFs is based on clinical experience without detailed anatomical information. In this study, casts of TPFs/TEFs were obtained from 16 patients; these were the first steps in manufacturing customised prostheses. Fistulas were classified according to the shape and dimension of the tracheopharyngeal and tracheo-oesophageal silicone casts and prostheses as well as on epithetic requirements. Four different types of fistulas were classified: Type A, a fistula with a straight axis between the neopharynx and oesophagus; Type B, a fistula with a stenosis of the neopharynx but a straight axis; Type C, the axis between the neopharynx and oesophagus is flexed anteriorly; and Type D, neighbouring structures are absent creating a large defect. This classification system might improve the manufacturing processes of customised prostheses in individual cases with challenging tracheopharyngeal and tracheo-oesophageal fistulas. PMID:25178413

  17. Heuber Maneuver in Evaluation of Direct Carotid-Cavernous Fistula

    Science.gov (United States)

    Rajagopal, Rengarajan; Mehta, Neeraj; Saran, Sonal; Khera, Pushpinder S.

    2016-01-01

    Summary Carotid-cavernous fistulas are abnormal communications between the carotid system and the cavernous sinus. Elevated venous pressure produces congestion in the orbit with resultant transudation of fluid and increased intraocular pressure, thereby leading to secondary glaucoma which may result in visual loss. Immediate treatment is hence, warranted in these cases. The planning of endovascular management is dependent on many parameters, the most important of which are the size and location of the fistula. Since these are high-flow fistulas, assessment requires certain manoeuvers. Heuber manoeuver is one of the manoeuvers used to demonstrate the size of the fistula.

  18. Oronasal Fistula and Complete Edentulism: What to Do?

    Directory of Open Access Journals (Sweden)

    Pushappreet Kaur

    2014-12-01

    Full Text Available Oronasal fistula is an internal fistula which represents an abnormal epitheliazed tract between oral and nasal cavity, thus impairing associated functions of deglutition and speech by nasal regurgitation of fluid and nasal speech respectively, besides risk of nasal infection resulting from food lodgement. This paper provides a brief yet definitive insight on the etiology, diagnosis and surgical closure of oronasal fistula along with a case report and discussion on prosthodontic rehabilitation of a 65 year old female with an iatrogenic oronasal fistula developed as a result of maxillary molar extraction using a complete metal based denture.

  19. Orbicularis oris musculomucosal flap for anterior palatal fistula

    Directory of Open Access Journals (Sweden)

    Tiwari V

    2006-01-01

    Full Text Available Anterior palatal fistulae or residual anterior clefts are a frequent problem following palatoplasty. Various techniques have been used to repair such fistulae, each having its own advantages and disadvantages. We have successfully used orbicularis oris musculomucosal flap to close anterior fistula and residual clefts in 25 patients. This study shows the superiority of this flap over other techniques because of its reliable blood supply, easy elevation and transfer to fistula site and finally because it is a single-stage procedure.

  20. Current Diagnosis and Management of Pelvic Fistulae in Women.

    Science.gov (United States)

    Rogers, Rebecca G; Jeppson, Peter C

    2016-09-01

    Pelvic fistulae are an abnormal communication among the genitourinary tract, the gastrointestinal tract, and the vagina or perineum. Genital tract fistulae have been described in the medical literature for the past several thousand years. Advancements in both the diagnosis and treatment of vaginal fistulae have been obtained over the past century as surgical interventions have become safer and surgical techniques have improved. The most common cause of fistulae worldwide is obstructed labor. In developed countries, fistulae most commonly occur after benign gynecologic surgery, but obstructed labor, malignancy, radiation exposure, and inflammatory bowel disease can also cause fistulae. Fistulae significantly affect quality of life. Diagnostic studies and radiologic imaging can help aid the diagnosis, but a thorough physical examination is the most important component in the evaluation and diagnosis of a fistula. Temporizing treatments are available to help ease patient suffering until surgical management can be performed. Surgical repairs can be performed using an abdominal, vaginal, or transanal approach. Although technically challenging, surgical repair is usually successful, but closure of the fistula tract does not guarantee continence of urine or feces, because there is often underlying damage to the bowel and bladder. PMID:27500321

  1. Management of fistula-in-ano: An introduction

    Institute of Scientific and Technical Information of China (English)

    AM El-Tawil

    2011-01-01

    Peri-anal fistulae are a worldwide health problem that can affect any person anywhere. Surgical management of these fistulae is not free from risks. Recurrence and fecal incontinence are the most common complica-tions after surgery. The cumulative personal surgical experience in managing cases with anal fistulae is sig-nificantly considered as necessary for obtaining better results with minimal adverse effects after surgery. The purpose for conducting this survey is to facilitate better outcome after surgical interventions in idiopathic anal fistulae' cases.

  2. Dialysis fistula or graft: the role for randomized clinical trials.

    Science.gov (United States)

    Allon, Michael; Lok, Charmaine E

    2010-12-01

    The Fistula First Initiative has strongly encouraged nephrologists, vascular access surgeons, and dialysis units in the United States to make valiant efforts to increase fistula use in the hemodialysis population. Unfortunately, the rigid "fistula first" recommendations are not based on solid, current, evidence-based data and may be harmful to some hemodialysis patients by subjecting them to prolonged catheter dependence with its attendant risks of bacteremia and central vein stenosis. Once they are successfully cannulated for dialysis, fistulas last longer than grafts and require fewer interventions to maintain long-term patency for dialysis. However, fistulas have a much higher primary failure rate than grafts, require more interventions to achieve maturation, and entail longer catheter dependence, thereby leading to more catheter-related complications. Given the tradeoffs between fistulas and grafts, there is equipoise about their relative merits in patients with moderate to high risk of fistula nonmaturation. The time is right for definitive, large, multicenter randomized clinical trials to compare fistulas and grafts in various subsets of chronic kidney disease patients. Until the results of such clinical trials are known, the optimal vascular access for a given patients should be determined by the nephrologist and access surgeon by taking into account (1) whether dialysis has been initiated, (2) the patient's life expectancy, (3) whether the patient has had a previous failed vascular access, and (4) the likelihood of fistula nonmaturation. Careful clinical judgment should optimize vascular access outcomes and minimize prolonged catheter dependence among hemodialysis patients. PMID:21030576

  3. Detachable balloon embolization of an aneurysmal gastroduodenal arterioportal fistula

    Energy Technology Data Exchange (ETDEWEB)

    Defreyne, Luc; De Schrijver, Ignace; Vanlangenhove, Peter; Kunnen, Marc [Department of Radiology and Medical Imaging, Ghent University Hospital (Belgium)

    2002-01-01

    Extrahepatic arteriovenous fistulas involving the gastroduodenal artery and the portal venous system are rare and almost always a late complication of gastric surgery. Secondary portal hypertension and mesenteric ischemia may provoke abdominal pain, upper and lower gastrointestinal hemorrhage, diarrhea, and weight loss. Until recently, surgical excision has been the therapy of choice with excellent results. The authors report a case of gastroduodenal arterioportal fistula with a rare large interpositioned aneurysm in a cardiopulmonary-compromised patient who was considered a non-surgical candidate. The gastroduodenal arterioportal fistula was occluded endovascularly by means of a detachable balloon. A survey of the literature of this rare type of arterioportal fistula is included. (orig.)

  4. Countermeasure against postoperative fistulas of head and neck cancer

    International Nuclear Information System (INIS)

    It is very difficult to treat postoperative fistulas of head and neck cancer by irradiation and other preoperative therapy. We reviewed 179 patients with oral cancer, mesopharyngeal and hypopharyngeal cancer underwent reconstruction between 1994 and 2003. Our analysis reveals that the incidence of fistula is 18.4% and exposure dose is predisposing factor for fistula formation. We observed many fistulas in posterior of oral floor and pedicle flap more than free flap. There are 14 patients of surgical repair, we detected pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA) in them. (author)

  5. An unusual case of pancreatic fistula.

    Science.gov (United States)

    Johnston, M J; Prew, C L; Fraser, I

    2013-03-21

    We report an unusual case of a pancreatic fistula communicating with an appendicectomy wound. This occurred following an episode of acute haemorrhagic pancreatitis. The patient was initially admitted with signs and symptoms indicating appendicitis and went to theatre for an open appendicectomy. However, this did not resolve his symptoms and a laparotomy was performed the next day revealing haemorrhagic pancreatitis. He endured a stormy post-operative course, the cause of which was found to be an external pancreatic fistula with discharge of amylase-rich fluid from the Lanz incision. A trial of conservative management failed despite multiple percutaneous drainage procedures and treatment with broad-spectrum antibiotics. After a second opinion was sought, it was decided to fit a roux loop anastomosis between the head of the pancreas and the duodenum to divert the fistulous fluid. This procedure was a success and the patient remains well 2 years later.

  6. Dural fistulas of the cavernous sinus

    Energy Technology Data Exchange (ETDEWEB)

    Guibert-Tranier, F.; Piton, J.; Caille, J.M.; Lemoine, J.J.

    1984-11-01

    Five cases of dural fistulas of the cavernous sinus are reported. The clinical aspect of this lesion is often misleading in the absence of subjective or objective bruits. The diagnosis is made at angiography which should systematically include the internal and external carotid arteries bilaterally. The goal of this study was to elucidate the great variability of the venous drainage and to correlate it with the clinical symptoms and course. The main problem is to know when and how these fistulas should be treated. Vascular ligatures should not be performed. Therapeutic angiography is the treatment of choice, but should be limited to the following indications: poorly tolerated bruits, severe ophthalmic damage (elevated ocular tension, diminished visual acuity, or oculomotor paralysis), angiographically demonstrated massive arteriovenous shunting, and a high degree of cortical venous reflux. Whatever the indication, the course after embolisation is rarely predictable and in particular the risk of extensive venous thrombosis or recurrence is great.

  7. Dural fistulas of the cavernous sinus

    International Nuclear Information System (INIS)

    Five cases of dural fistulas of the cavernous sinus are reported. The clinical aspect of this lesion is often misleading in the absence of subjective or objective bruits. The diagnosis is made at angiography which should systematically include the internal and external carotid arteries bilaterally. The goal of this study was to elucidate the great variability of the venous drainage and to correlate it with the clinical symptoms and course. The main problem is to know when and how these fistulas should be treated. Vascular ligatures should not be performed. Therapeutic angiography is the treatment of choice, but should be limited to the following indications: poorly tolerated bruits, severe ophthalmic damage (elevated ocular tension, diminished visual acuity, or oculomotor paralysis), angiographically demonstrated massive arteriovenous shunting, and a high degree of cortical venous reflux. Whatever the indication, the course after embolisation is rarely predictable and in particular the risk of extensive venous thrombosis or recurrence is great. (orig.)

  8. An unusual case of pancreatic fistula.

    Science.gov (United States)

    Johnston, M J; Prew, C L; Fraser, I

    2013-01-01

    We report an unusual case of a pancreatic fistula communicating with an appendicectomy wound. This occurred following an episode of acute haemorrhagic pancreatitis. The patient was initially admitted with signs and symptoms indicating appendicitis and went to theatre for an open appendicectomy. However, this did not resolve his symptoms and a laparotomy was performed the next day revealing haemorrhagic pancreatitis. He endured a stormy post-operative course, the cause of which was found to be an external pancreatic fistula with discharge of amylase-rich fluid from the Lanz incision. A trial of conservative management failed despite multiple percutaneous drainage procedures and treatment with broad-spectrum antibiotics. After a second opinion was sought, it was decided to fit a roux loop anastomosis between the head of the pancreas and the duodenum to divert the fistulous fluid. This procedure was a success and the patient remains well 2 years later. PMID:24964425

  9. Percutaneous transarterial embolization of extrahepatic arteroportal fistula

    Institute of Scientific and Technical Information of China (English)

    Gianluca Marrone; Settimo Caruso; Roberto Miraglia; Ilaria Tarantino; Riccardo Volpes; Angelo Luca

    2006-01-01

    Arteroportal fistula is a rare cause of prehepatic portalhypertension. A 44-year-old male with hepatitis virus C infection was admitted for acute variceal bleeding.Endoscopy showed the presence of large esophageal varices. The ultrasound revealed a mass near the head of pancreas, which was characterized at the colorDoppler by a turbulent flow, and arterialization of portal vein flow. CT scan of abdomen showed a large aneurysm of the gastroduodenal artery communicating into the superior mesenteric vein. The sinusoidal portal pressure measured as hepatic vein pressure gradient was normal, confirming the pre-hepatic origin of portal hypertension. The diagnosis of extrahepatic portal hypertension secondary to arteroportal fistula was established, and the percutaneous embolization was performed.Three months later, the endoscopy showed absence of esophageal varices and ascites. At the moment, the patient is in good clinical condition, without signs of portal hypertension.

  10. Competing Orders and Anomalies.

    Science.gov (United States)

    Moon, Eun-Gook

    2016-01-01

    A conservation law is one of the most fundamental properties in nature, but a certain class of conservation "laws" could be spoiled by intrinsic quantum mechanical effects, so-called quantum anomalies. Profound properties of the anomalies have deepened our understanding in quantum many body systems. Here, we investigate quantum anomaly effects in quantum phase transitions between competing orders and striking consequences of their presence. We explicitly calculate topological nature of anomalies of non-linear sigma models (NLSMs) with the Wess-Zumino-Witten (WZW) terms. The non-perturbative nature is directly related with the 't Hooft anomaly matching condition: anomalies are conserved in renormalization group flow. By applying the matching condition, we show massless excitations are enforced by the anomalies in a whole phase diagram in sharp contrast to the case of the Landau-Ginzburg-Wilson theory which only has massive excitations in symmetric phases. Furthermore, we find non-perturbative criteria to characterize quantum phase transitions between competing orders. For example, in 4D, we show the two competing order parameter theories, CP(1) and the NLSM with WZW, describe different universality class. Physical realizations and experimental implication of the anomalies are also discussed. PMID:27499184

  11. Anomalies and topology

    International Nuclear Information System (INIS)

    The lectures given cover the topological effects in gauge field theories, fermionic chiral anomalies, and some relationships between the two. Gauge field theories in three and four space-time dimensions are considered. Topological terms as external U(1) functional gauge potential connections in field space are discussed. Both the structure and physical impact of anomalies are described. 17 refs

  12. Competing Orders and Anomalies

    Science.gov (United States)

    Moon, Eun-Gook

    2016-08-01

    A conservation law is one of the most fundamental properties in nature, but a certain class of conservation “laws” could be spoiled by intrinsic quantum mechanical effects, so-called quantum anomalies. Profound properties of the anomalies have deepened our understanding in quantum many body systems. Here, we investigate quantum anomaly effects in quantum phase transitions between competing orders and striking consequences of their presence. We explicitly calculate topological nature of anomalies of non-linear sigma models (NLSMs) with the Wess-Zumino-Witten (WZW) terms. The non-perturbative nature is directly related with the ’t Hooft anomaly matching condition: anomalies are conserved in renormalization group flow. By applying the matching condition, we show massless excitations are enforced by the anomalies in a whole phase diagram in sharp contrast to the case of the Landau-Ginzburg-Wilson theory which only has massive excitations in symmetric phases. Furthermore, we find non-perturbative criteria to characterize quantum phase transitions between competing orders. For example, in 4D, we show the two competing order parameter theories, CP(1) and the NLSM with WZW, describe different universality class. Physical realizations and experimental implication of the anomalies are also discussed.

  13. Successful laparoscopic management for cholecystoenteric fistula

    Institute of Scientific and Technical Information of China (English)

    Wen-Ke Wang; Chun-Nan Yeh; Yi-Yin Jan

    2006-01-01

    AIM: Since 1987, laparoscopic cholecystectomy (LC)has been widely used as the favored treatment for gallbladder lesions. Cholecystoenteric fistula (CF) is an uncommon complication of the gallbladder disease, which has been one of the reasons for the conversion from LC to open cholecystectomy. Here, we have reported four cases of CF managed successfully by laparoscopic approach without conversion to open cholecystectomy.METHODS: During the 4-year period from 2000 to 2004, the medical records of the four patients with CF treated successfully with laparoscopic management at the Chang Gung Memorial Hospital-Taipei were retrospectively reviewed.RESULTS: The study comprised two male and two female patients with ages ranging from 36 to 74 years (median: 53.5 years). All the four patients had right upper quadrant pain. Two of the four patients were detected with pneumobilia by abdominal ultrasonography.One patient was diagnosed with cholecystocolic fistula preoperatively correctly by endoscopic retrograde cholangiopancreatography and the other one was diagnosed as cholecystoduodenal fistula by magnetic resonance cholangiopancreatography. Correct preoperative diagnosis of CF was made in two of the four patients with 50% preoperative diagnostic rate. All the four patients underwent LC and closure of the fistula was carried out by using Endo-GIA successfully with uneventful postoperative courses. The hospital stay of the four patients ranged from 7 to 10 d (median, 8 d).CONCLUSION: CF is a known complication of chronic gallbladder disease that is traditionally considered as a contraindication to LC. Correct preoperative diagnosis of CF demands high index of suspicion and determines the success of laparoscopic management for the subset of patients. The difficult laparoscopic repair is safe and effective in the experienced hands of laparoscopic surgeons.

  14. Pancreaticoureteral Fistula Following Penetrating Abdominal Trauma

    Directory of Open Access Journals (Sweden)

    Joshua H Wolf

    2007-09-01

    Full Text Available Context The main pancreatic duct can form a fistulous communication with another epithelium in the setting of prolonged inflammation, operative manipulation, or direct trauma. We present a rare complication of a pancreaticoureteral fistula following a trauma nephrectomy. Case report A 17-year-old male who sustained a gunshot wound to the back arrived to our Emergency Room hyopotensive, tachycardic, and with free intraperitoneal fluid on focused assessment sonography for trauma (FAST exam. He was taken to the operating room for an exploratory laporatomy where a left nephrectomy was performed to control active bleeding from the left renal hilum. Significant bleeding was also encountered at the portal venous confluence. After packing and damage control laparotomy, the periportal/pancreatic bleeding was controlled during a second procedure 6 hours later. After one month in the Intensive Care Unit with an open abdomen, a computed tomography (CT scan revealed a fluid collection in the splenic fossa which was drained by catheter. Persistent drainage revealed a high amylase concentration (greater than 50,000 U/L. A fistulogram revealed interruption of the main pancreatic duct, and a fluid collection by the tail of the pancreas that was in communication with the left ureter. The patient’s urine amylase was also elevated. The patient was treated nonoperatively given the healing open abdomen and controlled fistula. He had an otherwise uncomplicated recovery. Conclusions This is the second report of a pancreaticoureteral fistula in the literature. Treatment of this communication should be similar to that of other pancreatic fistulae.

  15. An unusual case of pancreatic fistula

    OpenAIRE

    Johnston, M. J.; Prew, C.L.; Fraser, I

    2013-01-01

    We report an unusual case of a pancreatic fistula communicating with an appendicectomy wound. This occurred following an episode of acute haemorrhagic pancreatitis. The patient was initially admitted with signs and symptoms indicating appendicitis and went to theatre for an open appendicectomy. However, this did not resolve his symptoms and a laparotomy was performed the next day revealing haemorrhagic pancreatitis. He endured a stormy post-operative course, the cause of which was found to be...

  16. Traumatic fistula:the case for reparations

    Directory of Open Access Journals (Sweden)

    Arletty Pinel

    2007-01-01

    Full Text Available As a conflict strategy, women are often sexually assaulted using sticks, guns, branches of trees and bottles. Women’s genitals are deliberately destroyed, some permanently. Traumatic fistula often results. As with victims of torture and other grave human rights abuses, there exists an obligation to restore the women to health as far as possible and to provide reparation for their violations.

  17. Pancreatic pseudocyst-portal vein fistula: Serial imaging and clinical follow-up from pseudocyst to fistula

    Energy Technology Data Exchange (ETDEWEB)

    Jee, Keun Nahn [Dept. of Radiology, Dankook University Hospital, Dankook University College of Medicine, Cheonan (Korea, Republic of)

    2015-03-15

    Pancreatic pseudocyst-portal vein fistula is an extremely rare complication of pancreatitis. Only 18 such cases have been previously reported in the medical literature. However, a serial process from pancreatic pseudocyst to fistula formation has not been described. The serial clinical and radiological findings in a 52-year-old chronic alcoholic male patient with fistula between pancreatic pseudocyst and main portal vein are presented.

  18. Transcatheter closure of coronary artery fistula using Guglielmi detachable coil

    Institute of Scientific and Technical Information of China (English)

    Muhammad Munawar; Bambang B. Siswanto; Ganesha M. Harimurti; Thach N. Nguyen

    2012-01-01

    Background Coronary artery fistula (CAF) is a rare anomaly.Transcatheter CAF closure has been introduced using various materials,but only few data are available on the Guglielmi detachable coil (GDC).The advantage of using GDC for transcatheter CAF closure is more controllable,therefore much safer when compared to other coils.This report is about our experience in transcatheter closure of CAF using fibered GDC in our hospital.Methods & Results From 2002 to 2007,there were 10 patients with CAFs (age range:28 to 56 year-old,7 males) who underwent transcatheter CAF closure.There were a total of 19 CAFs which originated from right coronary (n =5),left circumflex (n =3),left anterior descending artery (n =10) and left main trunk (n =1).Median number of coil deployment for each fistula was 3 (range:1 to 6).The pulmonary artery was the most common site of the distal communication of CAFs (n =14),followed by right atrium (n =3),left atrium (n =1) and left ventricle (n =1).Immediate coronary angiography after GDC deployment revealed no residual shunt in 12 (63.2%) CAFs,significant reduction of the flow in 5 (26.3%),while 2 (10.5%) could not be closed due to small size.Nine (90%) patients underwent a repeated angiography within 3 to 8 months.Among 12 CAFs that were occluded immediately post-deployment,there were 2 CAFs with insignificant residual flow.Among 6 CAFs with significantly decreased flow immediately post-deployment,2 were occluded totally in the follow-up angiography.In total,12 (70.5%) CAFs were occluded completely and 5 (29.5%) CAFs still had insignificant residual flow,which did not need any additional coil deployment.During a mean follow up of 4.3 ± 0.7 year,all patients remained symptom and complication free.Conclusions The fibered GDC is a safe and effective method for percutaneous closure of the CAFs.

  19. Elbow arteriovenous fistulas for chronic haemodialysis.

    Science.gov (United States)

    Elcheroth, J; de Pauw, L; Kinnaert, P

    1994-07-01

    Arteriovenous fistulas (AVFs) were created at the elbow, rather than using prosthetic grafts, when forearm vessels were inadequate. A total of 272 such fistulas were constructed: 49 between the brachial artery and a forearm vein, 91 between the brachial artery and the elbow perforating vein, 52 between the brachial artery and the cephalic vein and 80 between the brachial artery and the basilic vein. In each case the vein was sutured end to side to the artery. The immediate failure rate was 11.8 per cent. The 1- and 4-year cumulative patency rates were 68.7 and 51.2 per cent for brachial artery-forearm vein AVFs, 80.3 and 68.0 per cent for those between the brachial artery and the elbow perforator, 74.1 and 61.3 per cent for brachial artery-cephalic vein fistulas, and 76.7 and 49.2 per cent for those between the brachial artery and the basilic vein. The elbow AVF is a reliable means of establishing vascular access for haemodialysis. PMID:7922091

  20. Anomalies on orbifolds

    Energy Technology Data Exchange (ETDEWEB)

    Arkani-Hamed, Nima; Cohen, Andrew G.; Georgi, Howard

    2001-03-16

    We discuss the form of the chiral anomaly on an S1/Z2 orbifold with chiral boundary conditions. We find that the 4-divergence of the higher-dimensional current evaluated at a given point in the extra dimension is proportional to the probability of finding the chiral zero mode there. Nevertheless the anomaly, appropriately defined as the five dimensional divergence of the current, lives entirely on the orbifold fixed planes and is independent of the shape of the zero mode. Therefore long distance four dimensional anomaly cancellation ensures the consistency of the higher dimensional orbifold theory.

  1. Imaging of facial anomalies.

    Science.gov (United States)

    Castillo, M; Mukherji, S K

    1995-01-01

    Anomalies of the face may occur in its lower or middle segments. Anomalies of the lower face generally involve the derivatives of the branchial apparatus and therefore manifest as defects in the mandible, pinnae, external auditory canals, and portions of the middle ears. These anomalies are occasionally isolated, but most of them occur in combination with systemic syndromes. These anomalies generally do not occur with respiratory compromise. Anomalies of the midface may extend from the upper lip to the forehead, reflecting the complex embryology of this region. Most of these deformities are isolated, but some patients with facial clefts, notably the midline cleft syndrome and holoprosencephaly, have anomalies in other sites. This is important because these patients will require detailed imaging of the face and brain. Anomalies of the midface tend to involve the nose and its air-conducting passages. We prefer to divide these anomalies into those with and without respiratory obstruction. The most common anomalies that result in airway compromise include posterior choanal stenoses and atresias, bilateral cysts (mucoceles) of the distal lacrimal ducts, and stenosis of the pyriform (anterior) nasal aperture. These may be optimally evaluated with computed tomography (CT) and generally require immediate treatment to ensure adequate ventilation. Rare nasal anomalies that also result in airway obstruction are agenesis of the pharynx, agenesis of the nose, and hypoplasia of the nasal alae. Agenesis of the nasopharynx and nose are complex anomalies that require both CT and magnetic resonance imaging (MRI). The diagnosis of hypoplasia of the nasal alae is a clinical one; these anomalies do not require imaging studies. Besides facial clefts, anomalies of the nose without respiratory obstruction tend to be centered around the nasofrontal region. This is the site of the most common sincipital encephaloceles. Patients with frontonasal and nasoethmoidal encephaloceles require both

  2. Theoretically Optimal Distributed Anomaly Detection

    Data.gov (United States)

    National Aeronautics and Space Administration — A novel general framework for distributed anomaly detection with theoretical performance guarantees is proposed. Our algorithmic approach combines existing anomaly...

  3. Splenic arteriovenous fistula treated with percutaneous transarterial embolization

    DEFF Research Database (Denmark)

    Madsen, M.A.; Frevert, S.; Madsen, P.L.;

    2008-01-01

    Splenic arteriovenous fistula is a rare complication following splenectomy. We report a case of a large splenic arteriovenous fistula 23 years after splenectomy in a 50-year old male with abdominal pain, gastro-intestinal bleeding, ascites, diarrhoea, dyspnoea, portal hypertension and heart failure...

  4. [One case of postoperative facial paralysis after first branchial fistula].

    Science.gov (United States)

    Wang, Xia; Xu, Yaosheng

    2015-12-01

    Pus overflow from patent's fistula belew the left face near mandibular angle 2 years agowith a little pain. Symptoms relieved after oral antibiotics. This symptom frequently occurred in the past six months. Postoperative facial paralysis occurred after surgery, and recovered after treatment. It was diagnosed as the postoperative facial paralysis after first branchial fistula surgery.

  5. Tracheo-oesophageal fistula diagnosed with multidetector computed tomography.

    LENUS (Irish Health Repository)

    Hodnett, Pa

    2009-04-01

    This case highlights important issues in investigation of patients with suspected tracheo-oesophageal fistula including the value of multidetector computed tomography, the importance of thorough imaging evaluation when high clinical suspicion of tracheo-oesophageal fistula exists and the value of close interaction between radiologists and intensive care physicians in the investigation of these patients.

  6. Chemoradiotherapy for a patient with a giant esophageal fistula

    Institute of Scientific and Technical Information of China (English)

    Takuma Nomiya; Kazuhide Teruyama; Hitoshi Wada; Kenji Nemoto

    2007-01-01

    We describe our experience of treatment for a giant esophageal malignant fistula, which has not been reported previously. A 36-year-old woman who was diagnosed as having massive esophageal small cell carcinoma with metastases was treated with chemoradiotherapy.However, a giant esophagomediastinal fistula appeared due to shrinkage of the massive tumor, and all anti-cancer treatment was suspended. However, chemoradiotherapy was restarted at the request of the patient despite the presence of the fistula. After restarting treatment, the giant esophageal fistula was naturally closed despite intensive chemoradiotherapy, and the patient became able to eat and drink. Although the patient finally died,her QOL and prognosis seemed to be improved by the chemoradiotherapy. Anti-cancer treatment could be safely performed despite the presence of a giant fistula.The giant fistula closed while intensive chemotherapy was administered to the patient. Therefore, the presence of a fistula may not be a contraindication for curative chemoradiotherapy. Completion of treatment with proper management and maintenance of patients would be of benefit to patients with fistula.

  7. Esophagotracheal fistula caused by gastroesophageal reflux 9 years after esophagectomy

    Institute of Scientific and Technical Information of China (English)

    Kiyotomi Maruyama; Satoru Motoyama; Manabu Okuyama; Yusuke Sato; Kaori Hayashi; Yoshihiro Minamiya; Jun-ichi Ogawa

    2007-01-01

    Fistula between digestive tract and airway is one of the complications after esophagectomy with lymph node dissection. A case of esophagotracheal fistula secondary to esophagitis 9 years after esophagectomy and gastric pull-up for treatment of esophageal carcinoma is described. It was successfully treated with transposition of a pedided pectoralis major muscle flap.

  8. [Nutrition therapy in enterocutaneous fistula; from physiology to individualized treatment].

    Science.gov (United States)

    Rodríguez Cano, Ameyalli Mariana

    2014-01-01

    Enterocutaneous fistula is the most common of all intestinal fistulas. Is a condition that requires prolonged hospital stay due to complications such as electrolyte imbalance, malnutrition, metabolic disorders and sepsis. Nutritional support is an essential part of the management; it favors intestinal and immune function, promotes wound healing and decreases catabolism. Despite the recognition of the importance of nutrition support, there is no strong evidence on its comprehensive management, which can be limiting when establishing specific strategies. The metabolic imbalance that a fistula causes is unknown. For low-output fistulas, energy needs should be based on resting energy expenditure, and provide 1.0 to 1.5 g/kg/d of protein, while in high-output fistulas energy requirement may increase up to 1.5 times, and provide 1.5 to 2.5 g/kg of protein. It is suggested to provide twice the requirement of vitamins and trace elements, and between 5 and 10 times that of Vitamin C and Zinc, especially for high-output fistulas. A complete nutritional assessment, including type and location of the fistula, are factors to consider when selecting nutrition support, whether is enteral or parenteral nutrition. The enteral route should be preferred whenever possible, and combined with parenteral nutrition when the requirements cannot be met. Nutritional treatment strategies in fistulas may include the use of immunomodulators and even stress management.

  9. Repair of large palatal fistula using tongue flap

    Directory of Open Access Journals (Sweden)

    Fejjal Nawfal

    2014-01-01

    Full Text Available Large palatal fistulas are a challenging problem in cleft surgery. Many techniques are used to close the defect. The tongue flap is an easy and reproductible procedure for managing this complication. The authors report a case of a large palatal fistula closure with anteriorly based tongue flap.

  10. [Resolution of a neck chylous fistula with oral diet treatment].

    Science.gov (United States)

    Cánovas, B; Morlán, M A; Familiar, C; Sastre, J; Marco, A; López, J

    2005-01-01

    Chylous fistula after neck dissection is a well-described complication. This pHatology can lead to serious respiratory and nutritional complications. Therapeutical options for chylous fistula remains controversial. On last reviews, there are an agreement on the conservative management. Within of this management, low long-chain triglycerides fat diet is an essential part.

  11. All's Well That Ends Well: Shakespeare's treatment of anal fistula.

    Science.gov (United States)

    Cosman, B C

    1998-07-01

    Textual and contextual evidence suggests that the French king's fistula, a central plot device in Shakespeare's play All's Well That Ends Well, is a fistula-in-ano. Anal fistula was known to the lay public in Shakespeare's time. In addition, Shakespeare may have known of the anal fistula treatise of John Arderne, an ancestor on Shakespeare's mother's side. Shakespeare's use of anal fistula differs from all previous versions of the story, which first appeared in Boccaccio's Decameron and from its possible historical antecedent, the fistula of Charles V of France. This difference makes sense given the conventions of Elizabethan comedy, which included anal humor. It is also understandable when one looks at what wounds in different locations mean in European legend. In this light, it is not surprising that subsequent expurgations treat Boccaccio's and Shakespeare's fistulas differently, censoring only Shakespeare's. This reading has implications for the staging of All's Well That Ends Well, and for our view of the place of anal fistulas in cultural history.

  12. Learning about Poland Anomaly

    Science.gov (United States)

    ... performed too early, while the individual is growing, asymmetry can result or be made greater than before. ... Anomaly About.com- Poland Syndrome [rarediseases.about.com] Information about Poland syndrome produced by Mary Kugler, M.S. ...

  13. Scattering anomaly in optics

    CERN Document Server

    Silveirinha, Mario G

    2016-01-01

    In time-reversal invariant electronic systems the scattering matrix is anti-symmetric. This property enables an effect, designated here as "scattering anomaly", such that the electron transport does not suffer from back reflections, independent of the specific geometry of the propagation path or the presence of time-reversal invariant defects. In contrast, for a generic time-reversal invariant photonic system the scattering matrix is symmetric and there is no similar anomaly. Here, it is theoretically proven that despite these fundamental differences there is a wide class of photonic platforms - in some cases formed only by time-reversal invariant media - in which the scattering anomaly can occur. It is shown that an optical system invariant under the action of the composition of the time-reversal, parity and duality operators is characterized by an anti-symmetric scattering matrix. Specific examples of photonic platforms wherein the scattering anomaly occurs are given, and it is demonstrated with full wave n...

  14. Anomaly Detection in Sequences

    Data.gov (United States)

    National Aeronautics and Space Administration — We present a set of novel algorithms which we call sequenceMiner, that detect and characterize anomalies in large sets of high-dimensional symbol sequences that...

  15. Neutrino anomalies without oscillations

    Indian Academy of Sciences (India)

    Sandip Pakvasa

    2000-01-01

    I review explanations for the three neutrino anomalies (solar, atmospheric and LSND) which go beyond the `conventional' neutrino oscillations induced by mass-mixing. Several of these require non-zero neutrino masses as well.

  16. Skyrmions and anomalies

    International Nuclear Information System (INIS)

    The author summarizes the works presented at the meeting on skyrmions and anomalies. He divides the principal issues of this workshop into five categories: QCD effective lagrangians, chiral bags and the Cheshire cat principle, strangeness problem, phenomenology, mathematical structure

  17. Congenital laryngeal anomalies,

    OpenAIRE

    Rutter, Michael J.

    2014-01-01

    Introduction: It is essential for clinicians to understand issues relevant to the airway management of infants and to be cognizant of the fact that infants with congenital laryngeal anomalies are at particular risk for an unstable airway. Objectives: To familiarize clinicians with issues relevant to the airway management of infants and to present a succinct description of the diagnosis and management of an array of congenital laryngeal anomalies. Methods: Revision article, in which the ma...

  18. The Pioneer Anomaly

    CERN Document Server

    de Diego, Jose A

    2008-01-01

    Analysis of the radio-metric data from Pioneer 10 and 11 spacecrafts has indicated the presence of an unmodeled acceleration starting at 20 AU, which has become known as the Pioneer anomaly. The nature of this acceleration is uncertain. In this paper we give a description of the effect and review some relevant mechanisms proposed to explain the observed anomaly. We also discuss on some future projects to investigate this phenomenon.

  19. Volume anomaly in ferrimagnetism

    OpenAIRE

    Pascard, H.; Globus, A.

    1981-01-01

    The volume anomaly ΔV/V due to the magnetic energy corresponding to the exchange interactions is experimentally determined for YIG. The experimental values (from 77 K to Tc) agree with the values deduced from the theoretical expression based on the Néel's theories of volume anomaly and of ferrimagnetism. These results are compared with those obtained by other authors on ferromagnetic and antiferromagnetic materials with localized magnetic moments : a reduced curve is obtained.

  20. Anomalies and Entanglement Entropy

    CERN Document Server

    Nishioka, Tatsuma

    2015-01-01

    We initiate a systematic study of entanglement and Renyi entropies in the presence of gauge and gravitational anomalies in even-dimensional quantum field theories. We argue that the mixed and gravitational anomalies are sensitive to boosts and obtain a closed form expression for their behavior under such transformations. Explicit constructions exhibiting the dependence of entanglement entropy on boosts is provided for theories on spacetimes with non-trivial magnetic fluxes and (or) non-vanishing Pontryagin classes.

  1. Dual diaphragmatic anomalies.

    Science.gov (United States)

    Padmanabhan, Arjun; Thomas, Abin Varghese

    2016-01-01

    Although diaphragmatic anomalies such as an eventration and hiatus hernia are commonly encountered in incidental chest X-ray imaging, the presence of concomitant multiple anomalies is extremely rare. This is all the more true in adults. Herein, we present the case of a 75-year-old female, while undergoing a routine chest X-ray imaging, was found to have eventration of right hemidiaphragm along with a hiatus hernia as well. PMID:27625457

  2. Dual diaphragmatic anomalies

    Directory of Open Access Journals (Sweden)

    Arjun Padmanabhan

    2016-01-01

    Full Text Available Although diaphragmatic anomalies such as an eventration and hiatus hernia are commonly encountered in incidental chest X-ray imaging, the presence of concomitant multiple anomalies is extremely rare. This is all the more true in adults. Herein, we present the case of a 75-year-old female, while undergoing a routine chest X-ray imaging, was found to have eventration of right hemidiaphragm along with a hiatus hernia as well.

  3. A Case of Pyriform Sinus Fistula Infection with Double Tracts

    Directory of Open Access Journals (Sweden)

    Masato Shino

    2014-01-01

    Full Text Available Pyriform sinus fistula is a rare clinical entity and the precise origin remains controversial. The fistula is discovered among patients with acute suppurative thyroiditis or deep neck infection of the left side of the neck and is usually located in the left pyriform sinus. To the best of our knowledge, only a single tract has been reported to be responsible for pyriform sinus fistula infection. We present a case of a 13-year-old female patient with a pyriform sinus fistula that caused a deep infection of the left side of the neck and showed double-tract involvement discovered during surgical resection of the entire fistula. Both tracts arose around the pyriform sinus and terminated at the upper portion of the left lobe of the thyroid.

  4. USAID program for the prevention and treatment of vaginal fistula.

    Science.gov (United States)

    MacDonald, P; Stanton, M E

    2007-11-01

    The cornerstone of the US Agency for International Development (USAID) fistula program is to support and strengthen local capacity for fistula repair. The USAID program includes support to upgrade facilities, enhance local surgical repair capability, allocate equipment and supplies to operating rooms, implement quality improvement systems, and cover the women's transportation costs to and from the treatment facilities. The program also offers training in clinical and counseling skills; transferring skills South-to-South; and monitoring and evaluating the program's effectiveness. As new fistula cases continually increase the backlog of untreated cases, its efforts are also directed toward the prevention of fistula and the reintegration of treated women into their communities. Furthermore, the program challenges the culture of sexual violence against women that leads to traumatic gynecologic fistulas. PMID:17869253

  5. Ramiprilate inhibits functional matrix metalloproteinase activity in Crohn's disease fistulas

    DEFF Research Database (Denmark)

    Efsen, Eva; Saermark, Torben; Hansen, Alastair;

    2011-01-01

    Increased expression of matrix metalloproteinase (MMP)-2, -3 and -9 has been demonstrated in Crohn's disease fistulas, but it is unknown whether these enzymes are biologically active and represent a therapeutic target. Therefore, we investigated the proteolytic activity of MMPs in fistula tissue...... and examined the effect of inhibitors, including clinically available drugs that beside their main action also suppress MMPs. Fistula specimens were obtained by surgical excision from 22 patients with Crohn's disease and from 10 patients with fistulas resulting from other causes. Colonic endoscopic biopsies......-diamine-tetraacetic acid (EDTA), the synthetic broad-spectrum inhibitor, GM6001, the angiotensin-converting enzyme (ACE) inhibitor, ramiprilate, and the tetracycline, doxycycline. In Crohn's disease fistulas, about 50% of the total protease activity was attributable to MMP activity. The average total MMP activity...

  6. SADM potentiometer anomaly investigations

    Science.gov (United States)

    Wood, Brian; Mussett, David; Cattaldo, Olivier; Rohr, Thomas

    2005-07-01

    During the last 3 years Contraves Space have been developing a Low Power (1-2kW) Solar Array Drive Mechanism (SADM) aimed at small series production. The mechanism was subjected to two test programmes in order to qualify the SADM to acceptable levels. During the two test programmes, anomalies were experienced with the Potentiometers provided by Eurofarad SA and joint investigations were undertaken to resolve why these anomalies had occurred. This paper deals with the lessons learnt from the failure investigation on the two Eurofarad (rotary) Potentiometer anomaly. The Rotary Potentiometers that were used were fully redundant; using two back to back mounted "plastic tracks". It is a pancake configuration mounted directly to the shaft of the Slip Ring Assembly at the extreme in-board end of the SADM. It has no internal bearings. The anomaly initially manifested itself as a loss of performance in terms of linearity, which was first detected during Thermal Vacuum testing. A subsequent anomaly manifested itself by the complete failure of the redundant potentiometer again during thermal vacuum testing. This paper will follow and detail the chain of events following this anomaly and identifies corrective measures to be applied to the potentiometer design and assembly process.

  7. The Holographic Supercurrent Anomaly

    CERN Document Server

    Chaichian, Masud

    2004-01-01

    The \\gamma-trace anomaly of supersymmetry current in a supersymmetric gauge theory shares a superconformal anomaly multiplet with the chiral R-symmetry anomaly and the Weyl anomaly, and its holographic reproduction is a valuable test to the AdS/CFT correspondence conjecture. We investigate how the \\gamma-trace anomaly of the supersymmetry current of {\\cal N}=1 four-dimensional supersymmetric gauge theory in an {\\cal N}=1 conformal supergravity background can be extracted out from the ${\\cal N}=2$ gauged supergravity in five dimensions. It is shown that the reproduction of this super-Weyl anomaly originates from the following two facts: First the {\\cal N}=2 bulk supersymmetry transformation converts into {\\cal N}=1 superconformal transformation on the boundary, which consists of {\\cal N}=1 supersymmetry transformation and special conformal supersymmetry (or super-Weyl) transformation; second the supersymmetry variation of the bulk action of five-dimensional gauged supergravity is a total derivative. The non-co...

  8. Lateral semicircular canal fistula in cholesteatoma: diagnosis and management.

    Science.gov (United States)

    Meyer, Anais; Bouchetemblé, Pierre; Costentin, Bertrand; Dehesdin, Danièle; Lerosey, Yannick; Marie, Jean-Paul

    2016-08-01

    The objective of this retrospective study was to present the authors' experience on the management of labyrinthine fistula secondary to cholesteatoma. 695 patients, who underwent tympanoplasty for cholesteatoma, in a University Hospital between 1993 and 2013 were reviewed, to select only those with labyrinthine fistulas. 42 patients (6%) had cholesteatoma complicated by fistula of the lateral semicircular canal (LSCC). The following data points were collected: symptoms, pre- and postoperative clinical signs, surgeon, CT scan diagnosis, fistula type, surgical technique, preoperative vestibular function and audiometric outcomes. Most frequent symptoms were unspecific, such as otorrhea, hearing loss and dizziness. However, preoperative high-resolution computed tomography predicted fistula in 88 %. Using the Dornhoffer and Milewski classification, 16 cases (38 %) were identified as stage 1, 22 (52 %) as stage II, and 4 (10 %) as stage III. The choice between open or closed surgical procedure was independent of the type of fistulae. The cholesteatoma matrix was completely removed from the fistula and immediately covered by autogenous material. In eight patients (19 %), the canal was drilled with a diamond burr before sealing with autologous tissue. After surgery, hearing was preserved or improved in 76 % of the patients. There was no statistically significant relationship between the extent of the labyrinthine fistula and the hearing outcome. In conclusion, a complete and nontraumatic removal of the matrix cholesteatoma over the fistula in a one-staged procedure and its sealing with bone dust and fascia temporalis, with sometimes exclusion of the LSCC, is a safe and effective procedure to treat labyrinthine fistula. PMID:26351038

  9. Treatment of fistula-in-ano with fistula plug – A Review under special consideration of the technique

    Directory of Open Access Journals (Sweden)

    Ferdinand eKöckerling

    2015-10-01

    Full Text Available IntroducationIn a recent Cochrane review the authors concluded that there is an urgent need for well-powered, well-conducted randomized controlled trials comparing various modes of treatment of fistula-in-ano. Ten randomized controlled trials were available for analyses: There were no significant differences in recurrence rates or incontinuence rates in any of the studied comparisons. The following article reviews all studies available for treatment of fistula-in-ano with a fistula plug.Material and MethodsPubMed, Medline, Embase and the Cochrane medical database were searched up to December 2014. 47 articles were relevant for this review.ResultsHealing rates of 50 – 60 % can be expected for treatment of complex anal fistula with a fistula plug, with a plug-extrusion rate of 10 – 20 %. Such results can be achieved not only with plugs made of porcine intestinal submucosa, but also those made of other biological mesh materials, such as acellular dermal matrix. Important technical steps in the performance of a complex anal fistula plug repair need to be followed.SummaryTreatment of a complex fistula-in-ano with a fistula plug is an option with a success rate of 50 – 60 % with low complication rate. Further improvements in technique and better studies

  10. CLINICAL STUDY OF FISTULA IN ANO

    Directory of Open Access Journals (Sweden)

    Raj

    2015-10-01

    Full Text Available Fistula in Ano is a benign treatable lesion of the rectum and the anal canal. Cryptoglandular infection accounts for about 90% of these cases. Majority of the infections are Acute and a minority contributed by chronic low grade infection hence pointing to varying etiologies. The pathogenesis has been attributed to the bursting open of an acute or inadequately treated Anorectal abscess into the peri anal skin. Diagnosis of the condition can be made easily with a good source of light, a proctoscope and a meticulous digital examination. Establishing a cure in this condition is difficult owing to two reasons. Firstly, the site of the infection makes the patient reluctant to subject themselves to examination. Secondly, a significant percent of these diseases persist or recur when appropriate surgery is not done or when the post op care is inadequate. Mostly it affects the young and the middle age group thus affecting productive man hours and quality of life. MATERIALS AND METHODS: All cases of clinically diagnosed Fistulae-in-ano above the age of 12 years, admitted in various surgical units in K.R. Hospital (attached to Government Medical College, Mysore during the study period December 1, 2008 to May 31, 2010. REUSLTS: Age Incidence, Sex Incidence, Socio Economic Status, Modes of Presentation, No. of External Openings, Situation of External Openings, Level of Fistulae, Type of surgical treatment, Associated with Fissure in Ano, Postoperative complication and Results were studied. CONCLUSION: Commonest age of presentation in our series is 30-40 years – 40%. Males are more commonly affected. Ratio Male: Female::3:1, Disease is more commonly seen in people with lower socio economic status group. 80% High socio economic class 20%. Discharging sinus is the commonest mode of presentation 72% and pain 72% and 84% pass history of perianal abscess was the presenting symptoms.

  11. [Secondary aortoenteric fistula, multidisciplinary surgical management].

    Science.gov (United States)

    Cunha E Sá, Diogo; De Andrade, J Rebelo; Roquete, Paulo; Pestana, Cristina; Cabral, Gonçalo; Tiago, José; Dinis da Gama, A

    2011-01-01

    The authors report the clinical case of a 77-year old man, who underwent the surgical treatment of an abdominal aortic aneurism 11 years before, admitted in the hospital emergency department complaining of abdominal pain and melena. Clinical and laboratorial findings, together with CT-scan and endoscopy data, lead to the diagnosis of secondary aortoenteric fistula. This is a rare clinical entity, coursing with high morbimortality levels of and is still one of the most controversial issues in vascular surgery. The successful surgical treatment of this patient is described and the solution of choice is discussed, as well as other alternative approaches. PMID:23610769

  12. Pulmonary arterio-venous micro fistulae - Diagnostic

    International Nuclear Information System (INIS)

    Four patients with pulmonary arterio-venous micro-fistulae - of which two were male (50%) - the ages varying from 10 to 43 (X sup(∼) = 22,7), were studied at the Cardiology Centre of the 6th Ward of Santa Casa da Misericordia Hospital in Rio de Janeiro. They were all basically suffering from Manson's Schistosomiasis, the hepato-splenic form in 3 cases (75%) and the Rendu Osler Weber disease with juvenile cirrhosis in 1 case (25%). All four of them had portal hypertension. The individual cases were clinically evaluate with X-rays, scintillographic and hemodynamic tests. (author)

  13. Radiologic evaluation of postoperative gastropericardial fistula

    Directory of Open Access Journals (Sweden)

    Jeffrey S. Chen

    2014-01-01

    Full Text Available Laparoscopic Nissen fundoplication is the current standard surgical option for complicated GERD and symptomatic hiatal hernia. Though comparable in safety, short-term efficacy, and patient satisfaction when compared with open operation, laparoscopic Nissen fundoplication has demonstrated shorter hospital stays and recuperative times. Commonly reported complications include gastric or esophageal injury, splenic injury, pneumothorax, bleeding, pneumonia, fever, wound infections, and dysphagia. We present an unusual case of gastropericardial fistula that developed as a late complication of laparoscopic Nissen fundoplication performed 4 years earlier.

  14. Idiopathic esophagopleural fistula in the newborn

    Energy Technology Data Exchange (ETDEWEB)

    Iannaccone, G.; Cozzi, F.; Roggini, M.; Capocaccia, P.

    1982-07-01

    Idiopathic rupture of the esophagus in the neonate is a rare event, probably related to the same mechanism of ischemic necrosis responsible for other 'spontaneous' g.i. tract perforations in the newborn. The laceration is usually located on the right aspect of the distal esophagus and is complicated by esophagopleural fistula and hydropneumothorax. Plain chest film and esophagography are diagnostic. The condition is an emergency one and usually carries a bad prognosis without prompt surgical repair. A typical case is reported in a baby who survived without early surgery; a residual tiny blind pouch and a small hiatal hernia required surgery at 1 year of age.

  15. VATER/VACTERL Association and Caudal Regression with Xq25-q27.3 Microdeletion: A Case Report.

    Science.gov (United States)

    Puvabanditsin, Surasak; Van Gurp, James; February, Melissa; Khalil, Marwa; Mayne, Julia; Ai McConnell, Jennifer; Mehta, Rajeev

    2016-01-01

    We report a term female neonate with vertebral anomalies, anal and urethral atresia, esophageal atresia with tracheoesophageal fistula (TEF), renal agenesis, pulmonary hypoplasia, genital and sacral appendages, and a single umbilical artery. Genetic studies revealed a 20.91 Mb interstitial deletion of the long arm of X chromosome: Xq25-q27.3. This is a new case of VATER/VACTERL association with Xq25 microdeletion. PMID:26881326

  16. [The features of adults' coronary artery anomalies shown by 64-multi-detector rows CT].

    Science.gov (United States)

    Yuan, Zhentuan; Yu, Jianqun; Zhang, Youyi; Yuan, Hongmei

    2009-06-01

    To analyze the adults' coronary artery anomalies revealed by 64-MDCT, we retrospectively analyzed 34 cases of coronary artery anomalies (26 males and 8 females, averagely aged 53. 4 years with a range from 30 to 72 years). Multi-plannar reconstruction (MPR), maximum intensity projection (MIP), surface shadow display (SSD) and volume rendering (VR) were used to demonstrate the anomalous coronary artery. We found 4 cases of RCA from the left coronary sinus, 8 cases with secondary RCA, 1 case with high locations of left main (LM) segments from left sinus of valves, 1 case with LAD originated from main pulmonary artery, 3 cases with separate origin of LAD and LCX. Ten cases with myocardial bridge were shown (9 cases in LAD, 1 case in LCX); coronary fistula was seen in 2 cases (one was RCA-RA fistula, another was LAD-RV fistula), coronary aneurysm was found in 2 cases. Three cases in RCA were short and small. In conclusion, 64-MDCT is a good choice for diagnosing the anomalous coronary artery. PMID:19634659

  17. Concomitant Imperforate Hymen and Transverse Vaginal Septum Complicated with Pyocolpos and Abdominovaginal Fistula

    Directory of Open Access Journals (Sweden)

    Berna Dilbaz

    2014-01-01

    Full Text Available A 13-year-old patient with a complaint of worsening lower abdominal pain during the past 4 months was admitted to the emergency department. An abdominopelvic ultrasound scan revealed a distended uterocervical cavity suggestive of hematometrocolpos. Imperforate hymen was observed on examination of the external genitalia. MRI scan revealed an air-fluid level representing pyometrocolpos within a distended vagina. Posterior vaginal extraperitoneal leakage as the sign of a fistula between the vagina and the rectovaginal space was detected. Although laparoscopic approach was planned, malodorous pus expelled after the insertion of the Veress needle, it was decided to proceed to laparotomy. Pus with peritoneal microabscess formations was observed at laparotomy. The imperforate hymen and TVS were excised vaginally. A more complex anomaly should be suspected in cases with hematometra and concomitant imperforated hymen without any bulging and thorough evaluation using radiological imaging techniques should be performed before surgical approach.

  18. EFFECT OF HEPARIN ON THE PATENCY OF ARTERIOVENOUS FISTULA

    Directory of Open Access Journals (Sweden)

    H Ravari

    2008-11-01

    Full Text Available "nPatients with end stage renal disease need a good vascular access for hemodialysis. Arteriovenous fistula is the method of choice for vascular access in these patients. However, failure of arteriovenous fistula due to thrombosis is a major problem. The aim of this study was to evaluate the effect of the heparin on the patency of the arteriovenous fistula. This prospective interventional case control study was performed from November 2003 through May 2005 in vascular surgery ward in Imam Reza Hospital. All the patients who underwent a surgery in order to perform an arteriovenous fistula in cubital or snuff box areas for the dialysis means were enrolled. They were randomly divided into two groups. The case group (n = 96 received intraoperative heparin whereas the controls (n = 102 did not. Early observation of arteriovenous fistula (immediately after surgery showed patency in 89% of heparin group and in 87% of the control group. The patency rate 2 weeks after the surgery was 85% in heparin group versus 74% in the control group, resulting in a statistically significant difference (P value = 0.046. According to higher patency rate of arteriovenous fistula in 2 weeks following surgery in case group, we recommend intraoperative use of heparin in arteriovenous fistula operations.

  19. Management of enterocutaneous fistulas: 30-year clinical experience

    Institute of Scientific and Technical Information of China (English)

    黎介寿; 任建安; 朱维铭; 尹路; 韩建明

    2003-01-01

    Objectives To explore successful models of management of enterocutaneous fistulas and u nresolved problems requiring further study. Method Analysis of therapeutic results of 1168 cases treated in one center from January 1971 to December 2000. Results In this group of patients, the recovery rate was 93% and 37% of fistulas healed spontaneously after non-operative treatment. The mortality rate was 5.5%, mos t of which occurred due to sepsis. Of 659 cases receiving definitive operations for enteric fistula, 98% recovered. Recovery, mortality and operational succes s rates (94.2%, 4.4%, 99.7%) of cases treated between January 1985 and Decemb er 2000 were significantly better than those (90.4%, 8.2%, 95.5%) of cases treated earlier (January 1971-December 1984) (P<0.05). Conclusions The results from this study were better overall than those reported in previous literatures. The change in therapeutic strategy, improved technique in control of sepsis, rational nutritional support and careful monitoring of vital organs are the key reasons for improvement of managing enteric fistulas. However, incre asing spontaneous closure of fistula, improving the therapeutic rate of specific enteric fistula (IBD or radiation enteritis) and performing definitive operations for enteric fistula at early stages are still problematic and require further study.

  20. Enteroatmospheric fistula: from soup to nuts.

    Science.gov (United States)

    Majercik, Sarah; Kinikini, Merin; White, Thomas

    2012-08-01

    Enteroatmospheric fistula (EAF), a special subset of enterocutaneous fistula (ECF), is defined as a communication between the gastrointestinal (GI) tract and the atmosphere. It is one of the most devastating complications of "damage control" laparotomy (DCL) and results in significant morbidity and mortality. The published incidence of EAF ranges from 5%-19% of patients who have undergone DCL and survived long enough to develop complications. Their etiology is complex and ranges from persistent abdominal infection, anastomotic leakage, adhesions of the bowel to itself or fascia, and repeated bowel manipulation during return trips to the operating room or dressing changes. Prevention is clearly the best treatment strategy but may be difficult to achieve. Once an EAF occurs, immediate management consists of treatment of sepsis if present; nutrition, fluid, and electrolyte support in the form of parenteral nutrition (PN); and wound/effluent control and protection of surrounding tissues and exposed bowel. It should be noted that EAF almost never close spontaneously, and definitive repair usually requires major surgical intervention and abdominal wall reconstruction 6 to 12 months after the original insult. Enteral feeding should be attempted once the anatomy of the EAF is defined and reliable enteral access is obtained. Most patients can tolerate some amount of enteral and even oral feeding and do not need to be maintained on PN alone. Professional judgment, experience, and teamwork are key to successfully managing the patient with EAF.

  1. Anomalies without Massless Particles

    CERN Document Server

    Gurlanik, Z

    1994-01-01

    Baryon and lepton number in the standard model are violated by anomalies, even though the fermions are massive. This problem is studied in the context of a two dimensional model. In a uniform background field, fermion production arise from non-adiabatic behavior that compensates for the absence of massless modes. On the other hand, for localized instanton-like configurations, there is an adiabatic limit. In this case, the anomaly is produced by bound states which travel across the mass gap. The sphaleron corresponds to a bound state at the halfway point.

  2. Congenital laryngeal anomalies,

    Directory of Open Access Journals (Sweden)

    Michael J. Rutter

    2014-12-01

    Full Text Available Introduction: It is essential for clinicians to understand issues relevant to the airway management of infants and to be cognizant of the fact that infants with congenital laryngeal anomalies are at particular risk for an unstable airway. Objectives: To familiarize clinicians with issues relevant to the airway management of infants and to present a succinct description of the diagnosis and management of an array of congenital laryngeal anomalies. Methods: Revision article, in which the main aspects concerning airway management of infants will be analyzed. Conclusions: It is critical for clinicians to understand issues relevant to the airway management of infants.

  3. Delayed internal pancreatic fistula with pancreatic pleural effusion postsplenectomy

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    The occurrence of pancreatic pleural effusion,secondary to an internal pancreatic fistula,is a rare clinical syndrome and diagnosis is often missed.The key to the diagnosis is a dramatically elevated pleural fluid amylase.This pancreatic pleural effusion is also called a pancreatic pleural fistula.It is characterized by profuse pleural fluid and has a tendency to recur.Here we report a case of delayed internal pancreatic fistula with pancreatic pleural effusion emerging after splenectomy.From the treatment ...

  4. Management of chronic parotid fistula with sodium tetradecyl sulfate.

    Science.gov (United States)

    Singh, Virendra; Kumar, Pradeep; Agrawal, Aviral

    2013-01-01

    A parotid fistula is a rare, extremely unpleasant disease. It may be due to chronic pathologies of the facial soft tissues, trauma (tangential injury to face), infection or congenital. Various treatment modalities including surgical and conservative management are present to treat this disease. Conservative management plays a vital role in patients who are systemically compromised and unfit for surgery. In the present case report an alternative conservative technique of parotid fistula management has been described in a 28-year-old girl who was severe anemic with parotid fistula since last 25 yrs.

  5. Cassia fistula Linn: Potential candidate in the health management

    Directory of Open Access Journals (Sweden)

    Arshad H Rahmani

    2015-01-01

    Full Text Available Cassia fistula Linn is known as Golden shower has therapeutics importance in health care since ancient times. Research findings over the last two decade have confirmed the therapeutics consequence of C. fistula in the health management via modulation of biological activities due to the rich source of antioxidant. Several findings based on the animal model have confirmed the pharmacologically safety and efficacy and have opened a new window for human health management. This review reveals additional information about C. fistula in the health management via in vivo and in vitro study which will be beneficial toward diseases control.

  6. Enterovesical fistula caused by a bladder squamous cell carcinoma

    Institute of Scientific and Technical Information of China (English)

    Chun-Hsiang Ou Yang; Keng-Hao Liu; Tse-Ching Chen; Phei-Lang Chang; Ta-Sen Yeh

    2009-01-01

    Enterovesical fistulas are not uncommon in patients with inflammatory or malignant colonic disease, however,fistulas secondary to primary bladder carcinomas are extremely rare. We herein reported a patient presenting with intractable urinary tract infection due to enterovesical fistula formation caused by a squamous cell carcinoma of the urinary bladder. This patient underwent en bloc resection of the bladder dome and involved ileum, and recovered uneventfully without urinary complaint. To the best of our knowledge, this is the first case reported in the literature.

  7. Enterovesical Fistula Secondary to Squamous Cell Carcinoma of the Bladder.

    Science.gov (United States)

    Sellers, William; Fiorelli, Robert

    2015-11-01

    Enterovesical fistulas are a well-known complication of inflammatory and malignant bowel disease. Bladder carcinoma, however, is an extremely rare etiology. We describe a case of squamous cell carcinoma of the bladder with an enterovesical fistula. This rare phenomenon has never been previously reported in western literature. We review the diagnosis, work up and treatment of enterovesical fistulas. Unfortunately, the prognosis for these highly invasive tumors is very poor and the treatment is often palliative. The high morbidity and mortality makes management of these patients exceptionally challenging.

  8. Gastrointestinal Fistulas in Acute Pancreatitis With Infected Pancreatic or Peripancreatic Necrosis

    Science.gov (United States)

    Jiang, Wei; Tong, Zhihui; Yang, Dongliang; Ke, Lu; Shen, Xiao; Zhou, Jing; Li, Gang; Li, Weiqin; Li, Jieshou

    2016-01-01

    Abstract Gastrointestinal (GI) fistula is a well-recognized complication of acute pancreatitis (AP). However, it has been reported in limited literature. This study aimed to evaluate the incidence and outcome of GI fistulas in AP patients complicated with infected pancreatic or peripancreatic necrosis (IPN). Between 2010 and 2013 AP patients with IPN who diagnosed with GI fistula in our center were analyzed in this retrospective study. And we also conducted a comparison between patients with and without GI fistula regarding the baseline characteristics and outcomes. Over 4 years, a total of 928 AP patients were admitted into our center, of whom 119 patients with IPN were diagnosed with GI fistula and they developed 160 GI fistulas in total. Colonic fistula found in 72 patients was the most common form of GI fistula followed with duodenal fistula. All duodenal fistulas were managed by nonsurgical management. Ileostomy or colostomy was performed for 44 (61.1%) of 72 colonic fistulas. Twenty-one (29.2%) colonic fistulas were successfully treated by percutaneous drainage or continuous negative pressure irrigation. Mortality of patients with GI fistula did not differ significantly from those without GI fistula (28.6% vs 21.9%, P = 0.22). However, a significantly higher mortality (34.7%) was observed in those with colonic fistula. GI fistula is a common finding in patients of AP with IPN. Most of these fistulas can be successfully managed with different procedures depending on their sites of origin. Colonic fistula is related with higher mortality than those without GI fistula. PMID:27057908

  9. Anomaly Busters II

    International Nuclear Information System (INIS)

    The anomaly busters had struck on the first day of the Kyoto meeting with Yoji Totsuka of Tokyo speaking on baryon number nonjjonservation and 'related topics'. The unstable proton is a vital test of grand unified pictures pulling together the electroweak and quark/gluon forces in a single field theory

  10. Minnesota Bouguer Anomaly Grid

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — A 1.5 kilometer Bouguer anomaly grid for the state of Minnesota. Number of columns is 404 and number of rows is 463. The order of the data is from the lower left to...

  11. Bolivian Bouguer Anomaly Grid

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — A 1 kilometer Bouguer anomaly grid for the country of Bolivia.Number of columns is 550 and number of rows is 900. The order of the data is from the lower left to...

  12. North Atlantic Temperature Anomaly

    OpenAIRE

    Vukcevic, M.A.

    2009-01-01

    The author postulates the existence of a high correlation between North Atlantic Temperature Anomaly and the variations of magnetic field over the Hudson Bay region. Post-glacial uplift and convection in the underlying mantle uplift (as reflected in changes of the area's magnetic intensity) are making significant contribution to the Atlantic basin climate change.

  13. Anomalies and elliptic operators

    International Nuclear Information System (INIS)

    The coefficients of asymptotic expansion Spexp(-tA) at t→0 are calculated for the quantum field theory operators. It is shown how to apply these results to the calculations of axial and conformal anomalies, the charge renormalization in gauge theory and effective action in twodimensional electrodynamics

  14. Obstetric fistula in Assam, India: a neglected cause of maternal morbidities and mortality

    Directory of Open Access Journals (Sweden)

    Suresh Jungari

    2015-02-01

    Full Text Available Each year between 50,000 to 100,000 women worldwide are affected by obstetric fistula, a hole in the birth canal. Obstetric fistula is one of the major cause for maternal morbidities and mortality and it has been successfully eradicated in developed nations. Women who experience obstetric fistula suffer constant incontinence, shame, and social segregation. Obstetric fistula is prevalent in African and Asian countries, including India. In India, data has been collected in a large scale survey of district level household survey regarding obstetric fistula and its causes. In this study, efforts are endeavoured to understand the prevalence and causes of obstetric fistula in Assam state, India, where prevalence of obstetric fistula is very high (4.5%. Chi-square test was applied to determine the affecting factors of obstetric fistula. Results showing the socioeconomic status, education, place of residence and age group are important determinants in variation of fistula prevalence among women.

  15. The Pioneer Anomaly

    Directory of Open Access Journals (Sweden)

    Viktor T. Toth

    2010-09-01

    Full Text Available Radio-metric Doppler tracking data received from the Pioneer 10 and 11 spacecraft from heliocentric distances of 20-70 AU has consistently indicated the presence of a small, anomalous, blue-shifted frequency drift uniformly changing with a rate of ~6 × 10–9 Hz/s. Ultimately, the drift was interpreted as a constant sunward deceleration of each particular spacecraft at the level of aP = (8.74 ± 1.33 × 10–10 m/s2. This apparent violation of the Newton's gravitational inverse square law has become known as the Pioneer anomaly; the nature of this anomaly remains unexplained. In this review, we summarize the current knowledge of the physical properties of the anomaly and the conditions that led to its detection and characterization. We review various mechanisms proposed to explain the anomaly and discuss the current state of efforts to determine its nature. A comprehensive new investigation of the anomalous behavior of the two Pioneers has begun recently. The new efforts rely on the much-extended set of radio-metric Doppler data for both spacecraft in conjunction with the newly available complete record of their telemetry files and a large archive of original project documentation. As the new study is yet to report its findings, this review provides the necessary background for the new results to appear in the near future. In particular, we provide a significant amount of information on the design, operations and behavior of the two Pioneers during their entire missions, including descriptions of various data formats and techniques used for their navigation and radio-science data analysis. As most of this information was recovered relatively recently, it was not used in the previous studies of the Pioneer anomaly, but it is critical for the new investigation.

  16. Astrometric solar system anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Nieto, Michael Martin [Los Alamos National Laboratory; Anderson, John D [PROPULSION LABORATORY

    2009-01-01

    There are at least four unexplained anomalies connected with astrometric data. perhaps the most disturbing is the fact that when a spacecraft on a flyby trajectory approaches the Earth within 2000 km or less, it often experiences a change in total orbital energy per unit mass. next, a secular change in the astronomical unit AU is definitely a concern. It is increasing by about 15 cm yr{sup -1}. The other two anomalies are perhaps less disturbing because of known sources of nongravitational acceleration. The first is an apparent slowing of the two Pioneer spacecraft as they exit the solar system in opposite directions. Some astronomers and physicists are convinced this effect is of concern, but many others are convinced it is produced by a nearly identical thermal emission from both spacecraft, in a direction away from the Sun, thereby producing acceleration toward the Sun. The fourth anomaly is a measured increase in the eccentricity of the Moon's orbit. Here again, an increase is expected from tidal friction in both the Earth and Moon. However, there is a reported unexplained increase that is significant at the three-sigma level. It is produent to suspect that all four anomalies have mundane explanations, or that one or more anomalies are a result of systematic error. Yet they might eventually be explained by new physics. For example, a slightly modified theory of gravitation is not ruled out, perhaps analogous to Einstein's 1916 explanation for the excess precession of Mercury's perihelion.

  17. Intracranial dural arteriovenous fistula with spinal medullary venous drainage

    Energy Technology Data Exchange (ETDEWEB)

    Wiesmann, M.; Padovan, C.S.; Pfister, H.W.; Yousry, T.A. [Muenchen Univ. (Germany). Abt. fuer Neuroradiologie

    2000-10-01

    We report on a 46-year-old patient in whom an intracranial dural arteriovenous (AV) fistula, supplied by a branch of the ascending pharyngeal artery, drained into spinal veins and produced rapidly progressive symptoms of myelopathy and brainstem dysfunction including respiratory insufficiency. Magnetic resonance imaging studies demonstrated brainstem oedema and dilated veins of the brainstem and spinal cord. Endovascular embolization of the fistula led to good neurological recovery, although the patient had been paraplegic for 24 h prior to embolization. This case demonstrates the MRI characteristics of an intracranial dural AV fistula with spinal drainage and illustrates the importance of early diagnosis and treatment. Even paraplegia may be reversible, if angiography is performed and the fistula treated before ischaemic and gliotic changes become irreversible. (orig.)

  18. Large vesico-vaginal fistula caused by a foreign body.

    Science.gov (United States)

    Massinde, An; Kihunrwa, A

    2013-07-01

    Foreign body is a rare cause of vesico-vaginal fistula most often reported in developed countries. In developing countries obstructed labor is the commonest cause of fistula. A nulliparous 19-year-old female presented with a 3-week history of a foreign body in the vagina causing urinary incontinence and offensive vaginal discharge. Her guardian allegedly inserted the foreign body after she refused a pre-arranged marriage. A plastic container was removed from the vagina under general anesthesia. A large vesico-vaginal fistula was discovered, which was successfully surgically repaired. We recommend urgent removal of the foreign body, preferably under general anesthesia. However, if the history or physical examination reveals prolonged exposure, repair of the fistula should be delayed to allow for adequate debridement in order to prevent any life-threatening complications.

  19. Role of fistulography in evaluating pancreatic fistula after pancreaticoduodenectomy.

    NARCIS (Netherlands)

    Faccioli, N.; Foti, G.; Molinari, E.; Hermans, J.J.; Comai, A.; Talamini, G.; Bassi, C.; Pozzi-Mucelli, R.

    2012-01-01

    OBJECTIVE: To evaluate the usefulness of fistulography as a diagnostic and management tool for clinically suspected pancreatic fistulas (PF) after pancreaticoduodenectomy (PD). METHODS: 84 consecutive fistulographies were performed for clinical suspicion of PF and retrospectively analysed. We radiol

  20. Role of fistulography in evaluating pancreatic fistula after pancreaticoduodenectomy

    NARCIS (Netherlands)

    N. Faccioli (Niccolo); G. Foti (G.); F. Molinari (Francesca); J.J. Hermans (John); A. Comai (A.); G. Talamini (G.); C. Bassi (Claudio); R. Pozzi Mucelli (Roberto Silvio)

    2012-01-01

    textabstractObjective: To evaluate the usefulness of fistulography as a diagnostic and management tool for clinically suspected pancreatic fistulas (PF) after pancreaticoduodenectomy (PD). Methods: 84 consecutive fistulographies were performed for clinical suspicion of PF and retrospectively analyse

  1. Clinical and echocardiographic features of aorto-atrial fistulas

    Directory of Open Access Journals (Sweden)

    Ananthasubramaniam Karthik

    2005-01-01

    Full Text Available Abstract Aorto-atrial fistulas (AAF are rare but important pathophysiologic conditions of the aorta and have varied presentations such as acute pulmonary edema, chronic heart failure and incidental detection of the fistula. A variety of mechanisms such as aortic dissection, endocarditis with pseudoaneurysm formation, post surgical scenarios or trauma may precipitate the fistula formation. With increasing survival of patients, particularly following complex aortic reconstructive surgeries and redo valve surgeries, recognition of this complication, its clinical features and echocardiographic diagnosis is important. Since physical exam in this condition may be misleading, echocardiography serves as the cornerstone for diagnosis. The case below illustrates aorto-left atrial fistula formation following redo aortic valve surgery with slowly progressive symptoms of heart failure. A brief review of the existing literature of this entity is presented including emphasis on echocardiographic diagnosis and treatment.

  2. Congenital lacrimal sac fistula: intraoperative visualization by polyvinyl siloxane cast.

    Science.gov (United States)

    Bhatnagar, Aparna; Eckstein, Lauren A; Douglas, Raymond S; Goldberg, Robert A

    2008-01-01

    We report the intraoperative use of polyvinyl siloxane impression material to demonstrate the anatomy of the lacrimal sac, canaliculi, and lacrimal duct in a case of congenital lacrimal sac fistula. A 1-week-old boy was examined for tearing since birth. Examination revealed a left congenital lacrimal sac fistula. After a failed surgery to close the fistula with silicone intubation at 6 months of age, the patient underwent endonasal dacryocystorhinostomy performed at 14 months of age, aided by intraoperative injection of polyvinyl siloxane (trade name Reprosil) to mark and protect the nasolacrimal sac and facilitate endonasal visualization. A polyvinyl siloxane cast demonstrated the anatomy of the accessory canaliculus causing nasolacrimal duct obstruction. Postoperatively, the epiphora resolved and the fistula remained closed. The polyvinyl siloxane cast provides a 3-dimensional "ex vivo " model of the lacrimal sac, upper duct, and canalicular anatomy, and can be used in dacryocystorhinostomy surgery to identify and protect the lacrimal sac.

  3. Recurrent perimedullary arteriovenous fistula at thoracic level

    Institute of Scientific and Technical Information of China (English)

    HAI Jian; CHEN Zuo-quan; DENG Dong-feng; PAN Qing-gang; LING Feng

    2006-01-01

    @@ Perimedullary arteriovenous fistula (PMAVF, type Ⅳ spinal cord arteriovenous malformation,SCAVM) is a direct arteriovenous shunt without abnormal vascular connection between the feeding artery and draining vein. Most patients with PMAVF present with a progressive myelopathy caused by venous hypertension, resulting in disabling deficits and incurable complete transverse myelopathy.1'2The lesion is usually located on the surface of the spinal cord or under the pia mater at the level of the conus medullaris or cauda equina, thoracic PMAVF is rarely encountered. Most PMAVFs are fed by the anterior spinal artery (ASA), posterior spinal artery (PSA), or both.1-5 Multiple arterial feeders from the ASA can make the treatment of the disease difficult.6From August 2004 to February 2005, we treated a patient with a recurrent PMAVF (type Ⅳb) at the thoracic level with multiple blood supply.

  4. Delayed Nephropleural Fistula After Percutaneous Nephrolithotomy.

    Science.gov (United States)

    Kaler, Kamaljot S; Cwikla, Daniel; Clayman, Ralph V

    2016-01-01

    Pleural effusions due to pleural injury following supracostal percutaneous nephrolithotomy (PCNL) occur in upwards of 15% of patients; however, these effusions are invariably diagnosed immediately postoperative or during the hospital stay. Herein, we report our initial experience with a delayed nephropleural fistula. A 52-year-old female underwent an uneventful supracostal right PCNL staghorn stone procedure and was discharged on postoperative day 1. She presented to the emergency department 8 days after her original procedure and one day after ureteral stent removal in the office, with right pleural effusion, concomitant contralateral renal colic secondary to migration of a left pelvic stone into her left proximal ureter, and acute renal failure/oliguria. She was treated with right chest tube drainage, bilateral nephrostomy tube placement, and subsequent left holmium laser ureterolithotripsy. PMID:27579431

  5. Inoperable aggressive mesenteric fibromatosis with ureteric fistula

    International Nuclear Information System (INIS)

    The purpose of our report is to illustrate an aggressive case of mesenteric fibromatosis in a 17-year-old girl with a ureteric fistula and to review imaging and pathological features, natural history and treatment options of this disease. Our patient underwent computed tomography that revealed a widespread intra-abdominal mass. The necrotic centre of this mass had a fistulous communication with the right ureter. Fibromatoses represent a spectrum of uncommon benign conditions characterised by proliferating fibrous tissue. The deep intra-abdominal form of mesenteric fibromatosis (MF), one of the rare subtypes of the 'fibromatoses' or 'desmoid tumours', grows rapidly and may become extensive. Surgery provides good results in limited disease and non-surgical modalities in cases of unresectable and residual disease

  6. A Newly Designed Enterocutaneous Esophageal Fistula Model in the Pig.

    Science.gov (United States)

    Rahmi, Gabriel; Perretta, Silvana; Pidial, Laetitia; Vanbiervliet, Geoffroy; Halvax, Peter; Legner, Andras; Lindner, Veronique; Barthet, Marc; Dallemagne, Bernard; Cellier, Christophe; Clément, Olivier

    2016-06-01

    Background Fistulas after esophagectomy are a significant cause of morbidity and mortality. Several endoscopic treatments have been attempted, with varying success. An experimental model that could validate new approaches such as cellular therapies is highly desirable. The aim of this study was to create a chronic esophageal enterocutaneous fistula model in order to study future experimental treatment options. Methods Eight pigs (six 35-kg young German and two 50-kg adult Yucatan pigs) were used. Through a left and right cervicotomy, under endoscopic view, 1 (group A, n = 6) or 2 (group B, n = 7) plastic catheters were introduced into the esophagus 30 cm from the dental arches bilaterally and left in place for 1 month. Radiologic and endoscopic fistula tract evaluations were performed at postoperative day (POD; 30) and at sacrifice (POD 45). Results Three fistulas were excluded from the study because of early (POD 5) dislodgment of the catheter, with complete fistula closure. At catheter removal (POD 30), the external orifice was larger in group B (5.2 ± 1.1 mm vs 2.6 ± 0.4 mm) with more severe inflammation (72% vs 33%). At POD 45, the external orifice was closed in all fistulas in group A and in 1/7 in group B. At necropsy, the fistula tract was still present in all animals. Yucatan pigs showed more complex tracts, with a high level of necrosis and substantial fibrotic infiltration. Conclusions In this article, we show a reproducible, safe, and effective technique to create an esophagocutaneous fistula model in a large experimental animal. PMID:26989046

  7. Coronary arterovenous fistula: to treat or not to treat?

    OpenAIRE

    Jiritano, Federica; Prestipino, Filippo; Mastroroberto, Pasquale; Chello, Massimo

    2015-01-01

    We reported the case of a 68-year old male with chest pain. The coronary angiography showed the disease of the left anterior descending coronary artery and, incidentally, an arteriovenous coronary fistula between this coronary branch and the pulmonary artery. The patient underwent off-pump coronary bypass through a left mini thoracotomy. In the present case, after a series of detailed exams, we decided not to close the fistula for several reasons, but mainly because of the singular localizati...

  8. Pathophysiology of fistula formation in Crohn’s disease

    Institute of Scientific and Technical Information of China (English)

    Michael; Scharl; Gerhard; Rogler

    2014-01-01

    Fistulae represent an important complication in patient suffering from Crohn’s disease(CD). Cumulative incidence of fistula formation in CD patients is 17%-50% and about one third of patients suffer from recurring fistulae formation. Medical treatment options often fail and also surgery frequently is not successful. Available data indicate that CD-associated fistulae originate from an epithelial defect that may be caused by ongoing inflammation. Having undergone epithelial to mesenchymal transition(EMT), intestinal epithelial cells(IEC) penetrate into deeper layers of the mucosa and the gut wall causing localized tissue damage formation of a tube like structure and finally a connection to other organs or the body surface. EMT of IEC may be initially aimed toimprove wound repair mechanisms since "conventional" wound healing mechanisms, such as migration of fibroblasts, are impaired in CD patients. EMT also enhances activation of matrix remodelling enzymes such as matrix metalloproteinase(MMP)-3 and MMP-9 causing further tissue damage and inflammation. Finally, soluble mediators like TNF and interleukin-13 further induce their own expression in an autocrine manner and enhance expression of molecules associated with cell invasiveness aggravating the process. Additionally, pathogen-associated molecular patterns also seem to play a role for induction of EMT and fistula development. Though current knowledge suggests a number of therapeutic options, new and more effective therapeutic approaches are urgently needed for patients suffering from CD-associated fistulae. A better understanding of the pathophysiology of fistula formation, however, is a prerequisite for the development of more efficacious medical anti-fistula treatments.

  9. Endoscopic Treatment of Gastrointestinal Perforations, Leaks, and Fistulae.

    Science.gov (United States)

    Rustagi, Tarun; McCarty, Thomas R; Aslanian, Harry R

    2015-01-01

    Gastrointestinal leaks and fistulae are common postoperative complications, whereas intestinal perforation more commonly complicates advanced endoscopic procedures. Although these complications have classically been managed surgically, there exists an ever-expanding role for endoscopic therapy and the involvement of advanced endoscopists as part of a multidisciplinary team including surgeons and interventional radiologists. This review will serve to highlight the innovative endoscopic interventions that provide an expanding range of viable endoscopic approaches to the management and therapy of gastrointestinal perforation, leaks, and fistulae.

  10. Nutritional Management in Enterocutaneous Fistula. What is the evidence?

    OpenAIRE

    Badrasawi, Manal; Shahar, Suzana; Sagap, Ismail

    2015-01-01

    The management of Enterocutaneous fistula (ECF) is challenging. It remains associated with morbidity and mortality, despite advancements in medical and surgical therapies. Early nutritional support using parenteral, enteral or fystuloclysis routs is essential to reverse catabolism and replace nutrients, fluid and electrolyte losses. This study aims to review the current literature on the management of ECF. Fistulae classifications have an impact on the calories and protein requirements. Early...

  11. Effectiveness of Recombinant Human Growth Hormone for Pharyngocutaneous Fistula Closure

    OpenAIRE

    Kucuk, Nurten; Sari, Murat; Midi, Ahmet; Yumusakhuylu, Ali Cemal; Findik, Ozan; Binnetoglu, Adem

    2015-01-01

    Objectives In laryngeal cancer, which comprises 25% of head and neck cancer, chemotherapy has come into prominence with the increase in organ-protective treatments. With such treatment, salvage surgery has increased following recurrence; the incidence of pharyngocutaneous fistula has also increased in both respiratory and digestive system surgery. We investigated the effects of recombinant human growth hormone on pharyngocutaneous fistula closure in Sprague-Dawley rats, based on an increase i...

  12. Thoracic fistulas of the pancreas and their complications in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Fritsch, R.; Schirg, E.; Buerger, D.

    1981-08-01

    The article reports on two thoracic fistulas of the pancreas in infants. Anamnesis revealed that recurring abdominal pain had occured in those children for years; at the time of their admission to hospital there was considerable dyspnoea with thoracic pain depending on the respiration. Fistulas of the pancreas with thoracic connection were identified as the cause. The article goes into the details of genesis, differential diagnosis and course of the disease.

  13. Carotid Cavernous Fistula Subsequent to Nasal Septoplasty; A Case Report

    Directory of Open Access Journals (Sweden)

    H Moin

    2005-03-01

    Full Text Available Carotid cavernous fistula (CCF is a rare and lethal condition; it can be spontaneous, traumatic or iatrogenic. This report Presents a case of CCF subsequent to nasal septoplasty who was a 24 years old lady with proptosis and severe decreased visual acuity. After cerebral angiography, trapping and embolization of fistula was performed with good recovery. Like our case, review of articles shows that the patients are signs and symptoms free after embolization.

  14. Arteriovenous fistulas aggravate the hemodynamic effect of vein bypass stenoses

    DEFF Research Database (Denmark)

    Nielsen, T G; Djurhuus, C; Pedersen, Erik Morre;

    1996-01-01

    PURPOSE: The purpose of this study was to assess the impact of arteriovenous fistulas combined with varying degrees of stenosis on distal bypass hemodynamics and Doppler spectral parameters. METHODS: In an in vitro flow model bypass stenoses causing 30%, 55%, and 70% diameter reduction were induced...... hemodynamic conditions of a more severe stenosis. Assessment of the hemodynamic impact of fistulas must be undertaken in the evaluation of in situ vein bypass stenoses....

  15. SPONTANEOUS DUODENO-BILIARY FISTULA CAUSED BY DUODENAL PEPTIC ULCER

    Directory of Open Access Journals (Sweden)

    N. Danila

    2005-07-01

    Full Text Available Spontaneous duodeno-biliary fistula represents a rare complication of chronic duodenal peptic ulcer. The authors present two cases with this pathology and also the particularities of surgical approach. Spontaneous duodeno-biliary fistula caused by chronic peptic ulcer is often a surprising diagnostic in the era of H2 blockers. The difficulties and the complexity of the diagnosis associated with the particularities of surgical technique represent the key of this rare disease.

  16. Palliative Endoscopic Therapy for Cancer Patients with Esophageal Fistula

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ji-chang; ZHANG Li-jian; WU Qi; ZHANG Jun; ZHOU Zong-hui; WU Yang; XU Zhao-li

    2008-01-01

    Objective:To find an effective treatment for advanced cancer patients with esophageal fistula. Methods:From 1998 to 2006, we studied 42 patients with advanced esophageal cancer and 5 lung cancer patients with carcinomatous esophageal fistula(3 females,44 males,aged 29-92 years). Ten patients with both esophageal cancer stricture and fistula were first dilated under endoscope,then a memory stent with a membrane was placed in the esophageal lumen. Others were treated only with a memory stent with a membrane,three of them with a large fistula(diameter>1.5 cm)were treated with bio-protein glue after placement of an esophageal metal stent.Results:The fistulas were covered by a stent and the patients could eat and drink immediately.Their quality of life was improved and their survival was prolonged, 44 out of 47 patients survived for>3 mo. Conclusion:Placement of esophageal stent with membrane or in combination with bio-protein glue through endoscope is an effective method for treating the bronchoesophageal fistula.

  17. Carotid Cavernous Fistula Associated with Persistent Trigeminal Artery

    Science.gov (United States)

    Hurst, Robert W.; Howard, Robert S.; Zager, Eric

    1998-01-01

    Carotid-cavernous fistula (CCF) associated with persistent trigeminal artery (PTA) is a rare but important clinical entity. We present a case treated by microcoil embolization with preservation of internal carotid, PTA, and hasilar artery flow following embolization. A 62-year-old female developed pulsatile tinnitus followed by left eye proptosis and diplopia. Examination revealed a cranial nerve VI palsy and an objective bruit over the left orbit. Angiographic evaluation revealed a carotid cavernous fistula originating from a persistent trigeminal artery. Placement of a detachable balloon across the fistula site while preserving the PTA proved impossible, and the fistula was treated with microcoils following placement of a microcatheter across the fistula into the cavernous sinus. Complete closure of the fistula was followed by resolution of the patient's symptoms. Preservation of all major vessels including the PTA was accomplished through the use of coil embolization. Careful evaluation of the angiogram is necessary to identify PTA associated with a CCF. Previous reports have described treatment of CCF with PTA by surgical or balloon ocolusion, some involving sacrifice of the PTA. Examination of the relevant embryology and anatomy reveals, however, that occlusion of the PTA must be approached with caution due to potential supply to the posterior circulation. ImagesFigure 1 PMID:17171071

  18. Surgical repair of ruptured abdominal aortic aneurysm with non-bleeding aortocaval fistula.

    Science.gov (United States)

    Unosawa, Satoshi; Kimura, Haruka; Niino, Tetsuya

    2013-01-01

    We present a case of an aortocaval fistula (ACF) without bleeding because a clot was covering the fistula. A 60-year-old man was diagnosed as having a ruptured abdominal aortic aneurysm (AAA) and an aortocaval fistula, by enhanced computed tomography (CT). After the aneurysm had been opened, the fistula was detected, but there was no bleeding because it was covered with clot. After graft repair, bleeding from the fistula occurred when the clot was removed by suction. Direct closure of the fistula was achieved after bleeding was controlled by digital compression. PMID:23825505

  19. Anomalies, Branes, and Currents

    OpenAIRE

    Cheung, Yeuk-Kwan E.; Yin, Zheng

    1997-01-01

    When a D-brane wraps around a cycle of a curved manifold, the twisting of its normal bundle can induce chiral asymmetry in its worldvolume theory. We obtain the general form of the resulting anomalies for D-branes and their intersections. They are not cancelled among themselves, and the standard inflow mechanism does not apply at first sight because of their apparent lack of factorizability and the apparent vanishing of the corresponding inflow. We show however after taking into consideration...

  20. The Pioneer Anomaly

    CERN Document Server

    Turyshev, Slava G

    2010-01-01

    Radio-metric Doppler tracking data received from the Pioneer 10 and 11 spacecraft from heliocentric distances of 20-70 AU has consistently indicated the presence of a small, anomalous, blue-shifted frequency drift uniformly changing with a rate of ~6 x 10^{-9} Hz/s. Ultimately, the drift was interpreted as a constant sunward deceleration of each particular spacecraft at the level of a_P = (8.74 +/- 1.33) x 10^{-10} m/s^2. This apparent violation of the Newton's gravitational inverse-square law has become known as the Pioneer anomaly; the nature of this anomaly remains unexplained. In this review, we summarize the current knowledge of the physical properties of the discovered effect and the conditions that led to its detection and characterization. We review various mechanisms proposed to explain the anomaly and discuss the current state of efforts to determine its nature. A comprehensive new investigation of the anomalous behavior of the two Pioneers has begun recently. The new efforts rely on the much-extend...

  1. Trisomy 18 with unilateral atypical ectrodactyly

    Energy Technology Data Exchange (ETDEWEB)

    Rogers, R.C. [Greenwood Genetic Center, SC (United States)

    1994-01-01

    Becerra et al. recently reported on an infant with multiple congenital anomalies who had trisomy 18. This preterm infant presented with bilateral ectrodactyly of feet, small cleft palate, esophageal atresia with associated tracheoesophageal fistula, congenital heart disease and other anomalies. The authors referenced article by Castle and Bernstein, in which they reported a male with trisomy 18 and cleft foot as well as a review of the literature which showed 2 other infants with trisomy 18 and ectrodactyly of the feet. An additional case of trisomy 18 associated with multiple congenital anomalies, including unilaterial, atypical ectrodactyly of the left foot.

  2. Pharyngocutaneous fistula onset after total laryngectomy: scintigraphic analysis.

    Science.gov (United States)

    Galli, J; Valenza, V; Parrilla, C; Galla, S; Marchese, M R; Castaldi, P; Almadori, G; Paludetti, G

    2009-10-01

    Pharyngocutaneous fistula is the most common non-fatal complication following total laryngectomy. To start oral feeding and exclude the presence of a pharyngocutaneous fistula, a subjective test and instrumental assessments using videofluoroscopy, have been described. The aim of this study was to evaluate the effectiveness of oral-pharyngo-oesophageal scintigraphy as an objective and non-invasive tool to establish presence, site and dimensions of the fistula. Observations were performed on 3 male patients, mean age 65 years, who underwent total laryngectomy and mono or bilateral neck dissection after failure of radiotherapy in 2 cases and of conservative laryngeal surgery in the third case, complicated by post-operative pharyngocutaneous fistula. Oral-pharyngo-oesophageal scintigraphy dynamic study with sequential images were obtained during the swallowing phases. In case 1, the test showed a wide pharyngocutaneous fistula the internal orifice of which was at the level of the base of the tongue: on the scintigraphic images, the radiomarked water bolus, from the fistulous orifice, descended along the stoma walls and only a small part reached the oesophagus. In the other two patients, the pharyngocutaneous fistula was small and the internal fistulous orifice was detected in the lower part of T-suture line. In conclusion, scintigraphy offered the possibility to precisely identify presence of pharyngocutaneous fistula and location of its internal orifice and to monitor its spontaneous closure. Therefore, important information could be obtained regarding the suture line status and the possibility of deciding whether to remove the nasogastric tube or to leave it in place. Finally, these data showed that oral-pharyngo-oesophageal scintigraphy could be performed in the early post-operative period to optimize starting safe oral feeding. PMID:20162023

  3. Recurrent ischemia resulting from left internal mammary artery-to-pulmonary artery fistula.

    Science.gov (United States)

    Madu, E C; Hanumanthu, S K; Kim, C; Prudoff, A

    2001-03-01

    This report describes a case series of recurrent ischemia after coronary artery bypass grafting resulting from left internal mammary artery-to-pulmonary artery fistula. An angiographic demonstration of this fistula is presented.

  4. Hemiparesis in carotid cavernous fistulas (CCFs):a case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    王慧晓; 白如林; 黄承光; 卢亦成; 张光霁

    2004-01-01

    @@ Carotid-cavernous fistulas (CCFs) are abnormal arteriovenous anastamoses between the carotid artery and the cavernous sinus. These fistulas may be classified by cause (spontaneous or traumatic), flow velocity (high or low ), or pathogenesis (direct or indirect).

  5. Usefulness of CT virtual endoscopy in imaging a large esophagorespiratory fistula

    Energy Technology Data Exchange (ETDEWEB)

    Sonomura, Tetsuo; Kishi, Kazushi; Ishii, Seigo; Kawai, Nobuyuki; Masuda, Mitsunori; Terada, Masaki; Nakamine, Hirokazu; Sato, Morio

    2000-04-01

    A 73-year-old woman with a large esophagorespiratory fistula underwent bronchoscopy and computed tomographic (CT) virtual endoscopy before stenting. Noninvasive CT virtual endoscopy showed the large fistula, and the CT findings agreed with the bronchoscopic findings.

  6. Obstetric fistula in Assam, India: a neglected cause of maternal morbidities and mortality

    OpenAIRE

    Suresh Jungari; Bal Govind Chauhan

    2015-01-01

    Each year between 50,000 to 100,000 women worldwide are affected by obstetric fistula, a hole in the birth canal. Obstetric fistula is one of the major cause for maternal morbidities and mortality and it has been successfully eradicated in developed nations. Women who experience obstetric fistula suffer constant incontinence, shame, and social segregation. Obstetric fistula is prevalent in African and Asian countries, including India. In India, data has been collected in a large scale survey ...

  7. Inferior Turbinate Flap for Nasal-side Closure of Palatal Fistula in Cleft Patients: Technical Note

    OpenAIRE

    Amin Rahpeyma; Saeedeh Khajehahmadi

    2015-01-01

    Summary: Residual palatal fistula after repair of palatal cleft is common. Repair of residual oronasal fistula is not always successful. Two-layer closure techniques that close these fistulas with soft tissue are a common practice. Turnover flaps are the most used flaps and often the sole method for nasal-side closure of fistula. Anteriorly based inferior turbinate flap can be used to provide soft tissue for nasal-side closure when turnover flaps will not provide sufficient tissue for this pu...

  8. Arteriovenous fistula complicating iliac artery pseudo aneurysm: diagnosis by CT angiography.

    Science.gov (United States)

    Huawei, L; Bei, D; Huan, Z; Zilai, P; Aorong, T; Kemin, C

    2002-01-01

    Fistula formation to the inferior vena cava is a rare complication of aortic aneurysm which is often misdiagnosed clinically. In one hundred of reported arteriocaval fistulae, none was originating from the right common iliac artery. We report a case of ileo-caval fistula due to a iatrogenic pseudoaneurysm. High resolution 3D imaging using breath-hold CT angiography is highly specific in identifying the location, extent of the aortocaval fistula as well as the neighbouring anatomic structures.

  9. CONGENITAL VESICOUTERINE FISTULA ALONG WITH DISTAL VAGINAL AGENESIS, SOLITARY KIDNEY AND TONGUE TIE: A RARITY

    OpenAIRE

    Khalid; Amit; Rana Pratap; Ahsan; Takallum

    2015-01-01

    : Congenital vesicouterine fistula in association with vaginal agenesis and solitary renal agenesis has been rarely reported. We present a case of 19 year old female suffering from cyclical menouria for last years. Physical examination revealed absence of vagina. IVP revealed left renal agenesis and CT scan revealed left renal agenesis with vesicouterine fistula. Cystoscopy showed vesicouterine fistula located above trigone near midline. Vesicouterine fistula was repaired along wi...

  10. A penile torsion with a fistula due to previous hypospadias surgery: A case report

    OpenAIRE

    Mustafa Rasid Toksoz; Ramazan Kocaaslan; Furkan Erol Karabekmez

    2014-01-01

    We presented a case of penile torsion due to previous hypospadias surgery. A patient applied to our clinic for treatment of hypospadias fistula and accompanying penile torsion. Patient’s urethral fistula was repaired first and penile torsion was corrected in the second stage due to multiple fistula tracts. Proximal based flip flap technique was used for closure of the fistula and simple degloving with release of fibrous tissue and pedicle of the previous preputial island flap was used for cor...

  11. Urinary System anomalies at birth

    Directory of Open Access Journals (Sweden)

    Sharada B. Menasinkai

    2015-06-01

    Full Text Available Background: Congenital anomalies of urinary system are common and are found in 3-4% of population, and lethal urinary anomalies account for 10% of termination of pregnancy. Methods: A study was done to know the incidence of congenital anomalies at birth for the period of 4 months from May 99 - Sept 99 at Cheluvamba hospital attached to Mysore medical college. Congenital anomalies in the still births, live births and aborted fetuses >20 weeks were studied along with the case history and ultrasound reports. Aborted fetuses and still born babies were collected for autopsy after the consent of parents. These babies were fixed in 10% formalin and autopsy was done after fixing, and anomalies were noted. Results: Total births during study period were 3000. There were 61 babies with congenital anomalies and 6 babies had anomalies of urinary system. Among the urinary system anomalies 1 baby had bilateral renal agenesis, 1 baby had unilateral renal agenesis with anophthalmia (Fraser syndrome, 2 babies had Multicystic dysplastic kidney disease (MCDK and 1 live baby had hydronephrosis due to obstruction at pelvi ureteric junction, and 1 live female baby had polycystic kidneys. Conclusion: Incidence of urinary system anomalies in the present study was 2 per 1000 births. U/S detection of urinary anomalies varies with period of gestation, amniotic fluid volume and visualisation of urinary bladder. Autopsy helps to detect renal agenesis. [Int J Res Med Sci 2015; 3(3.000: 743-748

  12. High-resolution MRI for Primary anal fistulas

    International Nuclear Information System (INIS)

    Objective: To evaluate the accuracy and clinical value of preoperative high-resolution magnetic resonance (MR) imaging with a phased-army coil for the detection of anal fistulas. Methods: A total of 20 patients with surgically proved anal fistulas underwent preoperative MR imaging with phased-array coil at 1.5 T MR unit. The imaging protocol included high-resolution T2-weighted turbo spin echo sequence acquisition at axial, sagittal and coronal planes and axial T2-weighted sequence with fat suppression. Results: Twenty patients were found to have 27 fistulas, 24 internal openings, 28 external openings, and 10 perianal abcesses. The sensitivity and specificity for detecting primary fistula tracks, abscesses and internal openings were 92.6% (25/27) and 92.3% (12/13), 100.0% (10/10) and 96.3% (26/27), 91.7% (22/24) and 85.7% (12/14), respectively. Conclusion: High-resolution Mil imaging is a very accurate preoperative technique for evaluating the classification of fistula-in-ano, the course of primary tracks and the presence of abscesses, thus providing important information for proper surgical treatment. (authors)

  13. Another view of "humanitarian ventures" and "fistula tourism".

    Science.gov (United States)

    Morgan, Mark A

    2007-06-01

    There are many ethical issues involved in medical missions to developing countries. The Current Opinion/Update "Humanitarian ventures or 'fistula tourism?': the ethical perils of pelvic surgery in the developing world" raised many concerns about surgical trips to treat obstetric fistula. Despite a lack of experience with obstetric fistula, western surgeons may still bring surgical and public health techniques that may be of value to health systems in developing countries. Emphasis should be placed on program development and assessment first. This should include not only surgical training but also help with counseling, prevention and reintegration. Participation in clinical trials should be up to the health care personnel in the country being helped, and aide should not depend on such participation. Success will likely be determined by a national effort and integration into existing health systems, not isolated "fistula champions." The appalling situation of obstetric fistula in the twenty-first century should be a wake-up call to obstetricians/gynecologists and urologists. The dictum "first do no harm" must not evolve into "first do nothing." PMID:17252312

  14. Risk factors for leukopenia in patients with gastrointestinal fistula

    Institute of Scientific and Technical Information of China (English)

    ZHOU Zheng; REN Jian-an; LIU Hai-yan; GU Guo-sheng; LI Jie-shou

    2010-01-01

    Background White blood cell count is an important index to the outcome of patients. In hospital, leukopenia is accompanied by high mortality, morbidity and treatment costs. However, in infectious diseases, the reasons responsible for leucopenia was not well elucidated. We investigated patients with gastrointestinal fistula to find risk factors for leukopenia.Methods A prospective case control investigation was carried out in the Gastrointestinal Fistula Center, General Surgical Institute of Jinling Hospital. Cases included gastrointestinal fistula patients with leukopenia (n=98) and controls composed of gastrointestinal fistula patients with normal white blood cell count (n=78). The two groups were compared for risk factors of leucopenia by statistical analysis.Results Factors associated with an increased risk for leukopenia included bacterial infection (25.5%) and hypoalbuminaemia (61.2%). Multivariable Logistic regression analysis identified bacterial infection (80%), urinary catheter (70%) and central vein catheter (60%) as the independent determinants for mortality in cases.Conclusions In patients with gastrointestinal fistula, two independent factors for leukopenia and three significant predictors of mortality were elucidated. We suggest that clinicians give patients more supportive management and apply prevention strategies to treat and prevent leukopenia.

  15. Chronic kidney disease aggravates arteriovenous fistula damage in rats.

    Science.gov (United States)

    Langer, Stephan; Kokozidou, Maria; Heiss, Christian; Kranz, Jennifer; Kessler, Tina; Paulus, Niklas; Krüger, Thilo; Jacobs, Michael J; Lente, Christina; Koeppel, Thomas A

    2010-12-01

    Neointimal hyperplasia (NIH) and impaired dilatation are important contributors to arteriovenous fistula (AVF) failure. It is unclear whether chronic kidney disease (CKD) itself causes adverse remodeling in arterialized veins. Here we determined if CKD specifically triggers adverse effects on vascular remodeling and assessed whether these changes affect the function of AVFs. For this purpose, we used rats on a normal diet or on an adenine-rich diet to induce CKD and created a fistula between the right femoral artery and vein. Fistula maturation was followed noninvasively by high-resolution ultrasound (US), and groups of rats were killed on 42 and 84 days after surgery for histological and immunohistochemical analyses of the AVFs and contralateral femoral vessels. In vivo US and ex vivo morphometric analyses confirmed a significant increase in NIH in the AVFs of both groups with CKD compared to those receiving a normal diet. Furthermore, we found using histological evaluation of the fistula veins in the rats with CKD that the media shrank and their calcification increased significantly. Afferent artery dilatation was significantly impaired in CKD and the downstream fistula vein had delayed dilation after surgery. These changes were accompanied by significantly increased peak systolic velocity at the site of the anastomosis, implying stenosis. Thus, CKD triggers adverse effects on vascular remodeling in AVFs, all of which contribute to anatomical and/or functional stenosis.

  16. Radial Artery Approach to Salvage Nonmaturing Radiocephalic Arteriovenous Fistulas

    Energy Technology Data Exchange (ETDEWEB)

    Hsieh, Mu-Yang; Lin, Lin; Tsai, Kuei-Chin; Wu, Chih-Cheng, E-mail: chihchengwumd@gmail.com [National Taiwan University Hospital, Department of Cardiology (China)

    2013-08-01

    PurposeTo evaluate the usefulness of an approach through the radial artery distal to the arteriovenous anastomosis for salvaging nonmaturing radiocephalic arteriovenous fistulas.MethodsProcedures that fulfilled the following criteria were retrospectively reviewed: (1) autogenous radiocephalic fistulas, (2) fistulas less than 3 months old, (3) distal radial artery approach for salvage. From 2005 to 2011, a total of 51 patients fulfilling the above criteria were enrolled. Outcome variables were obtained from angiographic, clinical and hemodialysis records, including the success, complication, and primary and secondary patency rates.ResultsThe overall anatomical and clinical success rates for the distal radial artery approach were 96 and 94 %, respectively. The average procedure time was 36 {+-} 19 min. Six patients (12 %) experienced minor complications as a result of extravasations. No arterial complication or puncture site complication was noted. The postinterventional 6-month primary patency rate was 51 %, and the 6-month secondary patency rate was 90 %. When the patients were divided into a stenosed group (20 patients) and an occluded group (31 patients), there were no differences in the success rate, complication rate, or primary and secondary patency rates.ConclusionAn approach through the radial artery distal to the arteriovenous anastomosis is an effective and safe alternative for the salvage of nonmaturing radiocephalic arteriovenous fistulas, even for occluded fistulas.

  17. Dural arteriovenous fistula associated with neoplastic dural sinus thrombosis: two cases

    Energy Technology Data Exchange (ETDEWEB)

    Vilela, P. [Neuroradiology Department, Garcia de Orta Hospital (Portugal); Willinsky, R.; TerBrugge, K. [Toronto Western Hospital, ON (Canada). Div. of Neuroradiology

    2001-10-01

    Intracranial dural arteriovenous fistulae are direct arteriovenous shunts within the dura matter. We report two cases of arteriovenous fistulae upstream to a neoplastic dural sinus thrombosis. These cases add further support to the acquired etiology of dural arteriovenous fistulae and to the fact that venous hypertension is one of the most important precipitating factors. (orig.)

  18. Acceptable results using plug for the treatment of complex anal fistulas

    DEFF Research Database (Denmark)

    Kleif, Jakob; Hagen, Kikke; Wille-Jørgensen, Peer

    2011-01-01

    The management of complex fistula-in-ano remains a surgical challenge. Previously published studies on the treatment of fistula-in-ano with the anal fistula plug (AFP) have reported a success rate reaching 35-87%. The aim of this study was to assess the results of the AFP procedure in a group of...

  19. Delayed Presentation of Renocolic Fistula at 4 Months after Blunt Abdominal Trauma

    Directory of Open Access Journals (Sweden)

    Sang Don Lee

    2011-01-01

    Full Text Available Causes of previously reported reno-colic fistulas included primary renal and colonic pathologic states involving infectious, malignant or other inflammatory processes. However, reno-colic fistula after renal injury is extremely uncommon. We report an unusual delayed presentation of reno-colic fistula that occurred at 4 months later after blunt abdominal trauma.

  20. Delayed Presentation of Renocolic Fistula at 4 Months after Blunt Abdominal Trauma

    OpenAIRE

    Sang Don Lee; Tae Nam Kim; Hong Koo Ha

    2011-01-01

    Causes of previously reported reno-colic fistulas included primary renal and colonic pathologic states involving infectious, malignant or other inflammatory processes. However, reno-colic fistula after renal injury is extremely uncommon. We report an unusual delayed presentation of reno-colic fistula that occurred at 4 months later after blunt abdominal trauma.

  1. Successful resection of enterovesical fistula in a patient with sigmoid colonic malignancy

    Institute of Scientific and Technical Information of China (English)

    江军; 朱方强; 姜庆; 王洛夫; 叶锦; 张连阳

    2003-01-01

    @@ Enterovesical fistula is a rare complication of a variety of inflammatory and neoplastic diseases. Early diagnosis of enterovesical fistula is difficult and its management is complicated. In this paper, we describe an unusual case of enterovesical fistula secondary to sigmoid colonic malignancy.

  2. BUCCAL ADVANCEMENT FLAP DAN ANTROSTOMI: UNTUK TERAPI ORO ANTRAL FISTULA (Laporan Kasus)

    OpenAIRE

    Rizal Rivandi

    2015-01-01

    Buccal advancement flap is one of the many ways of treating oro antral fistula. This technique is frequently used by dentists because it is easier to do and has several advantages compared to other techniques. This paper reports a case of oro antral fistula caused by complication of a tooth extraction, with discussions about definition, ethics and other therapies of oro antral fistula.

  3. Acceptable results using plug for the treatment of complex anal fistulas

    DEFF Research Database (Denmark)

    Kleif, Jakob; Hagen, Kikke; Wille-Jørgensen, Peer

    2011-01-01

    The management of complex fistula-in-ano remains a surgical challenge. Previously published studies on the treatment of fistula-in-ano with the anal fistula plug (AFP) have reported a success rate reaching 35-87%. The aim of this study was to assess the results of the AFP procedure in a group...

  4. Medical image of the week: bronchopleural fistula

    Directory of Open Access Journals (Sweden)

    Desai H

    2016-09-01

    Full Text Available No abstract available. Article truncated at 150 words. A 58-year-old man with past medical history significant for chronic smoking and seizures was referred to the emergency room after a chest x-ray done by his primary care physician for evaluation of cough showed a hydropneumothorax. His symptoms included dry cough for past 2 months without fever, chills or other associated symptoms. He did not have any thoracic procedures performed and had no past history of recurrent infections. He was hemodynamically stable. Physical examination was only significant with decreased breath sounds on the right side of the chest. Thoracic CT with contrast was performed which showed complete collapse of the right lower lobe, near complete collapse of right middle lobe as well as an air-fluid level. There was a suspicion of a direct communication between bronchi and pleural space at the posterior lateral margin of the collapsed right lower lobe (Figure 1. The presence of bronchopleural fistula (BPF was confirmed ...

  5. Observational manifestations of anomaly inflow

    OpenAIRE

    Boyarsky, Alexey; Ruchayskiy, Oleg; Shaposhnikov, Mikhail

    2005-01-01

    In theories with chiral couplings, one of the important consistency requirements is that of the cancellation of a gauge anomaly. In particular, this is one of the conditions imposed on the hypercharges in the standard model. However, anomaly cancellation condition of the standard model looks unnatural from the perspective of a theory with extra dimensions. Indeed, if our world were embedded into an odd-dimensional space, then the full theory would be automatically anomaly-free. In this paper ...

  6. [Personal experience in the treatment of perianal fistulas].

    Science.gov (United States)

    Simkovic, D; Pospísil, I

    1994-03-01

    The authors describe the therapeutic results assembled with perianal fistulae in 130 patients. The best and most reliable method for treatment of the above mentioned lesions is discision or excision of the fistula followed by the so-called "open method" of healing. Since 1988 by this method 74 patients were treated where only two relapses were recorded. Postoperative treatment is simple, dietetic provisions are not necessary. Regular digital control of the wound hastens granulation. After rapid epithelization the wound heals by an almost linear scar. As in particular intersphincteric and low transphincteric fistulae calt for careful sphincterotomy of an appropriate extent it is essential that these operations should be performed by a surgeon adequately experienced in proctosurgery. PMID:8184366

  7. Successful therapy of brachiocephalic arteriogastric fistula after esophagectomy.

    Science.gov (United States)

    Nagai, Yohei; Watanabe, Masayuki; Ikeda, Osamu; Nakasone, Yutaka; Sakaguchi, Hisashi; Kunitomo, Ryuji; Yamashita, Yasuyuki; Baba, Hideo

    2011-10-01

    We report the case of an 86-year-old man, who had undergone subtotal esophagectomy and reconstruction with a gastric tube through the retrosternal route 7 years ago, who was referred for treatment of a brachiocephalic arteriogastric fistula. An emergency stent-graft placement was performed to prevent massive bleeding from the fistula. After 2 weeks, a follow-up esophagogastroscopy revealed that the gastric tube ulcer had been penetrated, and the stent graft was exposed. Therefore, surgical treatment was indicated. After a carotid-carotid arterial bypass graft was made, the brachiocephalic artery was resected with the stent graft and the gastric wall. The defect between the cervical esophagus and the remnant gastric tube was replaced by a free jejunal graft. The patient tolerated these procedures well and was transferred to the referral hospital 3 months after surgery. Therefore, both an early diagnosis and the administration of multidisciplinary treatment are essential to save patients presenting with an arterioenteric fistula.

  8. [Endovascular repair of iliocaval arteriovenous fistula complicating lumbar disc surgery].

    Science.gov (United States)

    Ben Jemaa, H; Maalej, A; Lazzez, K; Jemal, H; Karray, S; Ben Mahfoudh, K

    2016-05-01

    Vascular complications of lumbar disc surgery are rare. Few cases have been reported. Arteriovenous fistulas are the most common. They are due to anatomical relationships between the last lumbar vertebrae, the corresponding discs, and the iliac vessels; degenerative lesions of the intervertebral discs facilitate instrumental vessel perforation, and operative difficulty. Computed tomography is particularly accurate for making the diagnosis. Treatment strategies consist in surgery or endovascular management. Percutaneous endovascular treatment using a stent-graft is a reasonable option for treating arteriovenous fistula. We describe the case of a 50-year-old patient who developed an iliocaval arteriovenous fistula following lumbar disc hernia surgery. The lesion was excluded by a stent-graft. The postoperative period was uneventful. PMID:26920402

  9. Vesical fistulae--an experience from a developing country.

    Directory of Open Access Journals (Sweden)

    Raut V

    1993-01-01

    Full Text Available This study analyses patients with vesical fistulae presenting at a teaching, referral hospital over the last ten years. There were 62 cases of vesical fistulae of which 60 were obstetric in origin (44 home and 16 hospital deliveries and 2 were following gynaecological surgery. Of the hospital deliveries which culminated in fistula formation, 8 were vaginal and 7 forceps deliveries. In one patient, lower segment caesarean section was carried out. After a thorough urological work-up, patients were subjected to standard technique of layered closure (61 by vaginal approach and one by abdominal. Repair was successful in 53 (87.09% patients. Of the 9 failures, 4 were repeat repairs.

  10. Detection of occult colovesical fistula by the Bourne test.

    Science.gov (United States)

    Amendola, M A; Agha, F P; Dent, T L; Amendola, B E; Shirazi, K K

    1984-04-01

    The value of different diagnostic tests in the detection of colovesical fistulas was studied in 28 surgically proven cases seen during the last 10 years at the University of Michigan, Ann Arbor. Etiologies were diverticulitis (19), Crohn disease (three), postradiation therapy (four), previous trauma (one), and bladder carcinoma (one). The fistulas were demonstrated by barium enema in 10 of 20 patients and by cystography in eight of 26. Cystoscopy was diagnostic in 11 of 25 patients and sigmoidoscopy in four of 24. Methylene blue test was positive in five of six patients, and in one patient given a charcoal enema the material appeared in the urine. The Bourne test, consisting of radiography of the centrifuged urine samples obtained immediately after a nondiagnostic barium enema, was positive in nine of 10 patients. In seven of these 10 patients, the Bourne test was the only positive evidence of an otherwise occult colovesical fistula later proven at surgery. PMID:6608228

  11. Contemporary surgical management of rectovaginal fistula in Crohn's disease.

    Science.gov (United States)

    Valente, Michael A; Hull, Tracy L

    2014-11-15

    Rectovaginal fistula is a disastrous complication of Crohn's disease (CD) that is exceedingly difficult to treat. It is a disabling condition that negatively impacts a women's quality of life. Successful management is possible only after accurate and complete assessment of the entire gastrointestinal tract has been performed. Current treatment algorithms range from observation to medical management to the need for surgical intervention. A wide variety of success rates have been reported for all management options. The choice of surgical repair methods depends on various fistula and patient characteristics. Before treatment is undertaken, establishing reasonable goals and expectations of therapy is essential for both the patient and surgeon. This article aims to highlight the various surgical techniques and their outcomes for repair of CD associated rectovaginal fistula.

  12. Doppler ultrasound in the diagnosis and follow-up of the muscle rupture and an arteriovenous fistula of the thigh in 12 year boy

    International Nuclear Information System (INIS)

    Background. With this case report the authors wish to present the accuracy of non-invasive vascular imaging methods, especially Doppler ultrasound, in the evaluation of the muscular trauma and periskeletal soft tissue vascular anomalies. Case report. Twelve year-old boy has been admitted with the right femoral quadriceps muscle traumatic rupture. Postoperative B-mod sonography (US) visualised recidivuous haematoma and Power Doppler depicted hypervascularized area, suspected vascular malformation (angioma). Doppler findings obtained on the right thigh vasculature gave us reasons to think about posttraumatic arteriovenous fistula. Doppler has been repeated in the specialized paediatric institution with the same results. Digital subtraction angiography, 8 months after trauma, did not confirm suspicions reported in US findings. Spiral computed tomographic angiography (CTA) performed 11 months after trauma clearly depicted a lesion which had been repeatedly described in US findings. Fourteen months after trauma the vascular surgeon performed the deep femoral artery muscular branches ligation, but in the official report only arteriovenous fistula was mentioned. After the surgery the patient was clinically better. The aetiology of the right femoral arteriovenous fistula and hypervascularized structure remains unclear. Conclusions. Every inadequately behaving, recidivous posttraumatic haematoma should be evaluated with Doppler ultrasound. CTA can be performed if it is needed to clarify US findings. (author)

  13. Treatment of traumatic trigeminal-cavernous fistula by coil embolization and compression of carotid artery

    Directory of Open Access Journals (Sweden)

    Yang Xinjian

    2007-01-01

    Full Text Available We report a case of a traumatic cavernous fistula supplied by a persistent primitive trigeminal artery. The process of treatment was unique in this case. Fistula was subcompletely occluded by coiling from primitive trigeminal artery. Residual fistula was helped to form thrombosis by compression of the carotid artery with hand in the procedure. Long-term follow-up was satisfactory. Traumatic cavernous fistula supplied by a persistent primitive trigeminal artery could be treated by embolization and temporal compression of the parent artery might be useful for residual minimal fistula.

  14. Spontaneous biliopneumothorax (thoracobilia) following gastropleural fistula due to stomach perforation by nasogastric tube.

    Science.gov (United States)

    Bini, Alessandro; Grazia, Manuele; Petrella, Francesco; Stella, Franco; Bazzocchi, Ruggero

    2004-07-01

    Gastropleural fistula may occur after pulmonary resection, perforated paraesophageal hernia, perforated malignant gastric ulcer at the fundus, or gastric bypass surgery for morbid obesity. We describe a case of gastropleural fistula after stomach perforation by a nasogastric tube in a patient who underwent Billroth II gastric resection for adenocarcinoma. Left biliopneumothorax occurred and was treated by thoracic drainage with -20 cm H2O aspiration. As gastropleural fistula persisted, laparotomy was repeated and gastric and diaphragmatic perforations were sutured. Gastropleural fistula is rare and, to our knowledge, this is the first reported case of gastropleural fistula and biliopneumothorax caused by gastric and diaphragmatic perforation by a nasogastric tube.

  15. Aortoduodenal fistula following aortic reconstruction of a pseudoaneurysm caused by stab wound 12 years ago

    Institute of Scientific and Technical Information of China (English)

    Jian-cang ZHOU; Qiu-ping XU; Lai-gen SHEN; Kong-han PAN; Yi-ping MOU

    2009-01-01

    Gastrointestinal bleeding due to aortoenteric fistula is extremely rare. Aortoenteric fistula is difficult to be diagnosed timely and entails a significant morbidity and mortality. Herein, we present an uncommon case of gastrointestinal bleeding caused by aortoduodenal fistula, which was a complication of a successful aortic reconstruction 4 months ago for an aortic pseudoaneurysm resulted from a stab wound 12 years ago. An urgent laparotomy confirmed an aortoduodenal fistula and repaired the defects in aorta and duodenum, but a prolonged shock led to the patient's death. In summary, early diagnosis and surgical intervention for aortoenteric fistula are vital for survival.

  16. A bill of rights for patients with obstetric fistula.

    Science.gov (United States)

    Wall, L Lewis

    2014-12-01

    According to the seven categories of vulnerability proposed by Kipnis (cognitive, juridical, deferential, medical, allocational, social, and infrastructural), and the four generally accepted principles of biomedical ethics (respect, beneficence, non-maleficence, and fairness), women with obstetric fistulas are an exceptionally vulnerable population. Therefore, they merit special consideration in both clinical care and research settings. Adoption of a formal bill of rights for patients with fistula similar to the one proposed in the present report should be encouraged at all facilities where these women are treated. Acknowledgment of their rights would help to improve their care and end the abuses they are exposed to in institutional settings. PMID:25194211

  17. Ramiprilate inhibits functional matrix metalloproteinase activity in Crohn's disease fistulas

    DEFF Research Database (Denmark)

    Efsen, Eva; Saermark, Torben; Hansen, Alastair;

    2011-01-01

    and examined the effect of inhibitors, including clinically available drugs that beside their main action also suppress MMPs. Fistula specimens were obtained by surgical excision from 22 patients with Crohn's disease and from 10 patients with fistulas resulting from other causes. Colonic endoscopic biopsies...... from six controls were also included. Total functional MMP activity was measured by a high-pressure liquid chromatography (HPLC)-based, fluorogenic MMP-substrate cleavage assay, and the specific activity of MMP-2, -3 and -9 by the MMP Biotrak Activity Assay. The MMP inhibitors comprised ethylene...

  18. Unique Presentation of Hematuria in a Patient with Arterioureteral Fistula

    Directory of Open Access Journals (Sweden)

    Tomas Mujo

    2016-01-01

    Full Text Available Active extravasation via an arterioureteral fistula (AUF is a rare and life-threatening emergency that requires efficient algorithms to save a patient’s life. Unfortunately, physicians may not be aware of its presence until the patient is in extremis. An AUF typically develops in a patient with multiple pelvic and aortoiliac vascular surgeries, prior radiation therapy for pelvic tumors, and chronic indwelling ureteral stents. We present a patient with a left internal iliac arterial-ureteral fistula and describe the evolution of management and treatment algorithms based on review of the literature.

  19. Coblation-assisted closure of persistent tracheocutaneous fistulae.

    Science.gov (United States)

    Walner, David L; Mularczyk, Chris; Kakodkar, Kedar

    2016-06-01

    Persistent tracheocutaneous fistulae (PTCFs) are sequelae of long-term tracheostomy tube use, and while many procedures exist to correct this issue, several are invasive and incur risk to the patient. This case study discusses a minimally invasive approach to closure of small PFTFs with a coblator device that may reduce the risks associated with other closure procedures. We demonstrated successful tracheocutaneous fistulae closure after coblation in all 4 patients that the operation was performed. We believe this technique can be considered for patients under select circumstances and can be part of a surgeon's armamentarium for the treatment of small PTCFs.

  20. Pneumobilia Resulting From Choledochoduodenal Fistula Secondary to Metastatic Colon Adenocarcinoma

    Science.gov (United States)

    Kramer, Scott; Tzimas, Demetrios; Saitta, Patrick

    2016-01-01

    Pneumobilia, or air within the biliary tree, is a poor prognostic indicator in a patient without prior biliary sphincterotomy. Differential diagnosis includes infection with gas-forming organisms, choledochoenteric fistula in the setting of gallstones or penetrating ulcer disease, malignant invasion from a primary liver or biliary tract tumor, or metastatic disease. Treatment depends on etiology and patient factors, but often requires surgical intervention. We report a patient with gastrointestinal bleeding in whom pneumobilia was incidentally noted on abdominal plain film. Computed tomography and endoscopy revealed the biliary-enteric fistula to be caused by metastatic colon adenocarcinoma invading the biliary tree. PMID:26958563

  1. Endovascular exclusion of aortoesophageal fistula after coarctation extraanatomical bypass.

    Science.gov (United States)

    Myers, Patrick O; Gemayel, Gino; Mugnai, Damiano; Murith, Nicolas; Kalangos, Afksendiyos

    2014-07-01

    Extraanatomical bypass has been advocated as the primary technique in adolescents or adults presenting with aortic coarctation. This approach carries significant morbidity, and graft-related complications may be more important in the young patient population. A 52-year-old man who had previously undergone extraanatomical bypass of aortic coarctation was diagnosed with a distal anastomotic pseudoaneurysm and aortoesophageal fistula. This was managed by proximal bypass plugging with an occluder, endovascular exclusion with a stent-graft in the thoracic descending aorta covering the pseudoaneurysm, and coarctation balloon dilation. Aortoesophageal fistula is a late complication observed after extraanatomical bypass for coarctation. This case illustrates this rare complication.

  2. MR enterography of ileocolovesicular fistula in pediatric Crohn disease

    Energy Technology Data Exchange (ETDEWEB)

    Sakala, Michelle D. [Wayne State University School of Medicine, Detroit, MI (United States); Dillman, Jonathan R.; Ladino-Torres, Maria F. [University of Michigan Health System, Department of Radiology, C.S. Mott Children' s Hospital, Section of Pediatric Radiology, Ann Arbor, MI (United States); McHugh, Jonathan B. [University of Michigan Health System, Department of Pathology, Ann Arbor, MI (United States); Adler, Jeremy [University of Michigan Health System, Department of Pediatrics and Communicable Diseases, C. S. Mott Children' s Hospital, Division of Pediatric Gastroenterology, Ann Arbor, MI (United States)

    2011-05-15

    Crohn disease, a form of chronic inflammatory bowel disease is characterized by discontinuous inflammatory lesions of the gastrointestinal tract, has a variety of behavioral patterns, including penetrating or fistulous disease. While magnetic resonance enterography (MRE) excellently depicts inflamed bowel segments, it can also be used to assess for a variety of Crohn-disease-related extraintestinal complications, including fistulae. We present the MRE findings of a complex ileocolovesicular fistula in a 14-year-old boy with Crohn disease, where the fistulous tract to the urinary bladder was best delineated on precontrast T1-W imaging because of the presence of fecal material. (orig.)

  3. Anomaly poles as common signatures of chiral and conformal anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Armillis, Roberta, E-mail: roberta.armillis@le.infn.i [Dipartimento di Fisica, Universita del Salento and INFN Sezione di Lecce, Via Arnesano, 73100 Lecce (Italy); Coriano, Claudio, E-mail: claudio.coriano@le.infn.i [Dipartimento di Fisica, Universita del Salento and INFN Sezione di Lecce, Via Arnesano, 73100 Lecce (Italy); Department of Physics, University of Crete, Heraklion, Crete (Greece); Delle Rose, Luigi, E-mail: luigi.dellerose@le.infn.i [Dipartimento di Fisica, Universita del Salento and INFN Sezione di Lecce, Via Arnesano, 73100 Lecce (Italy)

    2009-12-07

    One feature of the chiral anomaly, analyzed in a perturbative framework, is the appearance of massless poles which account for it. They are identified by a spectral analysis of the anomaly graph and are usually interpreted as being of an infrared origin. Recent investigations show that their presence is not just confined in the infrared, but that they appear in the effective action under the most general kinematical conditions, even if they decouple in the infrared. Further studies reveal that they are responsible for the non-unitary behaviour of these theories in the ultraviolet (UV) region. We extend this analysis to the case of the conformal anomaly, showing that the effective action describing the interaction of gauge fields with gravity is characterized by anomaly poles that give the entire anomaly and are decoupled in the infrared (IR), in complete analogy with the chiral case. This complements a related analysis by Giannotti and Mottola on the trace anomaly in gravity, in which an anomaly pole has been identified in the corresponding correlator using dispersion theory in the IR. Our extension is based on an exact computation of the off-shell correlation function involving an energy-momentum tensor and two vector currents (the gauge-gauge-graviton vertex) which is responsible for the appearance of the anomaly.

  4. Rare Upper Airway Anomalies.

    Science.gov (United States)

    Windsor, Alanna; Clemmens, Clarice; Jacobs, Ian N

    2016-01-01

    A broad spectrum of congenital upper airway anomalies can occur as a result of errors during embryologic development. In this review, we will describe the clinical presentation, diagnosis, and management strategies for a few select, rare congenital malformations of this system. The diagnostic tools used in workup of these disorders range from prenatal tests to radiological imaging, swallowing evaluations, indirect or direct laryngoscopy, and rigid bronchoscopy. While these congenital defects can occur in isolation, they are often associated with disorders of other organ systems or may present as part of a syndrome. Therefore workup and treatment planning for patients with these disorders often involves a team of multiple specialists, including paediatricians, otolaryngologists, pulmonologists, speech pathologists, gastroenterologists, and geneticists. PMID:26277452

  5. The York-Mason technique for recto-urethral fistulas Correção de fistula reto-uretral pela técnica de York-Mason

    OpenAIRE

    Alexandre Crippa; Marcos F. Dall' Oglio; Luciano J. Nesrallah; Endric Hasegawa; Alberto Azoubel Antunes; Miguel Srougi

    2007-01-01

    OBJECTIVE: Recto-urethral fistula formation following radical prostatectomy is an uncommon but potentially devastating event. There is no consensus in the literature regarding the treatment of these fistulas. We present here our experiences treating recto-urethral fistulas. MATERIAL AND METHODS: We analyzed 8 cases of rectourethral fistula treated at our institution in the last seven years. Seven of the patients underwent repair of the fistula using the modified York-Mason procedure. RESULTS:...

  6. A cost-effectiveness analysis of fistula treatment in the abdominal region using a new integrated fistula and wound management system

    DEFF Research Database (Denmark)

    Keiding, Hans; Skovgaard, Rasmus

    2008-01-01

    OBJECTIVE: To evaluate wear time and costs of a new fistula and wound management system (FWMS) compared to standard fistula treatments. METHODS: Data were collected from 22 patients with an abdominal fistula recruited from 5 sites in the United States. This economic evaluation was based on a cost......, the sensitivity analysis showed that 77% of patients achieved a cost reduction when changing to the FWMS. CONCLUSION: The FWMS was less costly than traditional methods for managing abdominal fistula, probably due to longer wear time and less time spent on each pouching session....

  7. Speech Rehabilitation For 10 Alaryngeal Patients Using Tracheoesophageal Puncture And Prosthesis Insertion In Amir Alam And Imam Khomeini Hospitals 2002-2003

    Directory of Open Access Journals (Sweden)

    M.T. Khorsi Ashtiani

    2006-05-01

    Full Text Available Background and Aim: Total laryngectomy following laryngeal cancer has many sequelae , that loss of voice is the most important of them. Tracheoesophageal puncture (TEP and prosthesis insertion has evolved into the most widely used and accepted technique for vocal rehabilitation. Materials and Methods: 10 patients that underwent TEP in Amir Alam and Imam Khomeini hospitals from Feb. 2002 through Nov. 2003; were included in this study. Prosthesis insertion in 4 patients is primary and in 6 patients is secondary; and all patients are men. Results: The age of patients was between 50 to 70. 90% of patients had history of cigarette smoking and 10% of them had history of drinking alcohol. Salivary leakage was seen in 30% of patients that was improved with conservative management. Fluency of speech in 30% of patients and intelligibility of speech & voice quality in 40% of patients is good. Conclusion: We could conclude that TEP has less complication & better speech results of other vocal rehabilitation methods. Carefully selection of patients & size of prosthesis has important role in results of TEP.

  8. Direct Carotid Cavernous Fistula of an Adult-Type Persistent Primitive Trigeminal Artery with Multiple Vascular Variations

    Science.gov (United States)

    Jin, Sung-Chul; Park, Hyun; Choi, Choong-Gon

    2011-01-01

    We report a case of spontaneous right carotid-cavernous fistula (CCF) in a proximal segment of persistent primitive trigeminal artery (PPTA) and combined vascular anomalies such as left duplicated hypoplastic proximal posterior cerebral arteries and a variation of anterior choroidal artery supplying temporal and occipital lobe. A 45-year-old male presented with progressive right exophthalmos, diplopia, and ocular pain. With manual compression of the internal carotid artery, a cerebral angiography revealed a right CCF from a PPTA. Treatment involved the placement of detachable non-fibered and fibered coils, and use of a hyperglide balloon to protect against coil herniation into the internal carotid artery. A final angiograph revealed complete occlusion of PPTA resulted in no contrast filling of CCF. PMID:21607181

  9. Direct carotid cavernous fistula of an adult-type persistent primitive trigeminal artery with multiple vascular variations.

    Science.gov (United States)

    Jin, Sung-Chul; Park, Hyun; Kwon, Do Hoon; Choi, Choong-Gon

    2011-04-01

    We report a case of spontaneous right carotid-cavernous fistula (CCF) in a proximal segment of persistent primitive trigeminal artery (PPTA) and combined vascular anomalies such as left duplicated hypoplastic proximal posterior cerebral arteries and a variation of anterior choroidal artery supplying temporal and occipital lobe. A 45-year-old male presented with progressive right exophthalmos, diplopia, and ocular pain. With manual compression of the internal carotid artery, a cerebral angiography revealed a right CCF from a PPTA. Treatment involved the placement of detachable non-fibered and fibered coils, and use of a hyperglide balloon to protect against coil herniation into the internal carotid artery. A final angiograph revealed complete occlusion of PPTA resulted in no contrast filling of CCF. PMID:21607181

  10. Seismic data fusion anomaly detection

    Science.gov (United States)

    Harrity, Kyle; Blasch, Erik; Alford, Mark; Ezekiel, Soundararajan; Ferris, David

    2014-06-01

    Detecting anomalies in non-stationary signals has valuable applications in many fields including medicine and meteorology. These include uses such as identifying possible heart conditions from an Electrocardiography (ECG) signals or predicting earthquakes via seismographic data. Over the many choices of anomaly detection algorithms, it is important to compare possible methods. In this paper, we examine and compare two approaches to anomaly detection and see how data fusion methods may improve performance. The first approach involves using an artificial neural network (ANN) to detect anomalies in a wavelet de-noised signal. The other method uses a perspective neural network (PNN) to analyze an arbitrary number of "perspectives" or transformations of the observed signal for anomalies. Possible perspectives may include wavelet de-noising, Fourier transform, peak-filtering, etc.. In order to evaluate these techniques via signal fusion metrics, we must apply signal preprocessing techniques such as de-noising methods to the original signal and then use a neural network to find anomalies in the generated signal. From this secondary result it is possible to use data fusion techniques that can be evaluated via existing data fusion metrics for single and multiple perspectives. The result will show which anomaly detection method, according to the metrics, is better suited overall for anomaly detection applications. The method used in this study could be applied to compare other signal processing algorithms.

  11. Trace Anomaly in Geometric Discretization

    OpenAIRE

    Czech, Bartlomiej

    2007-01-01

    I develop the simplest geometric-discretized analogue of two dimensional scalar field theory, which qualitatively reproduces the trace anomaly of the continuous theory. The discrete analogue provides an interpretation of the trace anomaly in terms of a non-trivial transformation of electric-magnetic duality-invariant modes of resistor networks that accommodate both electric and magnetic charge currents.

  12. Algebraic study of chiral anomalies

    Indian Academy of Sciences (India)

    Juan Mañes; Raymond Stora; Bruno Zumino

    2012-06-01

    The algebraic structure of chiral anomalies is made globally valid on non-trivial bundles by the introduction of a fixed background connection. Some of the techniques used in the study of the anomaly are improved or generalized, including a systematic way of generating towers of ‘descent equations’.

  13. Anomaly mediation deformed by axion

    International Nuclear Information System (INIS)

    We show that in supersymmetric axion models the axion supermultiplet obtains a sizable F-term due to a non-supersymmetric dynamics and it generally gives the gaugino masses comparable to the anomaly mediation contribution. Thus the gaugino mass relation predicted by the anomaly mediation effect can be significantly modified in the presence of axion to solve the strong CP problem

  14. Anomaly Poles as Common Signatures of Chiral and Conformal Anomalies

    CERN Document Server

    Armillis, Roberta; Rose, Luigi Delle

    2009-01-01

    One feature of the chiral anomaly, analyzed in a perturbative framework, is the appearance of massless poles which account for it. They are identified by a spectral analysis of the anomaly graph and are usually interpreted as being of an infrared origin. Recent investigations shown that their presence is not just confined in the infrared, but that they appear in the effective action under the most general kinematical conditions, even if they decouple in the infrared. Further studies reveal that they are responsible for the non-unitary behaviour of these theories in the ultraviolet (UV) region. We extend this analysis to the case of the conformal anomaly, showing that the effective action describing the interaction of gauge fields with gravity is characterized by anomaly poles that give the entire anomaly and are decoupled in the infrared (IR), in complete analogy with the chiral case. This complements a related analysis by Giannotti and Mottola on the trace anomaly in gravity, in which an anomaly pole has bee...

  15. Sudden Sensorineural Hearing Loss: The Question of Perilymph Fistula.

    Science.gov (United States)

    Backous, Douglas D.; Niparko, John K.

    1997-01-01

    Perilymph fistula (PLF) is an abnormal communication between the fluid-containing spaces of the inner ear and the air-containing spaces of the temporal bone that can cause hearing loss, tinnitus, aural fullness, vertigo, and postural instability. Diagnosis of PLF and management of those with presumed PLF are discussed. (Contains extensive…

  16. MR imaging evaluation of perianal fistulas: spectrum of imaging features.

    Science.gov (United States)

    de Miguel Criado, Jaime; del Salto, Laura García; Rivas, Patricia Fraga; del Hoyo, Luis Felipe Aguilera; Velasco, Leticia Gutiérrez; de las Vacas, M Isabel Díez Pérez; Marco Sanz, Ana G; Paradela, Marcos Manzano; Moreno, Eduardo Fraile

    2012-01-01

    Perianal fistulization is an inflammatory condition that affects the region around the anal canal, causing significant morbidity and often requiring repeated surgical treatments due to its high tendency to recur. To adopt the best surgical strategy and avoid recurrences, it is necessary to obtain precise radiologic information about the location of the fistulous track and the affected pelvic structures. Until recently, imaging techniques played a limited role in evaluation of perianal fistulas. However, magnetic resonance (MR) imaging now provides more precise information on the anatomy of the anal canal, the anal sphincter complex, and the relationships of the fistula to the pelvic floor structures and the plane of the levator ani muscle. MR imaging allows precise definition of the fistulous track and identification of secondary fistulas or abscesses. It provides accurate information for appropriate surgical treatment, decreasing the incidence of recurrence and allowing side effects such as fecal incontinence to be avoided. Radiologists should be familiar with the anatomic and pathologic findings of perianal fistulas and classify them using the St James's University Hospital MR imaging-based grading system.

  17. Condylomata acuminata within perianal fistulae tracts: report of two cases.

    Science.gov (United States)

    Panidis, Stavros; Paramythiotis, Daniel; Papadopoulos, Vasileios N; Michalopoulos, Antonios

    2015-04-01

    The commonest sights of appearance of condylomata acuminata are in the genital and anal regions. Herein we present two cases of condylomata within perianal fistulae tracts, resulting in recurrence in one case and a malignant-like tumour in the second. To our knowledge, these are the first cases reported in the literature. PMID:24872374

  18. Catheter-related infection in gastrointestinal fistula patients

    Institute of Scientific and Technical Information of China (English)

    Ge-Fei Wang; Jian-An Ren; Jun Jiang; Cao-Gan Fan; Xin-Bo Wang; Jie-Shou Li

    2004-01-01

    AIM: To study the incidence, bacterial spectrum and drug sensitivity of catheter-related infection (CRI) in gastrointestinal fistula patients.METHODS: A total of 216 patients with gastrointestinal fistulae during January 1998 to April 2001 were studied retrospectively. Two hundred and sixteen catheters of the 358 central venous catheters used in 216 gastrointestinal fistula patients were sent for microbiology analysis.RESULTS: Ninety-five bacteria were cultivated in 88catheters (24.6%). There were 54 Gram-negative bacteria (56.8%), 35 Gram-positive bacteria (36.8%), and 6 fungi (6.4%). During the treatment of CRI, 20 patients changed to use antibiotics or antifungal, and all patients were cured.The mean time of catheters used was 16.9±13.0 d.CONCLUSION: CRI is still the common complication during total parenteral nutrition (TPN) treatment in patients with gastrointestinal fistulae, and Gram-negative bacteria are the main pathogens, and bacterial translocation is considered the common reason for CRI.

  19. Carotid cavernous fistula after elective carotid endarterectomy: Case report

    Directory of Open Access Journals (Sweden)

    Andres Asser

    2014-12-01

    This is a case to illustrate a rare complication of carotid artery surgery. The patient had atherosclerotic vessel damage of ICA visible on earlier CT scans. This combined with abrupt increase of transmural pressure due to the revascularization procedure could possibly lead to arterial wall rupture and fistula formation.

  20. Pudendal thigh flap for repair of rectovaginal fistula.

    Science.gov (United States)

    Sathappan, S; Rica, M A I

    2006-08-01

    The pudendal thigh flap or the Singapore flap is a versatile flap that can be used in the repair of recto-vaginal fistulae. Apart from the potential problem of hair growth, this neurovascular flap proves to be surprisingly simple in technique, robust and has a high potential for normal or near-normal function. PMID:17240589

  1. A prospective study of pharyngocutaneous fistulas following total laryngectomy

    Directory of Open Access Journals (Sweden)

    Qureshi S

    2005-01-01

    Full Text Available Pharyngocutaneous (PC fistula is a common complication following laryngectomy. It leads to increased morbidity, delay in adjuvant treatment, prolonged hospitalization and an increase in treatment costs. Although a number of factors that result in PC fistula have been described, there is still no agreement on the most significant factors. We undertook a prospective study to critically analyze PC fistula and its association with various tumors, patient and treatment related factors. This was a prospective study that included 143 patients who underwent laryngeal surgery for squamous cell carcinoma of the larynx and pyriform sinus. Use of pectoralis major myocutaneous flap to reconstruct the neopharynx, primary disease in pyriform and extensive soft tissue infiltration were significantly associated with PC fistula. Prior treatment (radiotherapy and chemotherapy, type of closure (T closure, Y closure and vertical closure, Layers of closure (full thickness interrupted, submucosal interrupted, submucosal continuous type of suture material (silk, vicryl , age, sex, stage, preoperative tracheostomy, cut margin status, pre/postoperative hemoglobin and experience of surgeons did not relate significantly.

  2. Retained drains causing a bronchoperitoneal fistula: a case report

    Directory of Open Access Journals (Sweden)

    Kieninger Alicia A

    2011-05-01

    Full Text Available Abstract Introduction Bronchoperitoneal fistulas are extremely rare. We present a case where retained surgical drains from a previous surgery resulted in erosion and fistula formation. This condition required an extensive surgical procedure and advanced ventilator techniques. Case presentation A 24-year-old African-American man presented to our Emergency Department with a one-week history of fever, dyspnea, cough, and abdominal pain. A computed tomography scan of his chest and abdomen revealed bilateral lower lobe pneumonia and two retained Jackson-Pratt drains in the right upper quadrant. He was taken to the operating room for drain removal, a right hemicolectomy, debridement of a duodenal injury, a Roux-en-y duodenojejunostomy, and an end ileostomy. He subsequently became increasing hypoxemic in the intensive care unit and a bronchoperitoneal fistula was diagnosed. He required high-frequency oscillatory ventilation followed by lung isolation, and was successfully resuscitated using these techniques. Conclusion To the best of our knowledge, this is the first known case report of a bronchoperitoneal fistula caused by retained surgical drains. This is also the first known report that details successful management of this condition with advanced ventilatory techniques. This case highlights the importance of follow-up for trauma patients since retained surgical drains have the potential to cause life-threatening complications. When faced with this condition, clinicians should be aware of advanced ventilatory methods that can be employed in the intensive care unit. In this case, these techniques proved to be life-saving.

  3. El agua en Segobriga (Saelices, Hispania Citerior: Las fistulae plumbeae

    Directory of Open Access Journals (Sweden)

    Cebrián, Rosario

    2014-12-01

    Full Text Available In the present article the lead pipes found in the archaeological site of Segobriga and in its surroundings are presented. Some of these fistulae are related to the siphon aqueduct that brought drinking water from Fuente la Mar in Saelices, while others correspond to the internal water supply in the city. Both epigraphic references containing the abbreviated name of the municipality, r(es p(ublica S(egobrigensis vel Segobrigensium, identified on a fistula and in a lead cover, show the public property of the Segobriga hydraulic network.En este artículo presentamos las tuberías de plomo halladas en el yacimiento arqueológico de Segobriga y su entorno. Algunas de estas fistulae están relacionadas con el sifón del acueducto que condujo el agua potable desde la Fuente de la Mar en Saelices, mientras que otras corresponden a la red de distribución del agua en el interior de la ciudad. Las dos menciones epigráficas con el nombre abreviado del municipio, r(es p(ublica S(egobrigensis vel Segobrigensium, documentadas en una fistula y en la tapa de un registro ponen de manifiesto la propiedad pública del sistema hidráulico de Segobriga.

  4. Spontaneous gastrojejunal fistula is a complication of gastric ulcer

    Institute of Scientific and Technical Information of China (English)

    (D)or(d)e M (C)ulafi(c); Olivera D Mateji(c); Vladimir S (D)uki(c); Miodrag D Vuk(c)evi(c); Mirko D Kerkez

    2007-01-01

    Spontaneous gastrojejunal fistula formation is an extremely rare complication of gastric ulcer disease. We report a 77-year old woman who presented with diffuse abdominal pain, weight loss, malaise, nausea, and occasional dark stools. Laboratory tests showed extreme hyposideremic anemia with inflammatory syndrome. In addition, biochemical parameters of malnourishment were presented. Upper endoscopy revealed the patent esophagus along the full length without any pathological changes. Large and deep ulceration with perforation in the small intestine was detected in the posterior gastric wall. The small intestine loop was reached by endoscope through spontaneously developed gastrojejunal fistula.Polytopic biopsies of described ulcerative change were carried out. Histopathologically reepithelialized ulcerous zone was seen in the gastric mucosa. Also,gastrojejunal fistula was visualized after wide opening of hepatogastric and gastrocolic ligament. Jejunal loop 25cm from ligament of Treitz was attached to mesocolon and posterior gastric wall because of ulcer penetration.Postoperative course was uneventful. Per oral intake started on the 4th postoperative day, and the patient was discharged on the 8th postoperative day. In summary,this case indicates that persistent symptoms of peptic ulcer disease associated with nutritional disturbances may be caused by gastrojejunal fistula.

  5. Spontaneous gastrojejunal fistula is a complication of gastric ulcer.

    Science.gov (United States)

    Culafić, Dorde-M; Matejić, Olivera-D; Dukić, Vladimir-S; Vukcević, Miodrag-D; Kerkez, Mirko-D

    2007-01-21

    Spontaneous gastrojejunal fistula formation is an extremely rare complication of gastric ulcer disease. We report a 77-year old woman who presented with diffuse abdominal pain, weight loss, malaise, nausea, and occasional dark stools. Laboratory tests showed extreme hyposideremic anemia with inflammatory syndrome. In addition, biochemical parameters of malnourishment were presented. Upper endoscopy revealed the patent esophagus along the full length without any pathological changes. Large and deep ulceration with perforation in the small intestine was detected in the posterior gastric wall. The small intestine loop was reached by endoscope through spontaneously developed gastrojejunal fistula. Polytopic biopsies of described ulcerative change were carried out. Histopathologically reepithelialized ulcerous zone was seen in the gastric mucosa. Also, gastrojejunal fistula was visualized after wide opening of hepatogastric and gastrocolic ligament. Jejunal loop 25 cm from ligament of Treitz was attached to mesocolon and posterior gastric wall because of ulcer penetration. Postoperative course was uneventful. Per oral intake started on the 4(th) postoperative day, and the patient was discharged on the 8(th) postoperative day. In summary, this case indicates that persistent symptoms of peptic ulcer disease associated with nutritional disturbances may be caused by gastrojejunal fistula.

  6. Transanal approach in repairing acquired rectovestibular fistula in females

    Institute of Scientific and Technical Information of China (English)

    Ya-Jun Chen; Ting-Chong Zhang; Jin-Zhe Zhang

    2004-01-01

    AIM: To summarize the operative experience of the transanal approach in acquired rectovestibular fistula repair.METHODS: Ninety-six cases of acquired rectovestibular fistula in young females were analyzed retrospectively. The etiology and operative procedure were discussed. Operative essential points were, the patient was laid in prone frog position, with the knees and hips flexed at 90°; the perineum was elevated; and the anal opening was exposed. Four stay sutures were applied to the margin of the fistular orifice in the anal opening at points 3, 6, 9 and 12 o'clock.A circular incision of mucosa surrounding the stay sutures was made. The fistula was dissected from its anal opening to its vestibular opening. The wound of vestibule was sutured,and the rectoanal wound was then sutured transversely.RESULTS: All the 96 patients recovered uneventfully from operation with a successful rate of 93.75%.CONCLUSION: The transanal approach in the treatment of the acquired rectovestibular fistula is a simple and feasible technique.

  7. Giant aneurysm in a left coronary artery fistula

    DEFF Research Database (Denmark)

    Frestad, Daria; Helqvist, Steffen; Helvind, Morten;

    2013-01-01

    Congenital coronary artery fistula complicated with giant coronary artery aneurysm is a very rare condition. In this case report, we present a 65-year-old woman, referred to us with a continuous heart murmur, occasional atypical chest pain and few episodes of fainting. A giant aneurysm and a coro...

  8. Duodenocolic fistula: case report and review of the literature.

    Directory of Open Access Journals (Sweden)

    Xenos E

    1999-07-01

    Full Text Available Duodenocolic fistula is a rare complication of malignant and inflammatory bowel disease. It presents as diarrhoea and faeculent vomiting. The diagnosis is established with upper and lower gastrointestinal tract contrast studies. A case is reported and the optimal operative procedure is discussed.

  9. Risk factors for obstetric fistulae in north-eastern Nigeria.

    Science.gov (United States)

    Melah, G S; Massa, A A; Yahaya, U R; Bukar, M; Kizaya, D D; El-Nafaty, A U

    2007-11-01

    This prospective comparative study of obstetric fistulae (OF) was aimed at identifying risk factors. A total of 80 obstetric fistulae treated at the gynaecological unit of the FMCG, and 80 inpatients without fistulae recruited randomly as controls formed the basis of this study. Through interview and case record review, information on age, parity and marital status was collected. Other features were educational status, occupation and booking status of the pregnancy that might have led to this condition. The duration of labour, place of birth and mode of delivery, including its outcome were also collected. The data were analysed using the Epi Info. The majority of the patients were Hausa/Fulani 87.5%, Muslims 91.2%, with large vesicovaginal fistulae (average size 5.0 cm) mainly resulting from obstructed labour (93.7%). Major risk factors included early age at first marriage (average 14 years), short stature (average height 146.2 cm) and illiteracy (96.3%). Also low social class and lack of gainful employment were factors. Failure to book for antenatal care (93.7%), and rural place of residence (95%) were also factors associated with acquiring the fistulae. Living far away (>3 km) from a health facility also contributed or predisposed to the development of an obstetric fistula. Social violence and stigma associated with the fistulae included divorce, being ostracised as a social outcast, and lack of assistance from relations in terms of finding and funding treatment. This study supports improved access to basic essential obstetric care, family planning services, and timely referral when and where necessary. Universal education will provide a long-term solution by improving the standard of living and quality of life. Especially important are media- and community-based programmes on the ills of teenage marriage and child pregnancy using cultural and religiously-based values to give sound advice. In a male dominated society, reaching out to men with traditionally

  10. Sixty-four-multi-detector computed tomography diagnosis of coronary artery anomalies in 66 patients

    Institute of Scientific and Technical Information of China (English)

    YANG Shan; ZENG Meng-su; ZHANG Zhi-yong; LING Zhi-qing; MA Jian-ying; CHEN Gang

    2010-01-01

    Background The abnormalities of coronary arteries, though rare and sometimes benign, may first present clinically as myocardial infarction or sudden death. Multi-detector computed tomography (MDCT) is a non-invasive test that is highly suitable for detecting these anomalies. The study aimed to review the 64-MDCT appearance of the coronary artery anomalies in 66 patients and to discuss the clinical importance of these anomalies.Methods In 6014 consecutive patients examined over 12 months by 64-MDCT for the study of coronary artery disease, 66 were diagnosed for coronary artery anomalies. All patients were symptomatic for one or more of the following diseases: chest pain, dyspnoea, palpitations, arrhythmia and myocardial infarction. Nine patients had undergone a coronary angiography. All the CT images were evaluated by two radiologists and one cardiologist. The right coronary artery (RCA) and the conus branch arising separately, myocardial bridging and duplication of arteries were not analysed in our study.Results The incidence of coronary artery anomalies found in our study group was 1.097%. In the selected patients, seven different types of coronary anomalies were found by 64-MDCT examination. The high takeoff, origin of the coronary artery from the opposite or noncoronary sinus with an anomalous course, and coronary artery fistula were the three common forms of anomalies (n=16, 18 and 16, respectively). Compared with the results of the coronary angiography, the number of the drainage sites of two coronary artery fistula was less in MDCT images (3 small sites in total). In all cases, coronary artery computed tomography angiography (CTA) technique was able to recognize the origin of the coronary artery, its three-dimensional course and its spatial relationship with the adjacent structures. Conventional coronary angiography in two cases, however, was unable to provide sufficient information for correct and complete diagnosis.Conclusions In conclusion, the study

  11. Postoperative pancreatic fistulas are not equivalent after proximal, distal, and central pancreatectomy.

    Science.gov (United States)

    Pratt, Wande; Maithel, Shishir K; Vanounou, Tsafrir; Callery, Mark P; Vollmer, Charles M

    2006-11-01

    It is uncertain whether postoperative pancreatic fistulas after distal and central pancreatectomies behave similarly to those after pancreaticoduodenectomy. To date, this concept has not been validated either clinically or economically. Overall, 256 consecutive pancreatic resections from October 2001 to February 2006 (184 pancreaticoduodenectomies, 66 distal pancreatectomies, and 6 central pancreatectomies) were evaluated according to the International Study Group of Pancreatic Fistula classification scheme. Pancreatic fistula was defined as any measurable drainage on or after postoperative day 3, with amylase content greater than three times the normal serum value. Outcomes were divided into four grades: (1) no fistula, (2) grade A: biochemical fistula without clinical sequelae, (3) grade B: fistula requiring any therapeutic intervention, or (4) grade C: fistula with severe clinical sequelae. Grades B and C are considered clinically relevant fistulas based on worsening morbidity, increased length of stay, frequent hospital readmission, and increased costs/resource utilization. Clinical and economic outcomes were compared-grade for grade-across the three resection types. Fistulas of any extent (Grades A-C) occurred in one third of all patients; two thirds had no fistula. Overall, there were 16 readmissions (6%), six reoperations (2%), and no deaths attributable to pancreatic fistula. Outcomes between no fistula and grade A patients were identical across resection types, though grade A fistula was more common in distal pancreatectomy. For each resection type, length of stay and costs progressively increased with grades B and C. However, the negative impact of these clinically relevant fistulas varied between resection types. Rates for intensive care unit admission and rehabilitation placement were higher among pancreaticoduodenectomy patients. Total parenteral nutrition and antibiotic use were similar, but percutaneous drainage was used more often for distal

  12. Binning of satellite magnetic anomalies

    Science.gov (United States)

    Goyal, H. K.; Vonfrese, R. R. B.; Hinze, W. J.

    1985-01-01

    Crustal magnetic anomaly signals over satellite orbits were simulated to investigate numerical averaging as an anomaly estimator. Averaging as an anomaly estimator involves significant problems concerning spatial and amplitude smoothing of the satellite magnetic observations. The results of simulations suggest that the error of numerical averaging constitutes a small and relatively minor component of the total error-budget of higher orbital anomaly estimates, whereas for lower orbital estimates numerical averaging error increases substantially. As an alternative to numerical averaging, least-squares collocation was investigated and observed to produce substantially more accurate anomaly estimates, particularly as the orbital elevation of prediction was decreased towards the crustal sources. In contrast to averaging, collocation is a significantly more resource-intensive procedure to apply because of the practical, but surmountable problems related to establishing and inverting the covariance matrix for accurate anomaly prediction. However, collocation may be much more effectively used to exploit the anomaly details contained in the lower orbital satellite magnetic data for geologic analysis.

  13. Postoperative Pancreatic Fistula: A Surgeon’s Nightmare! An Insight with a Detailed Literature Review

    Directory of Open Access Journals (Sweden)

    Prasad Seetharam

    2015-03-01

    Full Text Available Context Postoperative fistula formation is an important complication following pancreatic resections. Objective A large volume of literature without uniform conclusions is available regarding various controversies about postoperative pancreatic fistulae. The term postoperative pancreatic fistula includes fistula resulting from any surgery involving pancreas, most commonly pancreaticoduodenectomy and distal pancreatectomy. In this review, we have tried to present a comprehensive account of postoperative pancreatic fistula with particular emphasis on important controversies clouding the subject. Methods We performed Medline literature search for relevant articles using the key words pancreas, pancreatic cancer, pancreatectomy, pancreatoduodenectomy, Whipple’s operation, postoperative, complications, fistula, management and treatment in various combinations with the Boolean operators AND, OR and NOT. Conclusions Postoperative pancreatic fistula is a troublesome complication of pancreaticoduodenectomy. Although the risk factors for postoperative pancreatic fistula have been extensively described, none of the methods recommended for preventing postoperative pancreatic fistula have been conclusively proved to be effective. While endoscopic treatment and percutaneous treatment form important aspects of treatment of postoperative pancreatic fistula, surgery may be required for select cases.

  14. Aorto-right atrial fistula after ascending aortic replacement or aortic value replacement

    International Nuclear Information System (INIS)

    Objective: To evaluate the CT features of aorto-right atrial fistula after aortic valve replacement (AVR) or ascending aortic replacement. Methods: Eighty-seven patients with aortic-right atrial fistula underwent CT after operation. The CT features were retrospectively analyzed. Fistula was measured according to maximum width of the shunt. Results: Aorto-right atrial fistula was detected in 87 patients after aortic valve replacement or ascending aortic replacement by CT scan. Among them, 25 patients were diagnosed as mild aorto-right atrial fistula, 47 patients as moderate, and 15 patients as severe. Thirty-seven patients underwent follow-up CT.Among them, 10 patients with mild to moderate aorto-right atrial fistula were considered to have complete regression, 8 patients with mild aorto-right atrial fistula considered to have incomplete regression, 14 patients with mild to moderate aorto-right atrial fistula considered to have stable condition, and 5 patients with moderate aorto-right atrial fistula considered to have progression at the 3-month follow-up. Conclusion: CT is a useful tool for defining aorto-right atrial fistula after AVR or ascending aortic replacement and for evaluating it in follow-up. (authors)

  15. Prevalence of Congenital Coronary Artery Anomalies and Variants in 2697 Consecutive Patients Using 64-Detector Row Coronary CTAngiography

    International Nuclear Information System (INIS)

    Coronary artery anomalies are not common, but could be very serious. This study determines the frequency of coronary anomalies and normal variants by multi-detector-row computed tomography (MDCT). The results of cardiac MDCT study in 2697 consecutive patients were analyzed retrospectively. Acquisition was performed by a 64-detector row CT machine. Imaging results were assessed by experienced radiologists. Myocardial bridging was by far the most frequent coronary variant (n = 576, 21.3%). Eighty-three subjects (3.1%) showed other coronary anomalies and variants. Anomalies of origination and course of the left main coronary artery (LMCA) were detected in 1.09% of the subjects. The frequency of these anomalies in the right coronary artery (RCA), left circumflex artery (LCx), left anterior descending artery (LAD), posterior descending artery (PDA) and obtuse marginal (OM) artery were 1.24%, 0.33%, 0.1%, 0.07% and 0.03%, respectively. The single coronary pattern was seen in 0.18% and coronary fistulas in 0.07%. Based on the fact that coronary CT-angiography using MDCT can display different coronary anomalies, this study shows similar results to other reports on the subject. Future advances in the performance of CT machines will further improve the quality of CT-based cardiac imaging

  16. Prevalence of Congenital Coronary Artery Anomalies and Variants in 2697 Consecutive Patients Using 64-Detector Row Coronary CTAngiography

    Directory of Open Access Journals (Sweden)

    Farzaneh Fattahi Masrour

    2012-01-01

    Full Text Available Background: Coronary artery anomalies are not common, but could be very serious.Objectives: This study determines the frequency of coronary anomalies and normal variants by multi-detector-row computed tomography (MDCT.Patients and Methods: The results of cardiac MDCT study in 2697 consecutive patients were analyzed retrospectively. Acquisition was performed by a 64-detector row CT machine. Imaging results were assessed by experienced radiologists.Results: Myocardial bridging was by far the most frequent coronary variant (n = 576, 21.3%. Eighty-three subjects (3.1% showed other coronary anomalies and variants. Anomalies of origination and course of the left main coronary artery (LMCA were detected in 1.09% of the subjects. The frequency of these anomalies in the right coronary artery (RCA, left circumflex artery (LCx, left anterior descending artery (LAD, posterior descending artery (PDA and obtuse marginal (OM artery were 1.24%, 0.33%, 0.1%, 0.07% and 0.03%, respectively. The single coronary pattern was seen in 0.18% and coronary fistulas in 0.07%.Conclusion: Based on the fact that coronary CT-angiography using MDCT can display different coronary anomalies, this study shows similar results to other reports on the subject. Future advances in the performance of CT machines will further improve the quality of CT-based cardiac imaging.Keywords: Coronary Artery Disease,Tomography,X-Ray Computed,Patients

  17. ALP hints from cooling anomalies

    CERN Document Server

    Giannotti, Maurizio

    2015-01-01

    We review the current status of the anomalies in stellar cooling and argue that, among the new physics candidates, an axion-like particle would represent the best option to account for the hinted additional cooling.

  18. Notes on Anomaly Induced Transport

    CERN Document Server

    Landsteiner, Karl

    2016-01-01

    Chiral anomalies give rise to dissipationless transport phenomena such as the chiral magnetic and vortical effects. In these notes I review the theory from a quantum field theoretic, hydrodynamic and holographic perspective. A physical interpretation of the otherwise somewhat obscure concepts of consistent and covariant anomalies will be given. Vanishing of the CME in strict equilibrium will be connected to the boundary conditions in momentum space imposed by the regularization. The role of the gravitational anomaly will be explained. That it contributes to transport in an unexpectedly low order in the derivative expansion can be easiest understood via holography. Anomalous transport is supposed to play also a key role in understanding the electronics of advanced materials, the Dirac- and Weyl (semi)metals. Anomaly related phenomena such as negative magnetoresistivity, anomalous Hall effect, thermal anomalous Hall effect and Fermi arcs can be understood via anomalous transport. Finally I briefly review a holo...

  19. On renormalization of axial anomaly

    International Nuclear Information System (INIS)

    It is shown that multiplicative renormalization of the axial singlet current results in renormalization of the axial anomaly in all orders of perturbation theory. It is a necessary condition for the Adler - Bardeen theorem being valid. 10 refs.; 2 figs

  20. Gravitational anomaly and transport phenomena

    OpenAIRE

    Landsteiner, Karl; Megías Fernández, Eugenio; Pena-Benítez, Francisco

    2011-01-01

    Quantum anomalies give rise to new transport phenomena. In particular, a magnetic field can induce an anomalous current via the chiral magnetic effect and a vortex in the relativistic fluid can also induce a current via the chiral vortical effect. The related transport coefficients can be calculated via Kubo formulas. We evaluate the Kubo formula for the anomalous vortical conductivity at weak coupling and show that it receives contributions proportional to the gravitational anomaly coefficie...

  1. Satellite elevation magnetic anomaly maps

    Science.gov (United States)

    Braile, L. W.; Hinze, W. J. (Principal Investigator)

    1982-01-01

    The problem of inverting 2 deg average MAGSAT scalar anomalies for the region 80 W, 60 E longitude and 40 S, 70 N latitude was attempted on the LARS computer; however, the effort was aborted due to insufficient allocation of CPU-time. This problem is currently being resubmitted and should be implemented shortly for quantitative comparison with free-air gravity anomaly, geothermal, and tectonic data.

  2. Boundary Anomalies and Correlation Functions

    OpenAIRE

    Huang, Kuo-Wei(C.N. Yang Institute for Theoretical Physics, Department of Physics and Astronomy, Stony Brook University, Stony Brook, NY, 11794, U.S.A.)

    2016-01-01

    It was shown recently that boundary terms of conformal anomalies recover the universal contribution to the entanglement entropy and also play an important role in the boundary monotonicity theorem of odd-dimensional quantum field theories. Motivated by these results, we investigate relationships between boundary anomalies and the stress tensor correlation functions in conformal field theories. In particular, we focus on how the conformal Ward identity and the renormalization group equation ar...

  3. Situs anomalies on prenatal MRI

    International Nuclear Information System (INIS)

    Objective: Situs anomalies refer to an abnormal organ arrangement, which may be associated with severe errors of development. Due regard being given to prenatal magnetic resonance imaging (MRI) as an adjunct to ultrasonography (US), this study sought to demonstrate the in utero visualization of situs anomalies on MRI, compared to US. Materials and methods: This retrospective study included 12 fetuses with situs anomalies depicted on fetal MRI using prenatal US as a comparison modality. With an MRI standard protocol, the whole fetus was assessed for anomalies, with regard to the position and morphology of the following structures: heart; venous drainage and aorta; stomach and intestines; liver and gallbladder; and the presence and number of spleens. Results: Situs inversus totalis was found in 3/12 fetuses; situs inversus with levocardia in 1/12 fetuses; situs inversus abdominis in 2/12 fetuses; situs ambiguous with polysplenia in 3/12 fetuses, and with asplenia in 2/12 fetuses; and isolated dextrocardia in 1/12 fetuses. Congenital heart defects (CHDs), vascular anomalies, and intestinal malrotations were the most frequent associated malformations. In 5/12 cases, the US and MRI diagnoses were concordant. Compared to US, in 7/12 cases, additional MRI findings specified the situs anomaly, but CHDs were only partially visualized in six cases. Conclusions: Our initial MRI results demonstrate the visualization of situs anomalies and associated malformations in utero, which may provide important information for perinatal management. Using a standard protocol, MRI may identify additional findings, compared to US, which confirm and specify the situs anomaly, but, with limited MRI visualization of fetal CHDs.

  4. Space weather and space anomalies

    Directory of Open Access Journals (Sweden)

    L. I. Dorman

    2005-11-01

    Full Text Available A large database of anomalies, registered by 220 satellites in different orbits over the period 1971-1994 has been compiled. For the first time, data from 49 Russian Kosmos satellites have been included in a statistical analysis. The database also contains a large set of daily and hourly space weather parameters. A series of statistical analyses made it possible to quantify, for different satellite orbits, space weather conditions on the days characterized by anomaly occurrences. In particular, very intense fluxes (>1000 pfu at energy >10 MeV of solar protons are linked to anomalies registered by satellites in high-altitude (>15000 km, near-polar (inclination >55° orbits typical for navigation satellites, such as those used in the GPS network, NAVSTAR, etc. (the rate of anomalies increases by a factor ~20, and to a much smaller extent to anomalies in geostationary orbits, (they increase by a factor ~4. Direct and indirect connections between anomaly occurrence and geomagnetic perturbations are also discussed.

  5. Aeromagnetic anomalies over faulted strata

    Science.gov (United States)

    Grauch, V.J.S.; Hudson, Mark R.

    2011-01-01

    High-resolution aeromagnetic surveys are now an industry standard and they commonly detect anomalies that are attributed to faults within sedimentary basins. However, detailed studies identifying geologic sources of magnetic anomalies in sedimentary environments are rare in the literature. Opportunities to study these sources have come from well-exposed sedimentary basins of the Rio Grande rift in New Mexico and Colorado. High-resolution aeromagnetic data from these areas reveal numerous, curvilinear, low-amplitude (2–15 nT at 100-m terrain clearance) anomalies that consistently correspond to intrasedimentary normal faults (Figure 1). Detailed geophysical and rock-property studies provide evidence for the magnetic sources at several exposures of these faults in the central Rio Grande rift (summarized in Grauch and Hudson, 2007, and Hudson et al., 2008). A key result is that the aeromagnetic anomalies arise from the juxtaposition of magnetically differing strata at the faults as opposed to chemical processes acting at the fault zone. The studies also provide (1) guidelines for understanding and estimating the geophysical parameters controlling aeromagnetic anomalies at faulted strata (Grauch and Hudson), and (2) observations on key geologic factors that are favorable for developing similar sedimentary sources of aeromagnetic anomalies elsewhere (Hudson et al.).

  6. Heart Failure with Transient Left Bundle Branch Block in the Setting of Left Coronary Fistula

    Directory of Open Access Journals (Sweden)

    Stephen P. Juraschek

    2011-01-01

    Full Text Available Coronary arterial fistulas are rare communications between vessels or chambers of the heart. Although cardiac symptoms associated with fistulas are well described, fistulas are seldom considered in the differential diagnosis of acute myocardial ischemia. We describe the case of a 64-year-old man who presented with left shoulder pain, signs of heart failure, and a new left bundle branch block (LBBB. Cardiac catheterization revealed a small left anterior descending (LAD-to-pulmonary artery (PA fistula. Diuresis led to subjective improvement of the patient's symptoms and within several days the LBBB resolved. We hypothesize that the coronary fistula in this patient contributed to transient ischemia of the LAD territory through a coronary steal mechanism. We elected to observe rather than repair the fistula, as his symptoms and ECG changes resolved with treatment of his heart failure.

  7. Costs and outcomes of endovascular treatment of thrombosed dialysis autogenous fistulae.

    Science.gov (United States)

    Coentrao, Luis

    2013-01-01

    Functional vascular access is a prerequisite for adequate haemodialysis treatment in patients with end-stage renal disease. Autogenous arteriovenous fistulae are considered superior to synthetic grafts and central venous catheters; however, fistulae are not without problems. Fistulae thrombosis has become a clinical challenge in nephrology practice, with relevant clinical implications for dialysis patients. Several studies have reported on the feasibility and relatively high-clinical success rate of the endovascular approach to thrombosed fistulae in recent years. However, as repeated interventions are usually required to achieve long-term access survival, maintenance of a previously thrombosed fistulae could be a highly expensive policy. The goals of this article are to provide the reader an insight into the multiple endovascular approaches for thrombosed arteriovenous fistulae, bearing in mind its clinical effectiveness and financial implications. PMID:23897178

  8. Gastro-umbilical fistula as a rare complication of benign gastric ulcer perforation: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ju Young; Jang, Kyung Mi; Yoon, Hoi Soo; Kim, Min Jeong; Lee, Kwan Seop; Lee, Yul; Bae, Sang Hoon [College of Medicine, Hallym University, Anyang (Korea, Republic of)

    2007-11-15

    As fistula occurring between the stomach and other abdominal internal organs or to the surface of the body is usually encountered as a complication of stomach cancer or colon cancer, peptic ulcer disease, or other variable causes. The most common type of gastric fistula is a gastro-colic fistula that is mainly found as a complication of a gastric carcinoma or of a carcinoma of the transverse colon invading each other. Sometimes, a benign gastric ulcer perforation also can cause a gastro-colic fistula. However, as far as we know, a fistula occurring between the stomach and the umbilicus has not been reported. Here we present a case report of a gastro-umbilical fistula in a young woman that manifested as a umbilical discharge.

  9. FREE VASTUS LATERALIS MUSCLE FLAP FOR CLOSURE OF RECURRENT ORONASAL FISTULA: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Prakash Kumar

    2015-06-01

    Full Text Available Recurrent oronasal fistulas after cleft palate repair present a difficult problem for the cleft surgeon. Repeated surgeries to close the fistula results in increased scar formation with associated soft tissue contracture and a resultant increase in fistula size. Although locally available flaps ha s been the standard procedure for closure of small fistulae, Large fistulas requires regional flaps like tongue flaps requiring multistage transfer, with resultant intra oral scarring, to avoid the problems associated with loco regional flaps and recent in crease in success rates of free tissue transfers make them a viable, one - stage means of closing these defects. In this case report we present our clinical experience with recurren t palatal fistula and highlight the effective use of the free vastuslateralis mus cle flap as a means of repair.

  10. The upper arm arterio-venous fistula--an alternative for vascular access in haemodialysis

    DEFF Research Database (Denmark)

    Gade, J; Aabech, J; Hansen, R I

    1995-01-01

    Forty-eight consecutive arteriovenous fistulae of the upper arm constructed in 44 patients between 1983 and 1987 were reviewed. The median observation time was 8.5 months (range 1 day-65 months). The overall patency rate for fistulae used for haemodialysis (early failures excluded) was 50% after...... one year and 38% after two years. However, only six (18.7%) of the used fistulae stopped because of thrombosis. The total number of thromboses was nine (19.6%). The main cause of discontinuance of fistulae was a high number of deaths (n = 22), presumably a result of a high median age of 62 years....... Early failure rate was seven of 46 (15.2%); in three cases (6.5%) this was caused by thrombosis. The results are compared to other alternatives for radiocephalic fistulae and the difficulties of comparisons are discussed. It is concluded that the upper arm arteriovenous fistula can serve as a second...

  11. Ileorectal fistula due to a rectal cancer—A case report

    OpenAIRE

    Takahashi, Minoru; Fukuda, Takahiro

    2010-01-01

    A 51-year-old man was seen at our hospital because of diarrhea. Barium enema and colonoscopy revealed a cancer in the lower rectum and fistula formation from the site to ileum. Resection of the rectal cancer and ileorectal fistula was performed. Histologically, the resected lesion was mucinous adenocarcinoma with contiguous invasion from the rectum to the ileum. The patient is alive with no sign of recurrence 120 months after operation. Fistula formation between the colon and other gastrointe...

  12. Intestinal prolapse through omphalomesenteric fistula, a rare cause of neonatal occlusion: A case report

    OpenAIRE

    Cheikh Diouf; Ndeye Aby Ndoye; Aimé Lakh Faye; Oumar Ndour; Gabriel Ngom

    2016-01-01

    Acute intestinal obstruction secondary to omphalomesenteric fistula is a very rare condition. Omphalomesenteric fistula is a consequence of a defect in involution of the vitelline duct between the fifth and ninth week of intrauterine development. We are reporting on a case of neonatal intestinal obstruction due to a prolapse of small bowel through an omphalomesenteric fistula. A newborn baby aged 15 days was admitted in emergency with acute intestinal obstruction lasting for two days. The phy...

  13. Bioassay-Directed Isolation of Active Compounds with Antiyeast Activity from a Cassia fistula Seed Extract

    OpenAIRE

    Subramanion L. Jothy; Sreenivasan Sasidharan; Lai Ngit Shin; Lachimanan Yoga Latha; Yee Ling Lau; Yeng Chen; Zuraini Zakaria

    2011-01-01

    Background and objective: Cassia fistula L belongs to the family Leguminosae, and it is one of the most popular herbal products in tropical countries. C. fistula seeds have been used as a herbal medicine and have pharmacological activity which includes anti-bacterial, anti-fungal, and antioxidant properties. The goal of this study was to identify compounds from C. fistula seeds which are responsible for anti-Candida albicans activity using bioassay-directed isolation. Results: The preliminary...

  14. Coronary artery fistula draining into pulmonary artery and optimal management: a review

    OpenAIRE

    Rippel, Radoslaw Adam; Kolvekar, Shyam

    2013-01-01

    Coronary artery fistula is a rare congenital malformation of high variability. The disease is illustrated with a description of a case example. The management of patients with coronary artery fistulas remains controversial. Both spontaneous regression and life threatening complications have been described. The fistula can be ligated or embolised; however, there are no long term outcome data regarding management. Intraoperative risk of myocardial infarction is less than 5% and death rate varie...

  15. Tunica vaginalis: An aid in hypospadias fistula repair: Our experience of 14 cases

    Directory of Open Access Journals (Sweden)

    Yogender Singh Kadian

    2011-01-01

    Full Text Available Background: Urethrocutaneous fistula is the most common complication of hypospadias surgery. The correction of such fistula is associated with a failure rate of 10 to 40%. The step in successful repair of a fistula is separation of the suture lines in the urethra and skin using well vascularized elastic tissue. We report our experience of using the tunica vaginalis flap as a layer between the neourethra and skin suture line in repair of recurrent urethrocutaneous fistula. Patients and Methods: We have used the tunica vaginalis flap for the repair of recurrent urethrocutaneous fistula in 14 children with a mean age of 6.5 years (range 3-14 years. All patients had undergone previous hypospadias repair and at least one previous attempt to close the fistula had failed. Surgery was initiated by injecting a povidone solution via urethral meatus to identify all fistulae. The fistulae were closed primarily and urethral suture line was covered with a flap of tunica vaginalis which was harvested either through a small scrotal incision and mobilized via a subcutaneous tunnel into the penile shaft (8/14 or by the same incision as for fistula closure (6/14. The testis was fixed to the scrotum. A urethral catheter was kept for urinary diversion for 10 days. Results: The repair was successful in all but one patient in whom there was leak from the fistula site. One patient in whom tunica vaginalis fascia was tunnelled into neourethra developed scrotal haematoma which needed drainage. Penile cosmesis was acceptable without any significant postoperative testicular complication in 13/14 patients. Conclusion: Repair of recurrent urethrocutaneous fistula with a tunica vaginalis flap is highly effective regardless of fistula location. This flap is easy to mobilize and provide effective coverage of urethral suture line. Putting a glove drain should be considered into scrotal wound if perfect haemostasis is doubtful.

  16. Temporary ileostomy for the preservation of colon fistula in patients with postoperative complications: case report

    OpenAIRE

    Solaine Chiminácio De Oliveira Patrício; Alcides José Branco Filho; Ana Carla Broetto Biazon

    2011-01-01

    Among the postoperative complications in the digestive system, the fistulae are the most common ones. The changes resulting from these fistulae are very important, once they can determine the patient's situation and the development of multiple organic failures. This paper reports the case of a patient who had relevant complications after having undergone temporary ileostomy to maintain the colon fistulized. About 90 to 95% of the digestive tract fistulae have spontaneous resolution. In so...

  17. Sealing of Airway Fistulas for Metallic Covered Z-type Stents

    Directory of Open Access Journals (Sweden)

    Hongwu WANG

    2011-08-01

    Full Text Available Background and objective Treating airway fistulas, including esophagorespiratory fistulas (ERFs, bronchopleural fistulas (BPFs, and tracheomediastinal fistulas (TMFs, is difficult. The aim of this study is to evaluate the safety and clinical efficacy of metallic covered Z-type stents (CZTS for the treatment of airway fistulas through bronchoscopy or fluroscopy. Methods Thirty-eight patients with fistulas between the esophagus, mediastina, and airways (32 ERFs, 5 BPFs, and 1 TMF were retrospectively reviewed after treatment with covered metallic esophageal and airway stents. The fistulas were caused by esophageal (n=26, bronchogenic (n=11, and thyroid (n=1 carcinomas. Results Forty-six fistulas were found in 38 patients. The fistula size ranged from 0.5 cm to 7.0 cm. Forty airway covered metal stents (24 Y-type, 8 L-type, and 8 I-type and 24 esophageal metal stents were placed. Complete responses to the sealing effects of fistulas were noted in 4.3% of all the fistulas, 60.9% showed complete clinical responses, 23.9% showed partial responses, and 10.9% showed no response. An effectivity rate of 89.1% was observed, and the median survival duration of all patients was 5 months. Conclusion The use of CZTS appears to be safe and feasible for the palliative treatment of ERFs, BPFs, and TMFs. Airway stent placement is recommended for patients with ERF. In the event that airway stents fail, esophageal stents should be given. Airway bifurcation stents were observed to be especially suitable for the sealing of fistulas near the trachea carina.

  18. Randomized controlled trial of minimally invasive surgery using acellular dermal matrix for complex anorectal fistula

    Institute of Scientific and Technical Information of China (English)

    Ma-Mu-Ti-Jiang; A; ba-bai-ke-re; Er-Ha-Ti; Ai

    2010-01-01

    AIM: To compare the efficacy and safety of acellular dermal matrix (ADM) bioprosthetic material and endorectal advancement flap (ERAF) in treatment of complex anorectal fistula. METHODS: Ninety consecutive patients with complex anorectal fistulae admitted to Anorectal Surgical Department of First Affi liated Hospital, Xinjiang Medical University from March 2008 to July 2009, were enrolled in this study. Complex anorectal fistula was diagnosed following its clinical, radiographic, or endoscopic diagnostic cr...

  19. Essential oil constituents and their biological activities from the leaves of Cassia fistula growing in Nepal

    OpenAIRE

    Prabodh Satyal; Dosoky, Noura S.; Ambika Poudel; William N. Setzer

    2013-01-01

    Cassia fistula L. (Fabaceae) fruit is used traditionally in Nepal as an antipyretic and to treat constipation, while the leaves are used to treat jaundice, piles, rheumatism, ulcers, insect bites, facial paralysis and skin eruptions. C. fistula leaves are important ingredients in Ayurvedic medicine. This study was undertaken to characterize the volatile constituents of C. fistula leaves and to evaluate their antimicrobial and cytotoxic properties. The essential oil from the leaves of Cassia f...

  20. Endovascular Management of Splenic Arteriovenous Fistula with Giant Venous Aneurysmal Dilatation

    OpenAIRE

    Hamed Ibrahim, Wael; M Bassurrah, Hana

    2012-01-01

    Although splenic artery aneurysm is the commonest visceral and third most common intra abdominal aneurysm after aorta and iliac artery, aneurysm of splenic artery along with aneurysm of splenic vein and arteriovenous fistula is a rare entity. Most of them are 10 cm have been reported. We report a case of 11 cm × 8 cm giant splenic vein aneurysm with splenic arteriovenous fistula as the 1st case of giant splenic venous aneurysm with arteriovenous fistula managed by endovascular treatment.

  1. BUCCAL ADVANCEMENT FLAP DAN ANTROSTOMI: UNTUK TERAPI ORO ANTRAL FISTULA (Laporan Kasus

    Directory of Open Access Journals (Sweden)

    Rizal Rivandi

    2015-08-01

    Full Text Available Buccal advancement flap is one of the many ways of treating oro antral fistula. This technique is frequently used by dentists because it is easier to do and has several advantages compared to other techniques. This paper reports a case of oro antral fistula caused by complication of a tooth extraction, with discussions about definition, ethics and other therapies of oro antral fistula.

  2. Arteriovenous Fistula Complicated by Popliteal Venous Access for Endovascular Thrombolytic Therapy of Deep Vein Thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Byun, Sung Su; Kim, Jeong Ho; Park, Chul Hi; Hwang, Hee Young; Kim, Hyung SiK [Gacheon University Gil Medical Center, Gacheon (Korea, Republic of); Jeon, Young Sun; Kim, Won Hong [Inha University College of Medicine, Incheon (Korea, Republic of)

    2008-10-15

    We report a case of an iatrogenic arteriovenous fistula complicated by catheter- directed thrombolytic therapy in a patient with acute deep vein thrombosis of a lower extremity. To the best of our knowledge, this is the first report of an arteriovenous fistula between the sural artery and popliteal vein in that situation. As the vessels have a close anatomical relationship, the arteriovenous fistula seems to be a potential complication after endovascular thrombolytic therapy of acute deep vein thrombosis.

  3. [Sigmoidoperianal fistula associated with diverticulitis and Cul de Sac situation--diagnostics and therapy].

    Science.gov (United States)

    Weyand, G; Rinast, E; Englert, A; Houf, M

    2002-07-01

    We report on the case of a 64-year-old female patient who presented herself in our outpatient clinic because of a perianal fistula with recurrent abscesses. We describe the step diagnostics and the surgical treatment of the causal sigmoido-perianal fistula with diverticulitis and Cul de sac situation. Clinical examination, fistulography, colonoscopy and MRT were part of the precise representation and preparation for the high anterior rectosigmoidal resection with simultaneous rectopexy according to Sudeck which were performed without complications. The sigmoidoperianal fistula must be taken into account as a differential diagnosis of a recalcitrant high perianal fistula. PMID:12122593

  4. Fistula Formation between Right Upper Bronchus and Bronchus Intermedius Caused by Endobronchial Tuberculosis: A Case Report.

    Science.gov (United States)

    Kim, Mikyoung; Kang, Eun Seok; Park, Jin Yong; Kang, Hwa Rim; Kim, Jee Hyun; Chang, YouJin; Choi, Kang Hyeon; Lee, Ki Man; Kim, Yook; An, Jin Young

    2015-07-01

    Endobronchial tuberculosis is defined as a tuberculous infection of the tracheobronchial tree and has a prevalence of up to 50% in active pulmonary tuberculosis cases. The most common complication of endobronchial tuberculosis is bronchial stenosis; benign fistula formation by endobronchial tuberculosis is rare, especially inter-bronchial fistula formation. We reported a rare case of a 73-year-old woman with a fistula between the right upper bronchus and bronchus intermedius. A diagnosis of inter-bronchial fistula caused by endobronchial tuberculosis was based on the results of chest computed tomography scans, bronchoscopy, and microbiological and pathological tests. The patient was treated with anti-tuberculous medication, and her symptoms gradually improved.

  5. Inferior Turbinate Flap for Nasal-side Closure of Palatal Fistula in Cleft Patients: Technical Note

    Directory of Open Access Journals (Sweden)

    Amin Rahpeyma

    2014-12-01

    Full Text Available Summary: Residual palatal fistula after repair of palatal cleft is common. Repair of residual oronasal fistula is not always successful. Two-layer closure techniques that close these fistulas with soft tissue are a common practice. Turnover flaps are the most used flaps and often the sole method for nasal-side closure of fistula. Anteriorly based inferior turbinate flap can be used to provide soft tissue for nasal-side closure when turnover flaps will not provide sufficient tissue for this purpose. Under general anesthesia with nasotracheal intubation, inferior turbinate was released from posterior attachment. After removing the inferior conchal bone, mucoperiosteal flap was used for nasal-side closure of anterior palatal fistula in patients with cleft. Anteriorly based inferior turbinate flap was used for nasal-side closure of residual palatal fistula in 3 patients with cleft. Age of the patients was 14, 16, and 18, and recurrence of palatal fistula has not occurred. Anteriorly based inferior turbinate flap is an axial pattern flap with appropriate surface of the paddle and vicinity to the oral cavity roof. It can be used in large anterior, palatal fistula for reconstruction of nasal floor. Considering appropriate another flap for oral side coverage of such fistula is mandatory.

  6. The pattern of non-obstetric fistula:A Cameroonian experience

    Institute of Scientific and Technical Information of China (English)

    Pierre-Marie Tebeu; Eric Brice Touka; Yvette Mawamba; Calvin Tiyou; Joseph Nelson Fomulu; Charles Henry Rochat

    2014-01-01

    Objective:To investigate the pattern ofNon-obstetrical genital fistula(NOGF) inCameroonian context.Materials and methods:This was a cross-sectional analytic study, with two groups of patients, including those treated for non-obstetrical fistula as subject, and their obstetrical counterparts as the control.Data were retrieved from the obstetric fistula database of the Department ofObstetrics andGynecology in theUniversityTeachingHospital ofYaoundé Cameroon for patients operated fromJanuary,1,2009 toDecember31,2012.Results:NOGF represented19.78% of genital fistula.Uro-genital fistula(UGF) represented72.20% while non-obstetrical genito-digestive fistula(GDF) represented27.80% ofNOGF.The main cause ofUGF was hysterectomy(46.15%) while the main cause of genito-digestive fistula was vaginal infections (40.00%).Most patients had never been operated before their arrival in theYUTH(84.60% forUGF and60.00% forGDF).We had one failure at first surgical attempt.Conclusion:UGF fistula is the main type ofNOGF inCameroonian context, with hysterectomy being the leading cause.Proper knowledge onNOGF will enable better strategies to fight against genital fistula.

  7. Complicating causality: patient and professional perspectives on obstetric fistula in Nigeria.

    Science.gov (United States)

    Phillips, Beth S; Ononokpono, Dorothy N; Udofia, Nsikanabasi W

    2016-09-01

    Obstetric fistula, a preventable maternal morbidity characterised by chronic bladder and/or bowel incontinence, is widespread in Nigeria. This qualitative, multi-site study examined the competing narratives on obstetric fistula causality in Nigeria. Research methods were participant observation and in-depth interviews with 86 fistula patients and 43 healthcare professionals. The study found that both patient and professional narratives identified limited access to medical facilities as a major factor leading to obstetric fistula. Patients and professionals beliefs regarding the access problem, however, differed significantly. The majority of fistula patients reported either delivering or attempting to deliver in medical facilities and most patients attributed fistula to a lack of trained medical staff and mismanagement at medical facilities. Conversely, a majority of health professionals believed that women developed obstetric fistula because they chose to deliver at home due to women's traditional beliefs about womanhood and childbirth. Both groups described financial constraints and inadequate transport to medical facilities during complicated labour as related to obstetric fistula onset. Programmatic insights derived from these findings should inform fistula prevention interventions both with healthcare professionals and with Nigerian women. PMID:26958903

  8. CONGENITAL VESICOUTERINE FISTULA ALONG WITH DISTAL VAGINAL AGENESIS, SOLITARY KIDNEY AND TONGUE TIE: A RARITY

    Directory of Open Access Journals (Sweden)

    Khalid

    2015-11-01

    Full Text Available : Congenital vesicouterine fistula in association with vaginal agenesis and solitary renal agenesis has been rarely reported. We present a case of 19 year old female suffering from cyclical menouria for last years. Physical examination revealed absence of vagina. IVP revealed left renal agenesis and CT scan revealed left renal agenesis with vesicouterine fistula. Cystoscopy showed vesicouterine fistula located above trigone near midline. Vesicouterine fistula was repaired along with uterine preservation. Sigmoid colon neovagina was created. Patient is doing well and menstruating per vagina till last followup

  9. Outcome of Kidney Allografts in Recipients With a Femoral Arteriovenous Fistula: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Denise M.D. Özdemir-van Brunschot

    2016-09-01

    Full Text Available Two patients, who were on hemodialysis over a femoral arteriovenous fistula, were transplanted in our center. Despite adequate blood pressure, perfusion of the renal allograft remained poor after completion of the vascular anastomoses. Ligation of the femoral arteriovenous fistula (1.6 L/min led to adequate perfusion. Initial graft function was good. Although it remains unclear whether ischemia of a renal allograft is caused by venous hypertension or vascular steal due to a femoral arteriovenous fistula, it might be necessary to ligate a femoral arteriovenous fistula to obtain adequate graft perfusion.

  10. A penile torsion with a fistula due to previous hypospadias surgery: A case report

    Directory of Open Access Journals (Sweden)

    Mustafa Rasid Toksoz

    2015-01-01

    Full Text Available We presented a case of penile torsion due to previous hypospadias surgery. A patient applied to our clinic for treatment of hypospadias fistula and accompanying penile torsion. Patient’s urethral fistula was repaired first and penile torsion was corrected in the second stage due to multiple fistula tracts. Proximal based flip flap technique was used for closure of the fistula and simple degloving with release of fibrous tissue and pedicle of the previous preputial island flap was used for correction of the penile torsion. Post hypospadias surgery torsion deformity as in our case may corrected with simple degloving and dissection at the level of the buck fascia.

  11. Peroneal arteriovenous fistula and pseudoaneurysm: an unusual presentation.

    Science.gov (United States)

    Ching, Kevin C; McCluskey, Kevin M; Srinivasan, Abhay

    2014-01-01

    Peroneal artery arteriovenous fistulas and pseudoaneurysms are extremely rare with the majority of reported cases due to penetrating, orthopedic, or iatrogenic trauma. Failure to diagnose this unusual vascular pathology may lead to massive hemorrhage or limb threatening ischemia. We report an interesting case of a 14-year-old male who presented with acute musculoskeletal pain of his lower extremity. Initial radiographs were negative. Further imaging workup revealed a peroneal arteriovenous fistula with a large pseudoaneurysm. After initial endovascular intervention was unsuccessful, the vessels were surgically ligated in the operating room. Pathology revealed papillary endothelial hyperplasia consistent with an aneurysm and later genetic testing was consistent with Ehlers-Danlos syndrome Type IV. This case illustrates an unusual cause of acute atraumatic musculoskeletal pain and uncommon presentation of Ehlers-Danlos syndrome. PMID:25349770

  12. Post-operative duodenal fistula: percutaneous treatment and review

    Directory of Open Access Journals (Sweden)

    D.Huerta

    2015-04-01

    Full Text Available Duodenal fistula is a complex condition, relatively frequent presentation, being in most cases of postoperative origin. Among the latter, 6% to 11% are secondary to surgical treatment of perforated duodenal ulcer, and more unusual, as a complication of cholecystectomy. Two cases treated percutaneous at the Polyclinic Bank city of Buenos Aires are presented. The first, a female patient with a duodenal fistula as a postoperative complication of a perforated duodenal ulcer and the second one patient male with the same pathology but as a complication of cholecystectomy. Percutaneous treatment of this disease has been reported sporadically without having proven its usefulness. Once diagnosed the same Fistulography and obliteration were performed percutaneously achieving complete remission of the disease.

  13. Surgical treatment of complicated traumatic aneurysm and arteriovenous fistula

    Institute of Scientific and Technical Information of China (English)

    乔正荣; 时德

    2003-01-01

    Objective: To evaluate the surgical methods and the outcome of management for traumatic arterial aneurysm (TAA) and traumatic arteriovenous fistula (TAVF). Methods: A total of 121 patients with TAA or TAVF were treated by surgery. Clinical, operative and postoperative data were collected and analyzed retrospectively. Results: The surgical techniques included aneurysmectomy and arterial end-to-end anastomosis or vascular grafting or artery ligation, aneurysm ligation and bypass, vascular repair, fistula excision and vascular ligation or vascular grafting or repair and so on. One patient died (0.83%). The follow-up rates of TAA and TAVF were 65.7% and 60% respectively. Conclusions: Complicated TAA and TAVF in different sites should be treated with different methods.

  14. Acute paraplegia following embolization of spinal dural arteriovenous fistula

    Institute of Scientific and Technical Information of China (English)

    HUANG Cheng-guang; QI Xiang-qian; CHEN Huai-rui; L(U) Li-quan; WU Xiao-jun; BAI Ru-lin; LU Yi-cheng

    2011-01-01

    Embolization therapy has been used as the initial treatment for spinal dural arteriovenous fistula (SDAVF) only for certain patients or in certain medical institutions due to its minimal invasiveness, but the recurrence of embolization remains a clinical challenge. The recurrent patient usually exhibits a gradual onset of symptoms and progressive deterioration of neurological function. Developing paraplegia several hours after embolization is commonly seen in patients with venous thrombosis-related complications, for which anticoagulation therapy is often administered. This article reports on a SDAVF patient who had weakness of both lower extremities before embolization and developed complete paraplegia several hours after embolization therapy, later confirmed by angiography as fistula recurrence. The symptoms were relieved gradually after second embolization. The pathophysiology of this patient is also discussed.

  15. Robot-Assisted Laparoscopic Repair of Spontaneous Appendicovesical Fistula

    Science.gov (United States)

    Kibar, Yusuf; Yalcin, Serdar; Kopru, Burak; Topuz, Bahadir; Ebiloglu, Turgay

    2016-01-01

    Abstract Background: To report the first case of the spontaneous appendicovesical fistulas' (AVF) repair with robot assisted laparoscopy. Case Presentation: A 29-year-old male patient with urgent persistant bacteriuria and dysuria was referred to our clinic. Physical examination and blood tests were normal. He had used various antibiotics due to recurrent UTI for about 20 years. Computed tomography revealed the fistula tract between the distal end of the appendix and right lateral wall of the bladder dome. He was successfully treated with robot-assisted laparoscopic repair. Following this surgery, the patient's complaints were resolved completely. Conclusion: AVF is the rare condition. Robot-assisted laparoscopy repair of AVF is safe and effective treatment option.

  16. Peroneal Arteriovenous Fistula and Pseudoaneurysm: An Unusual Presentation

    Directory of Open Access Journals (Sweden)

    Kevin C. Ching

    2014-01-01

    Full Text Available Peroneal artery arteriovenous fistulas and pseudoaneurysms are extremely rare with the majority of reported cases due to penetrating, orthopedic, or iatrogenic trauma. Failure to diagnose this unusual vascular pathology may lead to massive hemorrhage or limb threatening ischemia. We report an interesting case of a 14-year-old male who presented with acute musculoskeletal pain of his lower extremity. Initial radiographs were negative. Further imaging workup revealed a peroneal arteriovenous fistula with a large pseudoaneurysm. After initial endovascular intervention was unsuccessful, the vessels were surgically ligated in the operating room. Pathology revealed papillary endothelial hyperplasia consistent with an aneurysm and later genetic testing was consistent with Ehlers-Danlos syndrome Type IV. This case illustrates an unusual cause of acute atraumatic musculoskeletal pain and uncommon presentation of Ehlers-Danlos syndrome.

  17. Ureteroarterial Fistulas After Robotic and Open Radical Cystectomy.

    Science.gov (United States)

    Palmerola, Ricardo; Westerman, Mary E; Fakhoury, Mathew; Boorjian, Stephen A; Richstone, Lee

    2016-01-01

    Ureteroarterial fistulas (UAFs) are defined as an abnormal communication between one of the major arteries and the ureter. Urologists most frequently encounter iatrogenic fistulas occurring in patients with a history of pelvic extirpative surgery, chronic ureteral catheterization, and history of pelvic radiation. We present two cases of UAFs in patients with no history of prior radiation, who underwent open radical cystectomy and robot-assisted radical cystectomy with intracorporeal ileal conduit. Both patients developed postoperative ureteroileal anastomotic leaks that were managed with indwelling ureteral catheters. Furthermore, both patients were having left-sided UAF after presenting with nonlife threatening gross hematuria, which became brisk and pulsatile during ureteral stent exchange. Endovascular stenting was performed in both patients with resolution of hemorrhage and full recovery. In one patient, nephrostomy tubes were placed and ureteral catheters were removed; the second patient was managed with continued ureteral catheterization without further episodes of hematuria. PMID:27579415

  18. The radiological management of the thrombosed arteriovenous dialysis fistula

    Energy Technology Data Exchange (ETDEWEB)

    Bent, C.L., E-mail: clare_bent@yahoo.co.u [Royal Bournemouth and Christchurch Hospitals, Bournemouth (United Kingdom); Sahni, V.A. [Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women' s Hospital, Harvard Medical School, Boston (United States); Matson, M.B. [Barts and The London NHS Trust, London (United Kingdom)

    2011-01-15

    Patent vascular access is a prerequisite for adequate haemodialysis, and is a major determinant of quality of life and long-term survival of patients with end-stage renal disease. Autogenous haemodialysis fistulas (AVFs) have demonstrated superior clinical outcome when compared to synthetic grafts, but both types of access remain susceptible to venous stenoses, and consequent thrombotic occlusion. Recent publications have reported primary patency rates of up to 100% following percutaneous de-clotting of AVFs incorporating techniques such as pharmacological thrombolysis, mechanical thrombectomy, and thrombo-aspiration. Endovascular management also provides information regarding the underlying cause of access thrombosis, with option to treat. Consequently, there has been a paradigm shift in the management of fistula thrombosis, with interventional radiology assuming a lead role in initial salvage procedures. This article will attempt to provide the reader with an insight into the multiple radiological techniques that can be employed to salvage a thrombosed AVF based on current published literature.

  19. A case report of ileovesical fistula in radiation enteritis

    Energy Technology Data Exchange (ETDEWEB)

    Ishibashi, Keiichiro; Tsuchiya, Akira; Ito, Takaaki; Akiyama, Akito; Ohkubo, Yuhei; Oyama, Hironori; Sato, Shigenori; Kusama, Hiroshi [Tokyo Medical Coll., Ibaraki (Japan). Kasumigaura Hospital

    1996-09-01

    A 49-year-old female was admitted with chief complaint of fecaluria on March 4th 1993. A radiation therapy had been performed for uterocervical cancer 18 years ago. The small intestine and bladder was detected by DIP and cystogram simultaneously. It was diagnosed as an ileovesical fistula. A segmental resection of the ileum with partial cystectomy was performed on March 23rd. Histopathologically, the ileum showed a radiation enteritis. Eventually, we diagnosed that this ileovesical fistula was caused by radiation. After operation, an incompletion of suture occurred. So we made an ileostomy secondarily and performed hyperbaric oxygen therapy. The patient was getting well temporarily but died of gastric hemorrhage on May 1st. (author)

  20. Synovial cutaneous fistula complicating a reverse total shoulder arthroplasty.

    Science.gov (United States)

    Letter, Haley P; Limback, Joseph; Wasyliw, Christopher; Bancroft, Laura; Scherer, Kurt

    2016-06-01

    Reverse total shoulder arthroplasty is becoming a common form of shoulder arthroplasty that is often performed in the setting of rotator cuff pathology. Infection is a rare complication but is more common in reverse total shoulder arthroplasty than in hemiarthroplasty or anatomic total shoulder arthroplasty. We present the case of a 69-year-old patient with a reverse total shoulder arthroplasty who presented with purulent drainage from the skin of his anterior shoulder. Computed tomography arthrogram confirmed the presence of a synovial cutaneous fistula. Synovial cutaneous fistula is a rare variant of periprosthetic infection that, to our knowledge, has not been described previously in the setting of a reverse total shoulder arthroplasty. Computed tomography arthrogram proved to be a reliable method for confirming the diagnosis and was used for operative planning to remove the hardware. PMID:27257460

  1. Acquired arteriovenous fistula in a grizzly bear (Ursus arctos horribilis).

    Science.gov (United States)

    Tuttle, Allison D; MacLean, Robert A; Linder, Keith; Cullen, John M; Wolfe, Barbara A; Loomis, Michael

    2009-03-01

    A captive adult male grizzly bear (Ursus arctos horribilis) was evaluated due to multifocal wounds of the skin and subcutaneous tissues sustained as a result of trauma from another grizzly bear. On presentation, one lesion that was located in the perineal region seemed to be a deep puncture with purple tissue protruding from it. This perineal wound did not heal in the same manner or rate as did the other wounds. Twenty-five days after initial detection, substantial active hemorrhage from the lesion occurred and necessitated anesthesia for examination of the bear. The entire lesion was surgically excised, which later proved curative. An acquired arteriovenous fistula was diagnosed via histopathology. Arteriovenous fistulas can develop after traumatic injury and should be considered as a potential complication in bears with nonhealing wounds.

  2. TRAUMATIC GASTROPLEURAL FISTULA COMPLICATED BY EMPYEMA AND PNEUMOTHORAX

    Directory of Open Access Journals (Sweden)

    Vijay Kumar

    2015-02-01

    Full Text Available We herein report a case of traumatic gastropleural fistula complicated by empyema and pneumothorax which is a rare entity. A 22 year old male was admitted with alleged history of stab injury to left lower chest. Patient was f ound to have left sided pneumothorax, for which intercostal drainage tube was inserted and the patient stabilised. Chest radiograph taken three days after the chest tube insertion showed persistent hydropneumothorax for which the patient underwent a contra st enhanced computed tomography of thorax (CECT. CECT of thorax revealed herniation of fundus of stomach through a defect in the left dome of diaphragm into the left thoracic cavity with leakage of oral contrast into the left pleural cavity. Preoperative diagnosis of gastropleural fistula was made and the same was confirmed in the intraoperative findings. The patient underwent laparotomy with repair of the diaphragmatic defect and closure of the gastric perforation. The patient made an uneventful recovery

  3. Oroantral fistula from bisphosphonate induced osteonecrosis of the jaw

    Directory of Open Access Journals (Sweden)

    Henry Sharp

    2010-07-01

    Full Text Available Bisphosphonates like alendronic acid, disodium etidronate, and risedronate are effective for preventing postmenopausal and corticosteroid induced osteoporosis. They are also useful in the treatment of Paget’s disease, hypercalcaemia of malignancy and in bony metastases. However osteonecrosis of the jaw has been reported following intravenous bisphosphonate use and rarely in those taking them orally.Increasingly, oroantral fistulae have been shown to occur as sequelae of bisphosphonate-induced osteonecrosis of the jaw and this case report highlights a patient that presented to our ENT department and required sinus surgery in collaboration with maxillofacial surgeons.This case report aims to raise awareness among ENT surgeons to these patients on bisphosphonates that could present to them with sinus disease from oroantral fistulae. There is an on-going audit in the maxillofacial community on this emerging trend.

  4. Prenatal sonographic diagnosis of focal musculoskeletal anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Jung Kyu; Cho, Jeong Yeon; Lee, Young Ho; Kim, Ei Jeong; Chun, Yi Kyeong [Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2002-09-15

    Focal musculoskeletal anomalies are various and may be an isolated finding or may be found in conjunction with numerous associations, including genetic syndromes, Karyotype abnormals, central nervous system anomalies and other general musculoskeletal disorders. Early prenatal diagnosis of these focal musculoskeletal anomalies nor only affects prenatal care and postnatal outcome but also helps in approaching other numerous associated anomalies.

  5. Diagnosis and management of acute traumatic arteriovenous fistula

    OpenAIRE

    Nagpal, Kamal; Ahmed, Kamran; Cuschieri, RJ

    2008-01-01

    Acute arterial injuries are often complicated by the development of an arteriovenous fistula (AVF). In the acute setting, an AVF may present at the same time as the arterial injury. A case of traumatic AVF in the thigh that presented with normal neurovascular examination findings is reported. AVF was diagnosed by duplex scan and managed promptly. The authors suggest that duplex imaging together with arteriography, where appropriate, should be performed routinely when penetrating wounds are in...

  6. Contemporary surgical management of rectovaginal fistula in Crohn's disease

    OpenAIRE

    Valente, Michael A; Hull, Tracy L

    2014-01-01

    Rectovaginal fistula is a disastrous complication of Crohn’s disease (CD) that is exceedingly difficult to treat. It is a disabling condition that negatively impacts a women’s quality of life. Successful management is possible only after accurate and complete assessment of the entire gastrointestinal tract has been performed. Current treatment algorithms range from observation to medical management to the need for surgical intervention. A wide variety of success rates have been reported for a...

  7. Intraoperative physical diagnosis in the management of anal fistula.

    Science.gov (United States)

    Gonzalez-Ruiz, Claudia; Kaiser, Andreas M; Vukasin, Petar; Beart, Robert W; Ortega, Adrian E

    2006-01-01

    This report reviews a prospective database applying a systematic fistulomy technique in 101 patients requiring surgery for fistula in ano at LAC+USC Medical Center during a 15-month period. Data were collected for the reliability of primary crypt palpation, success of tract injection with peroxide/methylene blue, and the accuracy of Goodsall's rule. Time to healing, recurrence, and incontinence according to type of procedure were also recorded. Palpation of the primary crypt was possible in 93 per cent. Hydrogen peroxide/methylene blue injection successfully delineated the tract in 83 per cent. Goodsall's rule was correct in 81 per cent. Each fistula was categorized as intersphincteric (n = 72), transphincteric (n = 33), extrasphincteric (n = 1), or submucosal (n = 6). At a mean follow-up period of 44 weeks, 89.2 per cent of patients were cured. Reasons for recurrence included wound bridging (n = 6), misdiagnosis of the tract (n = 3), and two blind-ended fistulae (n = 2). Time to healing in weeks was (mean, range): simple fistulotomy (12, 3-21), seton (16, 4-28), Hanley procedure (28, 8-48). Patients with a marsupialized tract healed at an average of 6 weeks (range 4-8). Four (3.9%) patients reported postoperative incontinence (1 gas, 3 liquid, 0 solids). PMID:16494174

  8. Characterization of Jamaican Delonix regia and Cassia fistula Seed Extracts

    Directory of Open Access Journals (Sweden)

    Andrea Goldson Barnaby

    2016-01-01

    Full Text Available Delonix regia and Cassia fistula seed extracts were evaluated for their antioxidant activity, total phenolics, ash, zinc and fatty acid content. Fourier Transform Infrared Spectroscopy (FTIR was utilized to assess the chemical functionalities present within the seeds. Antioxidant activity was determined by the 2,2-diphenyl-1-picrylhydrazyl (DPPH and Trolox equivalent antioxidant capacity (TEAC assays. Total phenolics were determined by the Folin-Ciocalteu assay. Lipid extracts were characterized by nuclear magnetic resonance spectroscopy and gas chromatography/mass spectrometry. Zinc concentration was determined by atomic absorption spectroscopy. Extracts from the seeds of C. fistula had a higher antioxidant activity, free radical scavenging activity, and phenolic content than D. regia. FTIR revealed that the seeds are a rich source of protein with small quantities of fat. C. fistula extracts contained a higher percentage of total fat than D. regia. Palmitic acid was identified as the predominant saturated fatty acid in both extracts. Oleic acid and linoleic acid were identified in smaller quantities. Seed extracts may be considered for use in food and nutraceutical applications.

  9. Gene Expression Changes in Venous Segment of Overflow Arteriovenous Fistula

    Directory of Open Access Journals (Sweden)

    Yasuhiro Hashimoto

    2013-01-01

    Full Text Available Aim. The objective of this study was to characterize coordinated molecular changes in the structure and composition of the walls of venous segments of arteriovenous (AV fistulas evoked by overflow. Methods. Venous tissue samples were collected from 6 hemodialysis patients with AV fistulas exposed to overflow and from the normal cephalic veins of 4 other hemodialysis patients. Total RNA was extracted from the venous tissue samples, and gene expression between the 2 groups was compared using Whole Human Genome DNA microarray 44 K. Microarray data were analyzed by GeneSpring GX software and Ingenuity Pathway Analysis. Results. The cDNA microarray analysis identified 397 upregulated genes and 456 downregulated genes. Gene ontology analysis with GeneSpring GX software revealed that biological developmental processes and glycosaminoglycan binding were the most upregulated. In addition, most upregulation occurred extracellularly. In the pathway analysis, the TGF beta signaling pathway, cytokines and inflammatory response pathway, hypertrophy model, and the myometrial relaxation and contraction pathway were significantly upregulated compared with the control cephalic vein. Conclusion. Combining microarray results and pathway information available via the Internet provided biological insight into the structure and composition of the venous wall of overflow AV fistulas.

  10. Spontaneous Cholecystocutaneous Fistula: A Rare Presentation of Gallstones

    Directory of Open Access Journals (Sweden)

    Leela Sayed

    2010-07-01

    Full Text Available Spontaneous cholecystocutaneous fistula, one of the rarest complications of acute cholecystitis, has been reported in fewer than 25 cases over the past 50 years. Not only is this case rare but interestingly the patient experienced no pain or symptoms consistent with gallbladder pathology leading up to her hospitalisation. Furthermore, laboratory studies, microbiology and computed tomography scanning did not establish a diagnosis until the fistula passed calculi.An 85-year-old lady with multiple co-morbidities presented to the Emergency Department with an erythematous soft and non-tender mass in her right flank. The mass had spontaneously ruptured and was discharging a serous-like material. Prior to further investigation a working diagnosis of an eroding/fungating caecal tumour was made. The lesion continued to discharge over a 3 month period which heralded the passage of 11 small, brown calculi thought to be gallstones. At this point spontaneous cholecystocutaneous fistula was diagnosed and was later confirmed by magnetic resonance imaging cholangiopancreatography.

  11. GEOMAGNETIC ANOMALY FIELD VECTOR OFF WESTERN AUSTRALIA

    OpenAIRE

    ノギ, ヨシフミ; エグチ, ヨシアキ; セアマ, ノブカズ; イセザキ, ノブヒロ; Yoshifumi, NOGI; Yoshiaki, EGUCHI; Nobukazu, SEAMA; Nobuhiro, ISEZAKI

    1993-01-01

    Vector data of the geomagnetic anomaly field were obtained during the 32nd Japanese Antarctic Research Expedition (JARE-32) off Western Australia. The strikes of the magnetic boundaries at their position were derived from vector data of the geomagnetic anomaly field. These strikes were interpreted as the directions of magnetic anomaly lineations originated either by seafloor spreading (seafloor spreading anomaly) or by morphological structures (structural magnetic anomaly). Some strikes of st...

  12. PSEUDO MAGNETIC ANOMALIES IN THE ANTARCTIC SEA

    OpenAIRE

    マツモト, タケシ; カミヌマ, カツタダ; Takeshi, MATSUMOTO; Katsutada, Kaminuma

    1988-01-01

    Pseudo magnetic anomaly in the Antarctic Sea has been calculated using the gravity data derived from altimetric geoid. Comparison of the pseudo magnetic anomaly thus calculated with the theoretical magnetic anomaly predicted from topography has been made with respect to the large fracture zones composed of short-wavelength ridges and troughs in the Southeastern Pacific, which shows that these two anomalies coincide well with each other. Gravity anomaly calculated from topography only also coi...

  13. Prenatal Sonographic Diagnosis of Focal Musculoskeletal Anomalies

    OpenAIRE

    Ryu, Jung Kyu; Cho, Jeong Yeon; Choi, Jong Sun

    2003-01-01

    Focal musculoskeletal anomalies vary, and can manifest as part of a syndrome or be accompanied by numerous other conditions such as genetic disorders, karyotype abnormalities, central nervous system anomalies and other skeletal anomalies. Isolated focal musculoskeletal anomaly does, however, also occur; its early prenatal diagnosis is important in deciding prenatal care, and also helps in counseling parents about the postnatal effects of numerous possible associated anomalies. We have encount...

  14. Usefulness of magnetic resonance in the evaluation of perianal fistulas; Utilidad de la resonancia magnetica en la valoracion de las fistulas perianales

    Energy Technology Data Exchange (ETDEWEB)

    Campo, M.; Isusi, M.; Oleaga, L.; Grande, D. [Hospital de Basurto. Bilbao (Spain); Fernandez, G.; Tardaguila, F. [Clinica POVISA. Vigo (Spain)

    2003-07-01

    Our aim was to confirm the usefulness of magnetic resonance in the evaluation of perianal fistulas, and in conjunction with a thought anatomical review of affected areas. This would allow for the building of a proper surgical plan, which would necessarily differ according to the fistula's complexity. We studied 75 patients with perianal fistulas and performed 81 MR studies by means of axial, sagittal and coronal T1 and T2 sequences. Fistula type, degree, etiology and correlation to surgical findings were all studied. Fifty-five patients underwent surgical treatment, and 26 underwent a more conservative treatment with MR follow-up. Ninety-nine fistulas were observed and classified according to norms set down by St. James University Hospital. Of the 55 cases submitted to surgery, 46 showed concordance between the surgical report and MR, whose sensitivity was 84%. In 9 patients, there was no correlation. In the study of perianal fistulas, it is important to establish both the fistulous tract and relationship to the sphincter complex. MR permits an identification of the sprinter complex and a more precise anatomical localization of the fistulous trajectory. It is also capable of differentiating between fibrosis and abscess. Therefore, MR is an appropriate technique for the study of perianal fistulas and related surgical planning. (Author) 6 refs.

  15. Graph anomalies in cyber communications

    Energy Technology Data Exchange (ETDEWEB)

    Vander Wiel, Scott A [Los Alamos National Laboratory; Storlie, Curtis B [Los Alamos National Laboratory; Sandine, Gary [Los Alamos National Laboratory; Hagberg, Aric A [Los Alamos National Laboratory; Fisk, Michael [Los Alamos National Laboratory

    2011-01-11

    Enterprises monitor cyber traffic for viruses, intruders and stolen information. Detection methods look for known signatures of malicious traffic or search for anomalies with respect to a nominal reference model. Traditional anomaly detection focuses on aggregate traffic at central nodes or on user-level monitoring. More recently, however, traffic is being viewed more holistically as a dynamic communication graph. Attention to the graph nature of the traffic has expanded the types of anomalies that are being sought. We give an overview of several cyber data streams collected at Los Alamos National Laboratory and discuss current work in modeling the graph dynamics of traffic over the network. We consider global properties and local properties within the communication graph. A method for monitoring relative entropy on multiple correlated properties is discussed in detail.

  16. Conformal Anomalies and Gravitational Waves

    CERN Document Server

    Meissner, Krzysztof A

    2016-01-01

    We argue that the presence of conformal anomalies in gravitational theories can lead to observable modifications to Einstein's equations via the induced anomalous effective actions, whose non-localities can overwhelm the smallness of the Planck scale. The fact that no such effects have been seen in recent cosmological or gravitational wave observations therefore imposes strong restrictions on the field content of possible extensions of Einstein's theory: all viable theories should have vanishing conformal anomalies. We then show that, among presently known theories, a complete cancellation of conformal anomalies in $D=4$ for both the $C^2$ invariant and the Euler (Gauss-Bonnet) invariant $E_4$ can only be achieved for $N$-extended supergravities with $N\\geq 5$, as well as for M theory compactified to four dimensions.

  17. Boundary anomalies and correlation functions

    Science.gov (United States)

    Huang, Kuo-Wei

    2016-08-01

    It was shown recently that boundary terms of conformal anomalies recover the universal contribution to the entanglement entropy and also play an important role in the boundary monotonicity theorem of odd-dimensional quantum field theories. Motivated by these results, we investigate relationships between boundary anomalies and the stress tensor correlation functions in conformal field theories. In particular, we focus on how the conformal Ward identity and the renormalization group equation are modified by boundary central charges. Renormalized stress tensors induced by boundary Weyl invariants are also discussed, with examples in spherical and cylindrical geometries.

  18. Boundary Anomalies and Correlation Functions

    CERN Document Server

    Huang, Kuo-Wei

    2016-01-01

    It was shown recently that boundary terms of conformal anomalies recover the universal contribution to the entanglement entropy and also play an important role in the boundary monotonicity theorem of odd-dimensional quantum field theories. Motivated by these results, we investigate relationships between boundary anomalies and the stress tensor correlation functions in conformal field theories. In particular, we focus on how the conformal Ward identity and the renormalization group equation are modified by boundary central charges. Renormalized stress tensors induced by boundary Weyl invariants are also discussed, with examples in spherical and cylindrical geometries.

  19. Community awareness about risk factors, presentation and prevention and obstetric fistula in Nabitovu village, Iganga district, Uganda

    OpenAIRE

    Kasamba, Nassar; Kaye, Dan K; Mbalinda, Scovia N.

    2013-01-01

    Background Obstetric fistula is a worldwide problem that is devastating for women in developing countries. The cardinal cause of obstetric fistula is prolonged obstructed labour and delay in seeking emergency obstetric care. Awareness about obstetric fistula is still low in developing countries. The objective was to assess the awareness about risk factors of obstetric fistulae in rural communities of Nabitovu village, Iganga district, Eastern Uganda. Methods A qualitative study using focus gr...

  20. Infected interventricular Teflon patch: repair and closure of fistula with omentum.

    OpenAIRE

    Chatzis, A; Pepper, J.; Treasure, T.

    1992-01-01

    A pericardiocutaneous fistula five years after repair of a rupture of the ventricular septum was managed by removing all foreign material (Teflon). The resulting defect was repaired with part of the central tendon of the diaphragm and a pedicle of omentum was used to cover the heart. This radical approach was found necessary after other measures, including surgical excision of the fistula, had failed.

  1. Neuro-endovascular Embolic Agent for Treatment of a Renal Arteriovenous Fistula

    Directory of Open Access Journals (Sweden)

    Gurpreet Singh

    2016-01-01

    Full Text Available Renal arteriovenous fistula is a known complication following a renal biopsy, and may require catheter based embolization. Distal location of these fistulas in the renal parenchyma in many a case may necessitate non-traditional embolic materials. Liquid embolic agents that allow a controlled delivery may be suitable in this situation, as demonstrated in this case report.

  2. The effect of arteriovenous fistulas on in situ saphenous vein bypasses

    DEFF Research Database (Denmark)

    Rørdam, Peter; Jensen, Leif Panduro; Schroeder, T;

    1991-01-01

    Doppler examination identified 89% of those branches with sufficient flow to opacify the deep venous system on completion arteriogram. Half of the missed fistulas underwent spontaneous thrombosis, and in only one case did the arteriovenous fistula lead to hemodynamic symptoms demanding surgical closure...

  3. Repair of vesicovaginal fistula caused by radiation therapy with labia maiora skin flap

    Directory of Open Access Journals (Sweden)

    Stanojević Dušan

    2010-01-01

    Full Text Available Introduction Vesicovaginal fistula can occur after delivery, gynaecologic or urologic surgery, irradiation therapy or as destruction caused by a tumour or trauma. The main problem after irradiation is decreased elasticity of the tissue around the fistula. We present our experience in the treatment of three patients with vesicovaginal fistula using a labia maiora skin flap. Case Outline From May 2007 to January 2008 three patients with vesicovaginal fistula were treated using labia maiora skin flap. The fistulae occurred after mean 19 months (11, 20 and 26 months following irradiation therapy applied to treat malignant disease. The mean age of the patients was 54 years (47, 53 and 62 years. The mean diameter of the fistulae was 3.5 cm (2, 4 and 4.5 cm. Using transvaginal approch, all devitalized and fibrous tissue was removed with the closure of the bladder wall. The labia maiora skin flap with good vascularization was transposed to close the defect and anastomozed to the vagina. The mean follow-up was 16 months (13, 17 and 18 months. Labia maiora skin flap size was mean 3.7 cm (2.6, 3.7 and 4.8 cm. We achieved satisfactory outcome in all patients. There were neither postoperative complications nor fistula recurrence. Conclusion Labia maiora skin flap presents a good alternative for surgical treatment of vesicovaginal fistula. The flap is more adequate for larger defects and for the repair of fibrously changed vaginal wall which is present after irradiation therapy. .

  4. Usefulness assessment of preoperative MRI fistulography in patients with perianal fistulas

    International Nuclear Information System (INIS)

    Accurate preoperative assessment of the perianal fistulous tract is the main purpose of the diagnostics and to a large extend determines surgery effectiveness. One of the useful diagnostic methods in perianal fistulas is magnetic resonance imaging. The authors presented experiences in the application of MRI fistulography for evaluation of cases of perianal fistulas difficult to diagnose and treat. Own examination method was described; MRI fistulography findings were analyzed and compared with intraoperative conditions in 14 patients (11 men and 3 women) diagnosed in the years 2005– 2009. Eight patients had recurrent fistulas and 6 had primary fistulas. Imaging was performed with a GE SIGNA LX HS scanner with a 1.5-Tesla field strength and a dedicated surface coil placed at the level of hip joints. Contrast agent was a gadolinium-based solution. Intraoperative findings were consistent with radiological descriptions of 13 MRI fistulographies. Only in one case, according to surgery findings, it was a transsphincteric fistula with an abscess in the ischioanal fossa, with an orifice in the posterior crypt; the radiologist described it as a transsphincteric, internal blind fistula. Due to its accuracy in the assessment of the perianal fistulous tracts in soft tissues, MRI fistulography becomes a useful and recommended diagnostic method in this pathology. It shows the location of the fistula regarding the system of anal sphincters, and identifies the internal orifice and branching of the fistula. It enables precise planning of surgical treatment. Authors suggest that this diagnostic method should be improved and applied more commonly

  5. Urethro-urethral fistula: A rare cause of post-TURP incontinence

    OpenAIRE

    Moorthy, H. Krishna; Biju S Pillai

    2014-01-01

    Prostatic abscess rarely follows acute prostatitis and can sometimes lead to a fistula by breaking into the prostatic urethra, peri-rectal tissues, the perineum, or the rectum. We report a case of a prostatic abscess tracking into the bulbar urethra after a transurethral resection of the prostate. This created a fistula, mimicking a urethral duplication and leading to urinary incontinence.

  6. Post-Traumatic Cavernous Fistula Fed by Persistent Trigeminal Artery: Treatment by GDC Embolisation

    Science.gov (United States)

    Deol, P.S.; Mishra, N.K.; Gupta, V.; Gaikwad, S.B.; Garg, A.; Singh, N.

    2001-01-01

    Summary A case of traumatic persistent primitive trigeminal artery (PPTA) cavernous sinus fistula treated with GDC embolisation is reported. Because of the small lumen of PPTA, posteriorly directed course and flow contribution from the posterior circulation, balloon embolisation via the carotid system was not considered appropriate. The fistula was successfully closed by GDC embolisation. PMID:20663331

  7. [Trigeminal-cavernous fistula. Report of a case and review of the literature].

    Science.gov (United States)

    Santos Franco, Jorge; Sánchez Olivera, Carlos; Saavedra Andrade, Rafael; Sandoval Balanzario, Miguel Antonio

    2013-01-01

    Persistent primitive trigeminal artery is a rare anatomical variant resulting from the absence of obliteration of the embryonic trigeminal artery. The shunt between the persistent primitive trigeminal artery and the cavernous sinus is called trigeminal-cavernous fistula. We report the case of a woman with a trigeminal-cavernous fistula secondary to head trauma who was treated by transarterial embolization. PMID:24108341

  8. Colopleural fistula caused by aspergillus: an extremely rare complication after lung resection-case report.

    Science.gov (United States)

    Hayashi, Akio; Susaki, Yoshiyuki; Ose, Naoko; Takeuchi, Yukiyasu; Maeda, Hajime

    2016-12-01

    A colopleural fistula is a rare condition reported to be caused by Crohn's disease, a malignant tumor of the gastrointestinal tract, and other clinical conditions. Some studies have noted that a sub-diaphragmatic abscess, usually organized following abdominal surgery, may play some role in the formation of this type of fistula. Therefore, a colopleural fistula is a complication very rarely encountered by thoracic surgeons after lung resection.We experienced an extremely rare case of colopleural fistula following a left lower lobectomy for lung aspergillosis. Here, we report a 71-year-old man with a surgical history of proximal gastrectomy for gastric cancer. He underwent left lower lobectomy of the lung for aspergillosis, and a colopleural fistula occurred on the second operative day as a complication. Aspergillus might be responsible for forming a fistula between the colon and lung via the diaphragm, and lung surgery manifested this rare condition. Although some reports suggest that surgical treatment is mandatory to cure this fistula, an immediate colostomy in our case reduced the internal pressure of the colon, thus enabling spontaneous closure of the fistula with appropriate drainage and antibiotics. The patient was discharged in a good condition. PMID:27108124

  9. Thoracic Duct Chylous Fistula Following Severe Electric Injury Combined with Sulfuric Acid Burns: A Case Report

    Science.gov (United States)

    Chang, Fei; Cheng, Dasheng; Qian, Mingyuan; Lu, Wei; Li, Huatao; Tang, Hongtai; Xia, Zhaofan

    2016-01-01

    Patient: Male, 32 Final Diagnosis: Thoracic duct chylous fistula Symptoms: Fistula Medication: — Clinical Procedure: A boneless muscle flap transplantatio Specialty: — Objective: Rare disease Background: As patients with thoracic duct injuries often suffer from severe local soft tissue defects, integrated surgical treatment is needed to achieve damage repair and wound closure. However, thoracic duct chylous fistula is rare in burn patients, although it typically involves severe soft tissue damage in the neck or chest. Case Report: A 32-year-old male patient fell after accidentally contacting an electric current (380 V) and knocked over a barrel of sulfuric acid. The sulfuric acid continuously poured onto his left neck and chest, causing combined electrical and sulfuric acid burn injuries to his anterior and posterior torso, and various parts of his limbs (25% of his total body surface area). During treatment, chylous fistula developed in the left clavicular region, which we diagnosed as thoracic duct chylous fistula. We used diet control, intravenous nutritional support, and continuous somatostatin to reduce the chylous fistula output, and hydrophilic silver ion-containing dressings for wound coverage. A boneless muscle flap was used to seal the left clavicular cavity, and, integrated, these led to resolution of the chylous fistula. Conclusions: Patients with severe electric or chemical burns in the neck or chest may be complicated with thoracic duct injuries. Although conservative treatment can control chylous fistula, wound cavity filling using a muscle flap is an effective approach for wound healing. PMID:27725628

  10. Nutritional management of enterocutaneous fistula: a retrospective study at a Malaysian university medical center.

    Science.gov (United States)

    Badrasawi, Manal Mh; Shahar, Suzana; Sagap, Ismail

    2014-01-01

    Enterocutaneous fistula is a challenging clinical condition with serious complications and considerable morbidity and mortality. Early nutritional support has been found to decrease these complications and to improve the clinical outcome. Location of the fistula and physiological status affect the nutrition management plan in terms of feeding route, calories, and protein requirements. This study investigated the nutritional management procedures at the Universiti Kebangsaan Malaysia Medical Center, and attempted to determine factors that affect the clinical outcome. Nutritional management was evaluated retrospectively in 22 patients with enterocutaneous fistula seen over a 5-year period. Medical records were reviewed to obtain data on nutritional status, biochemical indices, and route and tolerance of feeding. Calories and protein requirements are reported and categorized. The results show that surgery was the predominant etiology and low output fistula was the major physiological category; anatomically, the majority were ileocutaneous. The spontaneous healing rate was 14%, the total healing rate was 45%, and the mortality rate was 22%, with 14% due to fistula-associated complications. There was a significant relationship between body mass index/serum albumin levels and fistula healing; these parameters also had a significant relationship with mortality. Glutamine was used in 50% of cases; however, there was no significant relationship with fistula healing or mortality rate. The nutritional status of the patient has an important impact on the clinical outcome. Conservative management that includes nutrition support is very important in order to improve nutritional status before surgical repair of the fistula.

  11. Bile duct-duodenal fistula caused by AIDS/HIV-associated tuberculosis

    Directory of Open Access Journals (Sweden)

    Patino Carlos

    2003-01-01

    Full Text Available Allthough infrequent, digestive fistulae in HIV/AIDS patients have been reported throughout the digestive tract from the esophagus to the anus, with predominance of esophageal fistulae. AIDS/HIV-associated opportunistic infections may invade the digestive system and lead to fistula formation. Tuberculosis is the most common infection associated with these esophageal fistulae. We report here one case of bile duct-duodenal fistula in a female AIDS patient with associated abdominal Mycobacterium tuberculosis infection compromising lymphnodes of the hepatic pedicle where the fistula was found. According to the reviewed literature, this is the third case of bile duct-duodenal fistula associated with abdominal tuberculosis in AIDS patient, and the first where both the fistula and the tuberculosis infection were diagnosed at laparotomy for acute abdomen. Whether the AIDS patient with abdominal pain needs or not a laparotomy to treat an infectious disease is often a difficult matter for the surgeon to decide, as most of the times appropriate medical treatment will bring more benefit.

  12. Gaugino-Assisted Anomaly Mediation

    International Nuclear Information System (INIS)

    We present a model of supersymmetry breaking mediated through a small extra dimension. Standard model matter multiplets and a supersymmetry-breaking (or ''hidden'') sector are confined to opposite four-dimensional boundaries while gauge multiplets live in the bulk. The hidden sector does not contain a singlet and the dominant contribution to gaugino masses is via anomaly-mediated supersymmetry breaking. Scalar masses get contributions from both anomaly mediation and a tiny hard breaking of supersymmetry by operators on the hidden-sector boundary. These operators contribute to scalar masses at one loop and in most of parameter space, their contribution dominates. Thus it is easy to make all squared scalar masses positive. As no additional fields or symmetries are required below the Planck scale, we consider this the simplest working model of anomaly mediation. The gaugino spectrum is left untouched and the phenomenology of the model is roughly similar to anomaly mediated supersymmetry breaking with a universal scalar mass added. We identify the main differences in the spectrum between this model and other approaches. We also discuss mechanisms for generating the μ term and constraints on additional bulk fields. (author)

  13. Gaugino-assisted anomaly mediation

    International Nuclear Information System (INIS)

    I present a model of supersymmetry breaking mediated through a small extra dimension. Standard model matter multiplets and a supersymmetry-breaking (or 'hidden') sector are confined to opposite four-dimensional boundaries while gauge multiplets live in the bulk. The hidden sector does not contain a singlet and the dominant contribution to gaugino masses is via anomaly-mediated supersymmetry breaking. Scalar masses get contributions from both anomaly mediation and a tiny hard breaking of supersymmetry by operators on the hidden-sector boundary. These operators contribute to scalar masses at one loop and in most of parameter space, their contribution dominates. Thus it is easy to make all squared scalar masses positive. As no additional fields or symmetries are required below the Planck scale, this is among the simplest working models of anomaly mediation. The gaugino spectrum is left untouched and the phenomenology of the model is roughly similar to anomaly mediated supersymmetry breaking with a universal scalar mass added. Finally, the main differences in the spectrum between this model and other approaches are identified. This talk is based on work [1] done in collaboration with David E. Kaplan

  14. 64. The prevalence of coronary artery anomalies in Qassim province detected by cardiac computed tomography angiography

    Directory of Open Access Journals (Sweden)

    O. smettei

    2016-07-01

    Full Text Available Coronary artery anomalies (CAAs affect about 1% of the general population based on invasive coronary angiography (ICA data, computed tomography angiography (CTA enables better visualization of the origin, course, relation to the adjacent structures, and termination of CAAs compared to ICA. The aim of our work is to estimate the frequency of CAAs in Qassim province among patients underwent cardiac CTA at PSCCQ. Retrospective analysis of the CTA data of 2235 patients between 2009 and 2015. The prevalence of CAAs in our study was 1.029%. Among the 2235 patients, 241 (10.78% had CAAs or coronary variants, 198 (8.85% had myocardial bridging, 34 (1.52% had a variable location of the Coronary Ostia, Twenty two (0.98% had a separate origin of left anterior descending (LAD and left circumflex coronary (LCX arteries, ten (0.447% had a separate origin of the RCA and the Conus artery. Seventeen (0.76% had an anomalous origin of the coronaries. Six (0.268% had a coronary artery fistula, which is connected mainly to the right heart chambers, one of these fistulas was complicated by acute myocardial infarction. The incidence of CAAs in our patient population was similar to the former studies, CTA is an excellent tool for diagnosis and guiding the management of the CAAs.

  15. Ileorectal fistula due to a rectal cancer-A case report.

    Science.gov (United States)

    Takahashi, Minoru; Fukuda, Takahiro

    2011-01-01

    A 51-year-old man was seen at our hospital because of diarrhea. Barium enema and colonoscopy revealed a cancer in the lower rectum and fistula formation from the site to ileum. Resection of the rectal cancer and ileorectal fistula was performed. Histologically, the resected lesion was mucinous adenocarcinoma with contiguous invasion from the rectum to the ileum. The patient is alive with no sign of recurrence 120 months after operation. Fistula formation between the colon and other gastrointestinal tract organs is very rare, especially for rectal cancer. Fistula-forming colorectal cancers are rarely found to have metastatic lesions in the liver, peritoneum and lymph nodes despite their invasive behavior; accordingly, curative resection involving partial resection of the intestine with fistula is expected. PMID:22096678

  16. Imaging of Anal Fistulas: Comparison of Computed Tomographic Fistulography and Magnetic Resonance Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Liang, Changhu [Shandong Medical Imaging Research Institute, Shandong University, Jinan 250021 (China); Lu, Yongchao [Traditional Chinese Medicine Department, Provincial Hospital Affiliated to Shandong University, Jinan 250021 (China); Zhao, Bin [Shandong Medical Imaging Research Institute, Shandong University, Jinan 250021 (China); Du, Yinglin [Shandong Provincial Center for Disease Control and Prevention, Public Health Institute, Jinan 250014 (China); Wang, Cuiyan [Shandong Medical Imaging Research Institute, Shandong University, Jinan 250021 (China); Jiang, Wanli [Department of Radiology, Taishan Medical University, Taian 271000 (China)

    2014-07-01

    The primary importance of magnetic resonance (MR) imaging in evaluating anal fistulas lies in its ability to demonstrate hidden areas of sepsis and secondary extensions in patients with fistula in ano. MR imaging is relatively expensive, so there are many healthcare systems worldwide where access to MR imaging remains restricted. Until recently, computed tomography (CT) has played a limited role in imaging fistula in ano, largely owing to its poor resolution of soft tissue. In this article, the different imaging features of the CT and MRI are compared to demonstrate the relative accuracy of CT fistulography for the preoperative assessment of fistula in ano. CT fistulography and MR imaging have their own advantages for preoperative evaluation of perianal fistula, and can be applied to complement one another when necessary.

  17. Hybrid management of a spontaneous ilio-iliac arteriovenous fistula: a case report

    LENUS (Irish Health Repository)

    O'Brien, Gavin C

    2011-08-22

    Abstract Introduction Spontaneous iliac arteriovenous fistulae are a rare clinical entity. Such localized fistulation is usually a result of penetrating traumatic or iatrogenic injury. Clinical presentation can vary greatly but commonly includes back pain, high-output congestive cardiac failure and the presence of an abdominal bruit. Diagnosis, therefore, is often incidental or delayed. Case presentation We report a case of a spontaneous ilio-iliac arteriovenous fistula in a 68-year-old Caucasian man detected following presentation with unilateral claudication and congestive cardiac failure. Following computed tomography evaluation, the fistula was successfully treated with a combined endovascular (aorto-uni-iliac device) and open (femoro-femoral crossover) approach. Conclusion Endovascular surgery has revolutionized the management of such fistulae and we report an interesting case of a high-output iliac arteriovenous fistulae successfully treated with a hybrid vascular approach.

  18. Anomaly detection in online social networks

    CERN Document Server

    Savage, David; Yu, Xinghuo; Chou, Pauline; Wang, Qingmai

    2016-01-01

    Anomalies in online social networks can signify irregular, and often illegal behaviour. Anomalies in online social networks can signify irregular, and often illegal behaviour. Detection of such anomalies has been used to identify malicious individuals, including spammers, sexual predators, and online fraudsters. In this paper we survey existing computational techniques for detecting anomalies in online social networks. We characterise anomalies as being either static or dynamic, and as being labelled or unlabelled, and survey methods for detecting these different types of anomalies. We suggest that the detection of anomalies in online social networks is composed of two sub-processes; the selection and calculation of network features, and the classification of observations from this feature space. In addition, this paper provides an overview of the types of problems that anomaly detection can address and identifies key areas of future research.

  19. Focal skin defect, limb anomalies and microphthalmia.

    NARCIS (Netherlands)

    Jackson, K.E.; Andersson, H.C.

    2004-01-01

    We describe two unrelated female patients with congenital single focal skin defects, unilateral microphthalmia and limb anomalies. Growth and psychomotor development were normal and no brain malformation was detected. Although eye and limb anomalies are commonly associated, clinical anophthalmia and

  20. 2 case of lymphatico-calyceal fistula causing chyluria

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Seoung Oh; Hong, Seung Mo; Park, Jae Hyung; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1983-03-15

    After advent of lymphangiographic technique, the causes of chyluria can be evaluated by lymphangiography. The most common etiology known until today is parasitic origin, especially filariasis. In Korea, established organism of filariasis is Brugia malayi. And other nonparasitic etiologies such as retroperitoneal malignancy, chronic inflammatory diseases, trauma, pregnancy, aneurysm are very rate. The authors experienced two cases of lymphatico-calyceal fistulas causing chyluria demonstrated by lymphangiography. The etiology of these two cases were unknown exactly, but the clinical diagnosis were filariasis. These cases are reported with emphasis on the lymphangiographic findings of chyluria.