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Sample records for aortoureteric fistula case

  1. Coronary Fistulas: A Case Series

    Directory of Open Access Journals (Sweden)

    Nada Fennich

    2014-01-01

    Full Text Available Coronary artery fistula is an uncommon finding during angiographic exams. We report a case series of five patients with congenital coronary fistulas. The first patient was 56 years old and had a coronary fistula associated with a partial atrio ventricular defect, the second patient was 54 years old and had two fistulas originating from the right coronary artery with a severe atherosclerotic coronary disease, the third patient was 57 years old with a fistula originating from the circumflex artery associated with a rheumatic mitral stenosis, the fourth patient was 50 years old and had a fistulous communication between the right coronary artery and the right bronchial artery, and the last patient was 12 years old who had bilateral coronary fistulas draining into the right ventricle with an aneurismal dilatation of the coronary arteries. Angiographic aspects of coronary fistulas are various; management is controversial and depends on the presence of symptoms.

  2. Traumatic urethrocutaneous fistula: Case report andliterature review ...

    African Journals Online (AJOL)

    % of all trauma cases.Severe penile trauma may be complicated by urethrocutaneous fistula. A 22 year old male patient presentedwith urethrocutaneous fistula following severe crush injury of his penis from the rollers of a baking machine.

  3. Case report: Primary aortosigmoid fistula

    DEFF Research Database (Denmark)

    Khalaf, Chirin; Houlind, Kim Christian

    2017-01-01

    : Aortoenteric fistulas are more common secondary to previous vascular surgery of aorta, however, PAEF’s involve the sigmoid in only 2 %. Fistulization can be due to diverticulitis and can be difficult to diagnose. CONCLUSION: Retroperitoneal bleeding from the left iliac artery is more common due to a ruptured...... aneurism. This case, however, demonstrates a special PAEF formation as a very rare complication of diverticulitis. The pathophysiology of the PAEF is very unique along with the anatomic localization in the sigmoid colon and left external iliac artery....

  4. Gastrojejunocolic fistula after gastrojejunostomy: a case series

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    Wu Jin-Ming

    2008-06-01

    Full Text Available Abstract Introduction Gastrojejunocolic (GJC fistulae represent a significant post-surgical cause of morbidity and mortality. GJC fistulae represent rare post-surgical complications, and most are associated with gastric surgery. In the past, this complication has been under-recognized because a fistula may form years after surgery. Case presentation We describe two cases of gastrojejunocolic fistula in men aged 67 and 60 who both initially presented with watery diarrhea and weight loss. Upper GI studies with small bowel follow-through or barium contrast enema studies allowed a conclusive diagnosis to be made. Both patients underwent one-stage en bloc resection, and their postoperative course was uneventful. Conclusion With surgery, this condition is entirely correctable. Pre-operative nutritional status should be evaluated in patients undergoing corrective surgery, and total parenteral nutrition plays a major role in the provision of bowel rest to allow recovery in malnourished patients.

  5. Enterohepatic fistula in a Crohn's disease patient: A case report.

    Science.gov (United States)

    Van Backer, Justin T; Lee, Edward C

    2017-01-01

    Fistulous tracts are a hallmark of Crohn's Disease. However, solid organ to intestinal fistulas are rare with previously few case reports of colosplenic fistulas and one case report of an enterohepatic fistula. We review the available literature and present the first case report of an enterohepatic fistula in a female with Crohn's Disease to be treated operatively. The patient did well postoperatively with complete resolution of her fistula. Crohn's Disease is an inflammatory bowel disease that can present with fistulas. However, a fistula between the liver and bowel is exceedingly rare with only one previous case report. This is the first report of an enteroheptic fistula that has been managed successfully with an operation. Not all enteroenteric fistulas are apparent preoperatively. When discovered, laparoscopic enterohepatic fistula takedown is feasible for this rare disease process manifestation. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. An uncommon case of neck fistula.

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    Chatterjee, S; Das, S; Khan, J A; Bhattacharya, R N

    2003-01-01

    Congenital fistulae of the neck are branchial in origin and of these 2nd arch fistula is by far the most common, 3rd and 4th arch fistulae being very rare. Here, a case of fistula present since birth and extending from the neck, near the midline to the alveololingual sulcus, considered very rare, is presented. The patient was a 32-year-old male having sticky discharge through an opening in the upper part of the neck. Examination revealed an opening of approximately 1 mm diameter about 1 cm to the left of the midline just above the hyoid bone. A sinogram revealed a fistulous linear tract communicating with the oral cavity. Surgery was undertaken and the fistulous tract was excised.

  7. [Aorto-intestinal fistulas. 4 case reports].

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    Bansky, G; Valli, C; Häcki, W H; Turina, M

    1984-09-15

    Four cases of aorto-enteric fistula are reported. The two primary types occurred after rupture of an aneurysm of the abdominal aorta into the duodenum and as a consequence of tumor infiltration of both the aorta and the intestinal wall in a woman with metastatic ovarian cancer. The two secondary types developed as a late complication of reconstructive surgery of the abdominal aorta. The condition was diagnosed or suspected on the basis of endoscopic findings in two cases. The pathogenetic role of graft infection in the development of secondary aorto-enteric fistula is emphasized. The generally poor prognosis can be considerably improved if prompt resection of the graft is combined with axillo-bifemoral anastomosis.

  8. A Delayed Recrudescent Case of Sigmoidocutaneous Fistula due to Diverticulitis

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    Takaaki Fujii

    2007-10-01

    Full Text Available Colocutaneous fistula caused by diverticulitis is relatively rare, and a delayed recrudescent case of colocutaneous fistula is very uncommon. We herein report a rare case of a Japanese 56-year-old male with delayed recrudescent sigmoidocutaneous fistula due to diverticulitis. A colocutaneous fistula was formed after a drainage operation against a perforation of the sigmoid colon diverticulum. After 5 years from treatment, he was admitted to our hospital because of lower abdominal pain. We diagnosed the recrudescent sigmoidocutaneous fistula by abdominal computed tomography and gastrografin enema, and managed the patient with total parenteral nutrition and antibiotics. As the fistula formation did not improve, a low anterior resection with fistulectomy was performed. The postoperative course was uneventful and the patient was discharged. It has been reported that, in fistulas of the skin caused by diverticular disease, complete closure of the fistula by conservative therapy may not be possible. This case also implies the possibility of a recurrence of the fistula even if the conservative treatment was effective. In cases of colocutaneous fistulas due to diverticulitis, radical surgery is considered necessary because of possibility of recurrence of the fistula.

  9. CORONARY ARTERY FISTULA: A CASE REPORT

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    MZ Chowdhury

    2007-01-01

    Full Text Available The prevalence of congenital abnormalities of coronary artery is about 2% of general population. Of these abnormalities 5% were related to coronary artery fistulae (CAF. We report a case of 66 year old diabetic woman who presented with retrosternal chest pain. Her chest pain was associated with exercise and progressively deteriorated over the last 6 months. Electrocardiography showed right bundle branch block and Echo Color Doppler revealed hypo kinetic lateral wall. Coronary angiogram detected nothing abnormal except an aberrant tortuous branch of left circumflex. CT scan revealed a calcified sac medial to the descended thoracic aorta. A contrast enhancement was also done. All these imaging impressions were suggestive of coronary-to-pulmonary fistula. Ibrahim Med. Coll. J. 2007; 1(1: 32-33

  10. Airway Management Approach in Nasocutaneous Fistula: A Case Report.

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    Sanoja, Ivanna A; Toth, Kenneth S

    2018-01-15

    We present a case of a 63-year-old man with nasocutaneous fistula located outside the area covered by a large adult facemask. The patient was uncooperative for the standard airway assessment and any attempt at awake intubation. Positive pressure ventilation was compromised by the fistula. Although the incidence of overall complications, including fistula formation, following free flap reconstruction for oropharyngeal cancer is reported as high as 20%, few case reports detailing airway management exist. We demonstrate that it is possible to use conventional techniques to induce and ventilate a patient with a large, externalized, airway fistula by covering the defect with an occlusive transparent dressing.

  11. Traumatic urethrocutaneous fistula: Case report and literature review

    African Journals Online (AJOL)

    A.O. Obi

    % to 1.6% of all trauma cases. Severe penile trauma may be complicated by urethrocutaneous fistula. A 22 year old male patient presented with urethrocutaneous fistula following severe crush injury of his penis from the rollers of a baking ...

  12. Benign duodenocolic fistula. A case presenting with acidosis

    DEFF Research Database (Denmark)

    Benn, Marianne; Nielsen, F T; Antonsen, H K

    1997-01-01

    A case of benign duodenocolic fistula as a complication to peptic ulcer disease is presented, the case being interesting for the rarity of the diagnosis and by being complicated with acidosis. The etiology, clinical features, diagnosis, and treatment are reviewed.......A case of benign duodenocolic fistula as a complication to peptic ulcer disease is presented, the case being interesting for the rarity of the diagnosis and by being complicated with acidosis. The etiology, clinical features, diagnosis, and treatment are reviewed....

  13. A case of vesicouterine fistula after cesarean section with delivery through the bladder

    DEFF Research Database (Denmark)

    Schroeder, T; Kristensen, J K

    1983-01-01

    We report a case of a vesicouterine fistula subsequent to delivery at cesarean section through the bladder. A first attempt to close the fistula failed but a second operation adhering to the general principles of fistula repair was successful.......We report a case of a vesicouterine fistula subsequent to delivery at cesarean section through the bladder. A first attempt to close the fistula failed but a second operation adhering to the general principles of fistula repair was successful....

  14. Gurya cutting and female genital fistulas in Niger: ten cases.

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    Ouedraogo, Itengre; McConley, Regina; Payne, Christopher; Heller, Alison; Wall, L Lewis

    2018-03-01

    The objective was to determine the contribution of female genital cutting to genital fistula formation in Niger from the case records of a specialist fistula hospital. A retrospective review was undertaken of the records of 360 patients seen at the Danja Fistula Center, Danja, Niger, between March 2014 and September 2016. Pertinent clinical and socio-demographic data were abstracted from the cases identified. A total of 10 fistulas resulting from gurya cutting was obtained: 9 cases of urethral loss and 1 rectovaginal fistula. In none of the cases was genital cutting performed for obstructed labor or as part of ritual coming-of-age ceremonies, but all cutting procedures were considered "therapeutic" within the local cultural context as treatment for dyspareunia, lack of interest in or unwillingness to engage in sexual intercourse, or female behavior that was deemed to be culturally inappropriate by the male spouse, parents, or in-laws. Clinical cure (fistula closed and the patient continent) was obtained in all 10 cases, although 3 women required more than one operation. Gurya cutting is an uncommon, but preventable, cause of genital fistulas in Niger. The socio-cultural context which gives rise to gurya cutting is explored in some detail.

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

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    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.

  16. Vesicovaginal fistula complicating uterine evacuation: a case report ...

    African Journals Online (AJOL)

    Vesicovaginal fistula complicating uterine evacuation: a case report. MA Ijaiya, AP Aboyeji, GA Fawole, AAG Jimoh, OO Alabi, AO Olarinoye, OL Akintade, OK Ogah, DNC Nwachukwu, OA Alabi, SA Esuga, ZB Ijaiya ...

  17. Congenital Posterior Urethral Fistulae: Literature Review and Case Report.

    Science.gov (United States)

    Perez, Jaime F; Díaz B, Ana María; Ramos, Gustavo U; Peralta, Sara R

    2018-03-06

    Congenital posterior urethral-perineal fistula is an abnormal communication extending from the posterior urethra to the perineal skin. We present the case of an 11-year-old boy who had recurrent febrile urinary tract infections and abnormal dribbling of urine from the perineum. Fistulogram showed a paraescrotal fistula tract, which was then surgically excised. During the 10 months of follow-up, the patient remained asymptomatic without recurrence of urinary pathology. © 2018 S. Karger AG, Basel.

  18. Traumatic fistula:the case for reparations

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    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.

  19. Neurofibromatosis with vertebral artery A-V fistula and cervical meningocele -a case report-

    International Nuclear Information System (INIS)

    Kim, Yong Joo; Suh, Kyung Jin; Kim, Tae Heon; Kang, Duk Sik; Park, Yeun Mook; Park, June Sik

    1988-01-01

    Arteriovenous fistula is a rare abnormality in patient with neurofibromatosis. A review of English-language literature revealed only 3 reported cases. We report a case of neurofibromatosis with vertebral artery A-V fistula and cervical meningocele

  20. Congenital anterior urethrocutaneous fistula: Report of two rare cases

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    Jayalaxmi Shripati Aihole

    2015-05-01

    Full Text Available Isolated congenital anterior urethrocutaneous fistiula (CAUF is a rare anomaly. CAUF can be defined as a fistula of the penile urethra associated with a normal foreskin, in which urethral meatus and prepuce are intact. Additionally, it may be associated with other anomalies such as congenital hernias and anorectal malformations. Treatment of CAUF is individualized according to site of fistula, associated anomalies and condition of the distal urethra. We are reporting our experience of two cases that had abnormal openings on the ventral aspect of distal penis with normal foreskin without hypospadias and chordee.

  1. Endometriosis mimicking the perianal fistula tract: Case report

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    Gül Türkcü

    2014-09-01

    Full Text Available Endometriosis is the presence of endometrial glands and stroma outside the uterine cavity. Nowadays, in many cases, although routine use of episiotomy perineal endo metriosis is extremely rare. A 36 year old female patient was referred to our hospital with complaints of pain in the perianal region for five months. On physical examination, stiffness was palpated and then magnetic resonance im aging (MRI was performed. MRI is compatible with fistula tract. The lesion was excised and the histopathological appearance correspond to endometriosis. Perianal endo metriosis is rare in the perianal region and in the clinic mimicking perianal fistulas and malignancy should be kept in mind in the differential diagnosis

  2. Case Report: Spontaneous cholecystocutaneous fistula, a rare cholethiasis complication.

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    Rinzivillo, Nunzio Maria Angelo; Danna, Riccardo; Leanza, Vito; Lodato, Melissa; Marchese, Salvatore; Basile, Francesco; Zanghì, Guido Nicola

    2017-01-01

    One of the most unusual complications in cholethiasis is spontaneous cholecystocutaneous fistula, which has only been reported a few times in the literature.  We report the case of a 76 year old man who presented with a right hypochondrium subcutaneous abscess, with pain evoked through palpation.  No comorbidity in the patient's medical history were noted.   Confirmation of cholecystocutaneous fistula was made using the proper diagnostic process, which is computed tomography with contrast media, followed by hepatobiliary MRI. This confirmed the presence of a fistulous pathway between the gallbladder and the skin.  The patient underwent cholecystectomy surgery and open laparotomy with en block aponeurotic muscle, skin and fistula orifice excision.

  3. Acquired Salpingo-Enteric Fistula – A Case Report | Ogbeide ...

    African Journals Online (AJOL)

    Hysterosalpingogram a common radiological examination is routinely used in the investigation of infertility and sub-fertility in women. The close proximity of the uterus to adjacent pelvic structures results in various types of pelvic fistulas after pelvic disease, pelvic radiation therapy, trauma or pelvic surgery. The case of a 34 ...

  4. Management dilemma of cholecysto-colonic fistula: Case report

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    Waleed Gibreel

    2018-01-01

    Conclusion: Based on our experience with this particular case, we could safely conclude that an operation for cholecystocolonic fistula presence in the setting of biliary obstruction that failed decompressive attempts should be performed in an urgent fashion to avoid biliary sepsis development.

  5. A Case of Esophagopericardial Fistula as a Complication of Upper ...

    African Journals Online (AJOL)

    A case of suppurative pericarditis from an esophagopericardial fistula (EPF) following the upper gastrointestinal endoscopy (UGIE). A 38‑year‑old schizophrenic male patient with gastro-esophageal reflux disease (GORD) and previously dilated esophageal stricture was presented with acute retrosternal chest pain.

  6. Atrio-Esophageal Fistula: A Case Series and Literature Review.

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    Schuring, Craig A; Mountjoy, Luke J; Priaulx, Ashley B; Schneider, Robert J; Smith, Hayden L; Wall, Geoffrey C; Kadaria, Dipen; Sodhi, Amik

    2017-08-01

    BACKGROUND Percutaneous catheter radiofrequency ablation (RFA) and cryoablation of the left atrium and pulmonary vein ostia have become successful therapeutic modalities in the management of atrial fibrillation. Atrio-esophageal fistula is a rare complication. Awareness of complication risk is imperative because without prompt diagnosis and urgent surgical intervention, the outcome is often fatal. We present 3 cases of atrio-esophageal fistula following percutaneous catheter radiofrequency ablation (RFA). CASE REPORT Case 1: A 72-year old white male presented 27 days after percutaneous RFA for atrial fibrillation with fever, altered mental status, and melena. Esophagogastroduodenoscopy (EGD) revealed a 1-cm defect in the mid-esophagus. Upon thoracotomy, severe hemorrhage ensued from a concomitant injury to the left atrium. Multiple attempts to repair the left atrial perforation were unsuccessful and the patient died. Case 2: A 71-year old white male presented 29 days after percutaneous RFA for atrial fibrillation with fever and tonic-clonic seizure. Recognition of possible atrio-esophageal fistula was considered and confirmed on thoracotomy. Surgical fixation of the left atria and esophagus were performed. The patient survived and was discharged to a skilled care facility. Case 3: A 75-year old white male presented 24 days after percutaneous RFA for atrial fibrillation with chest pain. An echocardiogram revealed a large pericardial effusion and pericardiocentesis was performed. Despite aggressive measures, the patient died. The autopsy demonstrated a communicating esophageal fistula with the right pulmonary vein. CONCLUSIONS Clinicians tending to patients who have recently undergone atrial ablation need to be aware of atrio-esophageal fistula as a rare but highly fatal complication.

  7. A Cholecystocolonic Fistula Detected by MRCP in a Patient with Chronic Cholecystitis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Seong Su; Park, Soo Youn [Catholic University St. Vincent' s Hospital, Suwon (Korea, Republic of)

    2009-08-15

    A cholecystocolonic fistula is an uncommon late complication of chronic gallstone disease. Although it may cause acute life-threatening complications such as bowel obstruction or massive hemorrhaging, its accurate preoperative diagnosis may be difficult due to minimal or nonspecific symptoms. Cholecystocolonic fistulas have been diagnosed by various methods, including ERCP. However, the diagnosis of a cholecystocolonic fistula using MRCP has not been reported in the literature. In this case report, we describe a case of a cholecystocolonic fistula detected by MRCP.

  8. Vesicocutaneus fistula after cesarean section-a curious complication: Case report and review.

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    Tatar, Burak; Erdemoğlu, Ebru; Soyupek, Sedat; Yalçın, Yakup; Erdemoğlu, Evrim

    2016-03-01

    Vesicocutaneous fistulas are very rare pathologies in the urinary tract. We present the second case of a vesicocutaneus fistula after cesarean section, and discuss strategies for prevention, diagnosis, and treatment of this exceptional complication. A woman with a vesicocutaneous fistula after cesarean delivery was admitted and diagnostic tests including fluoroscopy, magnetic resonance imaging (MRI), and reconstructed MRI revealed the fistula tract and an urachal anomaly. The patient was treated through excision of the fistula tract. Laparotomy should be performed carefully, and the surgeon should be aware of the urachus. Inadvertent trauma to the urachus during laparotomy might cause serious unexpected complications. Possible etiologic factors for vesicocutaneous fistulae, prevention, and treatment methods are discussed.

  9. Pulmonary Arteriovenous Fistula: Clinical and Histologic Spectrum of Four Cases

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    Soomin Ahn

    2016-09-01

    Full Text Available Pulmonary arteriovenous fistula (PAVF is abnormally dilated vessels that provide a right-to-left shunt between pulmonary artery and pulmonary vein and is clinically divided into simple and complex type. Here, we report four cases of surgically resected sporadic PAVFs presenting various clinical and histologic spectrums. Cases 1 (a 57-old-female and 2 (a 54-old-female presented as incidentally identified single aneurysmal fistulas and the lesions were surgically removed without complication. On the other hand, case 3 (an 11-old-male showed diffuse dilated vascular sacs involving both lungs and caused severe hemodynamic and pulmonary dysfunction. Embolization and surgical resection of the main lesion failed to relieve the symptoms. Case 4 (a 36-old-male had a localized multiloculated cyst clinically mimicking congenital cystic adenomatoid malformation. Microscopically, the lesion consisted of dilated thick vessels, consistent with the diagnosis of fistulous arteriovenous malformation/hemangioma.

  10. Appendico-cutaneous fistula following hysterectomy: first case report

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    Antonio Sérgio Brenner

    2017-04-01

    Full Text Available Appendico-cutaneous fistulas not related to acute appendicitis or cancer are rare and show spontaneous resolution after conservative treatment, mainly when they show low output, absence of obstruction or sepsis and in patients with good nutritional status. We found no report in the literature on appendico-cutaneous fistula after hysterectomy. The evolution of this case shows that this type of fistula can have low, but persistent debt, requiring definitive surgery. Resumo: Fístulas apendico-cutâneas não relacionadas à apendicite aguda ou neoplasias são raras e de resolução espontânea após tratamento conservador, sobretudo quando se apresentam com baixo débito, ausência de obstrução ou sepse e em pacientes em bom estado nutricional. Não encontramos relato na literatura de fístula apendico-cutânea após histerectomia. A evolução desse caso demonstra que a esse tipo de fístula pode apresentar débito baixo, mas persistente, demandando cirurgia definitiva. Keywords: Fistula, Colorectal surgery, Appendix, Palavras-chave: Fístula, Cirurgia colorretal, Apêndice

  11. Unusual case of nephrocutaneous fistula – Our experience

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    Rajeev Thekumpadam Puthenveetil

    2016-01-01

    Full Text Available A rare case of nephrococutaneous fistula due to spontaneous expulsion of renal calculi is described. A 45-year-old man presented with urinary leakage from an ulcer over the left lumbar region for the last 3 months after a history of spontaneous expulsion of stones from this area. Ultrasonography abdomen revealed a small contracted kidney with multiple calculi in the kidney and renal pelvis, sinus tract from the lower pole of the left kidney with a ruptured calyceal calculus in the sinus tract. CT urography revealed a non excreting left kidney with multiple renal calculi, with hyperdense collection in the renal parenchyma extending to the subcutaneous tissue and left lung suggesting a xenthogranulomatous pyelonephritis (XGP. We performed a left-sided simple nephrectomy with excision of the fistulous tract. Histopathological examination revealed XGP. There have been a few case reports of XGP forming nephrocutaneous fistula in the back.

  12. Rectovaginal Fistula

    Science.gov (United States)

    ... 2015. Browning A, et al. Characteristics, management, and outcomes of repair of rectovaginal fistula among 1100 consecutive cases of genital tract fistula in Ethiopia. International Journal of Gynecology & Obstetrics. Accessed Aug. 23, 2015. Schwartz DA, et al. ...

  13. Pial Arteriovenous Fistula Caused by Trauma: A Case Report

    OpenAIRE

    NOMURA, Seiji; ISHIKAWA, Osamu; TANAKA, Kentaro; OTANI, Ryohei; MIURA, Keisuke; MAEDA, Keiichiro

    2015-01-01

    We report an extremely rare case of pial arteriovenous fistula (AVF) caused by trauma. A 61-year-old man suffered from brain contusion by a traffic accident. He was neurologically normal on admission. However, his headache gradually worsened, and partial seizures occurred thereafter. He presented with general tonic seizure 7 days after the head injury. Magnetic resonance imaging demonstrated the exacerbation of brain edema and an abnormal vein near the contusion. Subsequent angiography showed...

  14. [A case of intractable fistula after low anterior resection repaired by transsacral direct suture].

    Science.gov (United States)

    Yamada, Takanobu; Kodato, Takashi; Shirai, Junya; Kamiya, Mariko; Sujishi, Ken; Kumazu, Yuta; Sugano, Nobuhiro; Hatori, Shinsuke; Osaragi, Tomohiko; Yoneyama, Katsuya; Kasahara, Akio; Rino, Yasushi; Masuda, Munetaka; Yamamoto, Yuji

    2014-11-01

    We report a case of an intractable fistula repaired by transsacral direct suture. A 65-year-old man underwent low anterior resection for rectal cancer. He subsequently underwent ileostomy due to anastomosis leakage. The fistula of the anastomosis persisted 3 months after surgery. He underwent surgery to repair the fistula using a transsacral approach. After removing the coccyx, the fistula in the postrectal space was exposed directly. The presence of the fistula was confirmed by an air leak test and was closed by direct suture. After 33 days, the patient underwent ileostomy closure.

  15. Perianal fistula: retrospective study of surgical treatment of 241 cases

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    Drager Luciano Ferreira

    1998-01-01

    Full Text Available Perianal fistula, usually has a criptoglandular etiology, developing from a perianal abscess and communicating the anal mucosa with the perianal skin. The aim of this paper is to study retrospectively 241 cases of perianal fistula (172 men and 69 women; 2,5:1 aging from 7 and 80 years old (average: 37,4 years, operated on at the Hospital da Clínicas - UFMG, from 1977 to 1996. The surgical techniques and post-operative outcome have been analysed. Perianal abscesses with spontaneous drainage were the predominant etiology (132 patients; 54,8%. Eighty percent were submitted to fistulectomy as the first surgical treatment. Among early complications (78; 32,4%, local pain was the most frequent (60; 24,9%. Among the late complications (136; 56,4% fistula recurrence (101; 41,9% was the most frequent. There were 141 reoperations in 80 patients. Fistulectomy was the predominant surgical technique employed for the treatment (101; 71,6%. The average hospitalization time was 6,3 days until 1990 and 1,5 day from 1991 to 1996, after the advent of day-surgery beds in HC-UFMG. The surgical treatment of perianal fístula has a significant rate of post-operative complications and a high recurrence rate, in spite of the short stay in hospital.

  16. [Vesicouterine tiny fistula 8 years after a cesarean section - case report].

    Science.gov (United States)

    Spaček, J; Navrátil, P; Kestřánek, J; Spaček, J; Doležal, J; Broďák, M

    2013-12-01

    To describe a case of uterovesical fistula after cesarean section with symptoms of vulvovaginal discomfort. Case report. Department of Urology, Department of Obstetrics and Gynecology, University Hospital and Medical Faculty in Hradec Kralove, Charles University Prague. Uterovesical fistula is a rare and unusual complication of cesarean section. Uterovesical fistula is tough to diagnose because of unspecific symptoms. A multidisciplinary approach is necessary for its successful diagnosis and treatment.

  17. Pancreatogastrocutaneous fistula: a discussed case presentation

    International Nuclear Information System (INIS)

    Gonzalez Salcedo, Joel; Pita Armenteros, Luis; Perez Jomarron, Emilio; Morales Diaz, Ignacio

    2010-01-01

    This is a case presentation of a patient aged 47 with a huge right humpback appearing at 18 years old. He was operated on 14 years ago from a cystic formation increasing the volume of limbs and the appearance afterwards of a 2,5 cm tumor. Ten days before its admission showed a urinary infection, constipation, difficulty to release gases, pain and abdominal distention, visualizing such tumor. At radiography on noted many fecaloma and metallic foreign body. He was operated on verifying the presence of fecalomas, loop distention and foreign body whose tip was visualized and palpated. (author)

  18. A case of hypopharyngeal fistula suspected of late complication due to irradiation

    International Nuclear Information System (INIS)

    Fuchigami, Teruhiko; Karaho, Takehiro; Hyodo, Yoshihiro; Tanabe, Tetsuya; Kitahara, Satoshi

    2003-01-01

    We report a case of hypopharyngeal fistula which was suspected of being a late complication due to radiotherapy. The patient was 54-year-old female who had undergone total thyroidectomy for thyroid carcinoma in 1967, receiving a total of 75 Gy postoperative irradiation. In 2001 she came to our hospital complaining of neck pain and difficulty in swallowing. On pharyngoesophagogram we found a hypopharyngeal fistula. The fistula was located under the posterior wall of the hypopharynx between C4 and C7. It was undetectable with flexible fiberscope but was detected with rigid endoscope under the general anesthesia. We suspected it was a late complication of the irradiation. We performed endoscopic laser surgery (KTP), resected the tissue between the upper and lower openings of the fistula, and vertically exposed the fistula in the hypopharyngeal space. Her dysphagia improved. We discuss the mechanism of fistula formation in this case. (author)

  19. A case of hypopharyngeal fistula suspected of late complication due to irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Fuchigami, Teruhiko; Karaho, Takehiro; Hyodo, Yoshihiro; Tanabe, Tetsuya; Kitahara, Satoshi [National Defense Medical Coll., Tokorozawa, Saitama (Japan)

    2003-05-01

    We report a case of hypopharyngeal fistula which was suspected of being a late complication due to radiotherapy. The patient was 54-year-old female who had undergone total thyroidectomy for thyroid carcinoma in 1967, receiving a total of 75 Gy postoperative irradiation. In 2001 she came to our hospital complaining of neck pain and difficulty in swallowing. On pharyngoesophagogram we found a hypopharyngeal fistula. The fistula was located under the posterior wall of the hypopharynx between C4 and C7. It was undetectable with flexible fiberscope but was detected with rigid endoscope under the general anesthesia. We suspected it was a late complication of the irradiation. We performed endoscopic laser surgery (KTP), resected the tissue between the upper and lower openings of the fistula, and vertically exposed the fistula in the hypopharyngeal space. Her dysphagia improved. We discuss the mechanism of fistula formation in this case. (author)

  20. Colovesical fistula secondary to sigmoid diverticulitis mimicking bladder tumor on ultrasonography: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Yun Jung; Yi, Bum Ha; Lim, Joo Won; Lee, Dong Ho; Ko, Young Tae [Kyung Hee University College of Medicine, Seoul (Korea, Republic of)

    2002-12-15

    Colovesical fistula is not an infrequent urologic complication of diverticulitis. However, the frequency of diverticuli at sigmoid colon is low in Korea, and there have been few radiologic reports of colovesical fistula caused by diverticulitis. We report a case of colovesical fistula secondary to sigmoid diverticulitis that mimics bladder tumor on ultrasonography. Additional diagnostic modalities including CT and MRI were performed, and pathologic confirmation was done by surgery.

  1. Percutaneous treatment of a bronchobiliary fistula caused by cholelithiasis: case report

    International Nuclear Information System (INIS)

    Kim, Jae Soo; You, Jin Jong

    2004-01-01

    Bronchobiliary fistulae are rare disorders, with inflammatory diseases of the liver, trauma, previous surgery and biliary obstruction being frequent causative factors. Endoscopic or transhepatic biliary drainage has been used successfully to avoid surgical treatment. We describe a case of a bronchobiliary fistula a 78-year-old man with biliary obstruction caused by impacted calculi. Without surgical or endoscopic intervention, fistulae were treated by percutaneous transhepatic biliary drainage and removal of calculi, in conjunction with balloon sphincteroplasty

  2. Colovesical fistula secondary to sigmoid diverticulitis mimicking bladder tumor on ultrasonography: A case report

    International Nuclear Information System (INIS)

    Kang, Yun Jung; Yi, Bum Ha; Lim, Joo Won; Lee, Dong Ho; Ko, Young Tae

    2002-01-01

    Colovesical fistula is not an infrequent urologic complication of diverticulitis. However, the frequency of diverticuli at sigmoid colon is low in Korea, and there have been few radiologic reports of colovesical fistula caused by diverticulitis. We report a case of colovesical fistula secondary to sigmoid diverticulitis that mimics bladder tumor on ultrasonography. Additional diagnostic modalities including CT and MRI were performed, and pathologic confirmation was done by surgery.

  3. Traumatic Left Anterior Descending Coronary Artery-Right Ventricle Fistula: A Case Report

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Sheikhi

    2011-06-01

    Full Text Available Traumatic coronary artery-cameral fistulas (TCAF are rare and may present secondary to penetrating injuries (80% or iatrogenic traumas. Early operative intervention remains the recommended treatment modality for accidental traumatic coronary artery fistulas. We report the case of a 17-year-old man who presented with left anterior descending coronary artery-right ventricle fistula following penetrating cardiac trauma, which was successfully repaired surgically.

  4. Traumatic Left Anterior Descending Coronary Artery-Right Ventricle Fistula: A Case Report

    Directory of Open Access Journals (Sweden)

    Alireza Rezaee

    2011-05-01

    Full Text Available Traumatic coronary artery-cameral fistulas (TCAF are rare and may present secondary to penetrating injuries (80%or iatrogenic traumas. Early operative intervention remains the recommended treatment modality for accidental traumatic coronary artery fistulas. We report the case of a 17-year-old man who presented with left anterior descending coronary artery-right ventricle fistula following penetrating cardiac trauma, which was successfully repaired surgically.

  5. 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.

  6. Gastro-umbilical fistula as a rare complication of benign gastric ulcer perforation: a case report

    International Nuclear Information System (INIS)

    Lee, Ju Young; Jang, Kyung Mi; Yoon, Hoi Soo; Kim, Min Jeong; Lee, Kwan Seop; Lee, Yul; Bae, Sang Hoon

    2007-01-01

    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

  7. Pial Arteriovenous Fistula Caused by Trauma: A Case Report.

    Science.gov (United States)

    Nomura, Seiji; Ishikawa, Osamu; Tanaka, Kentaro; Otani, Ryohei; Miura, Keisuke; Maeda, Keiichiro

    2015-01-01

    We report an extremely rare case of pial arteriovenous fistula (AVF) caused by trauma. A 61-year-old man suffered from brain contusion by a traffic accident. He was neurologically normal on admission. However, his headache gradually worsened, and partial seizures occurred thereafter. He presented with general tonic seizure 7 days after the head injury. Magnetic resonance imaging demonstrated the exacerbation of brain edema and an abnormal vein near the contusion. Subsequent angiography showed a pial AVF, which was considered to be responsible for the brain edema. After treatment of the AVF by direct surgery, the brain edema was ameliorated. We should take into consideration the formation of vascular disease in cases with unexpected worsening of edema after brain injury.

  8. Closure of oro-antral fistula with pedicled buccal fat pad. A case ...

    African Journals Online (AJOL)

    This article demonstrates the use of BFP in the repair of chronic oro-antral fistula. Methods: A case of a chronic oro-antral fistula of 5- year duration in a 56- year old man successfully repaired with pedicled buccal fat pad after unsuccessful several attempts with other local flaps is presented. A review of relevant literature ...

  9. 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.

  10. Cerebrospinal fluid cutaneous fistula following obstetric epidural analgaesia. Case report.

    Science.gov (United States)

    Fedriani de Matos, J J; Quintero Salvago, A V; Gómez Cortés, M D

    2017-10-01

    Cutaneous fistula of cerebrospinal fluid is a rare complication of neuroaxial blockade. We report the case of a parturient in whom an epidural catheter was placed for labour analgesia and 12h after the catheter was removed, presented an abundant asymptomatic fluid leak from the puncture site, compatible in the cyto-chemical analysis with cerebrospinal fluid. She was treated with acetazolamide, compression of skin orifice of the fluid leakage, antibiotic prophylaxis, hydration and rest, and progressed satisfactorily without requiring blood patch. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. A case of atrio-esophageal fistula masquerading as upper GI bleed.

    Science.gov (United States)

    Rali, Parth; Rali, Mayur; Malik, Khalid

    2017-01-01

    We represent a fatal case of atrio esophageal fistula that presented as upper GI bleed. The case was complicated by rapidly progressing multi organ dysfunction syndrome and eventual death. This was an iatrogenic complication of an elective procedure.

  12. Analysis of 137 obstetric fistula cases seen at three fistula centres in ...

    African Journals Online (AJOL)

    All the patients had early marriage (before age 20 years) with median ages at first marriage of 15 years and at presentation in hospital of 16 years. Majority (93.4%) of the patients developed fistula during the first delivery. Approximately two-third of the patients had no form of education. Only 42.3% of the patients received ...

  13. Vesico Vaginal Fistula Following Sexual Assault: Case Report ...

    African Journals Online (AJOL)

    She had indwelling urethral catheter for 21 days with urinary antiseptic and the fistula healed. This approach is a treatment option in young girls with traumatic VVF particularly where limited tissue access will make surgical repair difficult. Key Words: Vesico-Vaginal Fistula, Sexual Assault. [ Trop J Obstet Gynaecol, 2004 ...

  14. Congenital anterior penile isolated urethrocutaneous fistula: A case ...

    African Journals Online (AJOL)

    Urethrocutaneous fistula is a common complication after hypospadias repair. If congenital, it is usually associated with other genitourinary and gastrointestinal anomalies. Isolated congenital urethral fistula is a very rare anomaly. We present a 4-year old circumcised boy with this unusual anomaly. Etiology, embryology, and ...

  15. Surgical repair of large aortocaval fistula with limited shunt: Case report

    Directory of Open Access Journals (Sweden)

    Takayuki Gyoten

    2014-09-01

    Full Text Available A 67-year-old man was admitted with severe back pain and bilateral lower limb swelling. Enhanced computed tomography showed an infrarenal abdominal aortic aneurysm (92 × 75 mm 2 and a short aortocaval fistula (7 mm. Immediately afterward, circulatory collapse occurred, and the patient was rushed to the operating theater. A much larger aortocaval fistula (22 × 35 mm 2 than that demonstrated by preoperative computed tomography was found and was repaired with a Dacron patch while using two balloon-tipped catheters to control bleeding. Then, the abdominal aortic aneurysm was replaced with a bifurcated graft. The patient’s postoperative course was uneventful. In this case, enhanced computed tomography detected the aortocaval fistula, but could not assess its size accurately. Successful surgical repair of an aortocaval fistula depends on early accurate delineation of the fistula and prompt control of bleeding.

  16. Malignant colo-duodenal fistula; case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Williams Nigel

    2006-12-01

    Full Text Available Abstract Background Colo-duodenal fistula is a rare complication of malignant and inflammatory bowel disease. Cases with malignant colo-duodenal fistulae can present with symptoms from the primary, from the fistula or from metastatic disease. The fistula often results in diarrhoea and vomiting with dramatic weight loss. Upper abdominal pain is usually present as is general malaise both from the presence of the disease and from the metabolic sequelae it causes. The diarrhoea relates to colonic bacterial contamination of the upper intestines rather than to a pure mechanical effect. Vomiting may be faeculant or truly faecal and eructation foul smelling but in the case reports this 'classic' symptomatology was often absent despite a fistula being present and patent enough to allow barium through it. Occasionally patients will present with a gastro-intestinal bleed. Case presentation We present an unusual case of colorectal carcinoma, where a 65 year old male patient presented with diarrhoea and vomiting secondary to a malignant colo-duodenal fistula near the hepatic flexure. Adenocarcinoma was confirmed on histology from a biopsy obtained during the patient's oesophageogastroduodenoscopy, and the fistula was demonstrated in his barium enema. Staging computed tomography showed a locally advanced carcinoma of the proximal transverse colon, with a fistula to the duodenum and regional lymphadenopathy. The patient was also found to have subcutaneous metastasis. Following discussions at the multidisciplinary meeting, this patient was referred for palliation, and died within 4 months after discharge from hospital. Conclusion We present the case, discuss the management and review the literature. Colo-duodenal fistulae from colonic primaries are rare but early diagnosis may allow curative surgery. This case emphasises the importance of accurate staging and repeated clinical examination.

  17. Malignant melanoma arising from a perianal fistula and harbouring a BRAF gene mutation: a case report

    International Nuclear Information System (INIS)

    Martinez-Cadenas, Conrado; Lozoya, Rafael; Boldó, Enrique; Bosch, Nuria; Peñas, Lucas; Flores-Couce, Esther; Ochoa, Enrique; Munárriz, Javier; Aracil, Juan P; Tajahuerce, Marcos; Royo, Ramón

    2011-01-01

    Melanoma of the anal region is a very uncommon disease, accounting for only 0.2-0.3% of all melanoma cases. Mutations of the BRAF gene are usually absent in melanomas occurring in this region as well as in other sun-protected regions. The development of a tumour in a longstanding perianal fistula is also extremely rare. More frequent is the case of a tumour presenting as a fistula, that is, the fistula being a consequence of the cancerous process, although we have found only two cases of fistula-generating melanomas reported in the literature. Here we report the case of a 38-year-old male who presented with a perianal fistula of four years of evolution. Histopathological examination of the fistulous tract confirmed the presence of malignant melanoma. Due to the small size and the central location of the melanoma inside the fistulous tract, we believe the melanoma reported here developed in the epithelium of the fistula once the latter was already formed. Resected sentinel lymph nodes were negative and the patient, after going through a wide local excision, remains disease-free nine years after diagnosis. DNA obtained from melanoma tissue was analysed by automated direct sequencing and the V600E (T1799A) mutation was detected in exon 15 of the BRAF gene. Since fistulae experience persistent inflammation, the fact that this melanoma harbours a BRAF mutation strengthens the view that oxidative stress caused by inflammatory processes plays an important role in the genesis of BRAF gene mutations

  18. Arteriovenous fistula as a complication of transradial coronary angiography: a case report

    Directory of Open Access Journals (Sweden)

    Dehghani Payam

    2013-01-01

    Full Text Available Abstract Introduction Iatrogenic arteriovenous fistula is a vascular condition that may result from coronary angiography. Many case reports have described arteriovenous fistula occurrence after coronary angiography using the transfemoral access route, but rarely as a complication of using the transradial approach. We report a rare case of a patient with arteriovenous fistula following transradial artery coronary angiography. Case presentation A 62-year-old Caucasian man underwent emergent coronary angiography using the right radial artery approach. One month after angiography, he discovered a turbulent sound near the access site. A right radial arteriovenous fistula was found upon duplex ultrasound investigation. The patient was treated conservatively. At 1-year follow-up, the arteriovenous fistula was unchanged and the patient remained hemodynamically stable and asymptomatic. Conclusion Iatrogenic arteriovenous fistula is a rare vascular complication of transradial artery coronary angiography. The natural history of arteriovenous fistula is benign and is thought to resolve spontaneously; therefore, a conservative approach, as opposed to surgical ligation, is recommended as the first-line treatment.

  19. A multidisciplinary clinical treatment of locally advanced rectal cancer complicated with rectovesical fistula: a case report

    Directory of Open Access Journals (Sweden)

    Zhan Tiancheng

    2012-10-01

    Full Text Available Abstract Introduction Rectal cancer with rectovesical fistula is a rare and difficult to treat entity. Here, we describe a case of rectal cancer with rectovesical fistula successfully managed by multimodality treatment. To the best of our knowledge, this is the first such case report in the literature. Case presentation A 51-year-old Chinese man was diagnosed as having rectal cancer accompanied by rectovesical fistula. He underwent treatment with neoadjuvant radiochemotherapy combined with total pelvic excision and adjuvant chemotherapy, as recommended by a multimodality treatment team. Post-operative pathology confirmed the achievement of pathological complete response. Conclusions This case suggests that a proactive multidisciplinary treatment is needed to achieve complete cure of locally advanced rectal cancer even in the presence of rectovesical fistula.

  20. Enterovesical fistula, a rare complication of Meckel’s diverticulum: A case report

    Directory of Open Access Journals (Sweden)

    Bourguiba M.A.

    2017-01-01

    Conclusion: Vesico-diverticular fistula resulting from a perforated Meckel's diverticulum is a rare complication. To our knowledge, this is only the fourth reported case which is not associated to inflammatory bowel disease.

  1. Arteriovenous fistula as a complication of transradial coronary angiography: a case report.

    Science.gov (United States)

    Dehghani, Payam; Culig, Jennifer; Patel, Darshan; Kraushaar, Greg; Schulte, Paul

    2013-01-14

    Iatrogenic arteriovenous fistula is a vascular condition that may result from coronary angiography. Many case reports have described arteriovenous fistula occurrence after coronary angiography using the transfemoral access route, but rarely as a complication of using the transradial approach. We report a rare case of a patient with arteriovenous fistula following transradial artery coronary angiography. A 62-year-old Caucasian man underwent emergent coronary angiography using the right radial artery approach. One month after angiography, he discovered a turbulent sound near the access site. A right radial arteriovenous fistula was found upon duplex ultrasound investigation. The patient was treated conservatively. At 1-year follow-up, the arteriovenous fistula was unchanged and the patient remained hemodynamically stable and asymptomatic. Iatrogenic arteriovenous fistula is a rare vascular complication of transradial artery coronary angiography. The natural history of arteriovenous fistula is benign and is thought to resolve spontaneously; therefore, a conservative approach, as opposed to surgical ligation, is recommended as the first-line treatment.

  2. Role of tongue flap in palatal fistula repair: A series of 41 cases

    Directory of Open Access Journals (Sweden)

    Ravi Kumar Mahajan

    2014-01-01

    Full Text Available Introduction: Despite the improved techniques of repair of cleft palate, fistula occurrence is still a possibility either due to an error in the surgical technique or due to the poor tissue quality of the patient. Though commonly the fistula closure is established by use of local flaps but at times the site and the size of the fistula make use of local flaps for its repair a remote possibility. The use of tongue flaps because of the central position in the floor of the mouth, mobility and the diversity of positioning the flaps make it a method of choice for closure of anterior palatal fistulae than any other tissues. The aim of this study was to analyse the utility of tongue flap in anterior palatal fistula repair. Materials and Methods: We had 41 patients admitted to our hospital during the period 2006-2012 for repair of palatal fistula and were enrolled into the study. In the entire 41 cases, fistula was placed anteriorly. The size of the fistulae varied from 2 cm × 1.5 cm to 5.5 cm × 3 cm. The flaps were divided after 3-week and final inset of the flap was done. Observation and Result: None of the patients developed flap necrosis, in one case there was the dehiscence of the flap, which was reinset and in one patient there was bleeding. None of our patients developed functional deformity of the tongue. Speech was improved in 75% cases. Conclusion: Leaving apart its only drawback of two-staged procedure and transient patient discomfort, tongue flap remains the flap of choice for managing very difficult and challenging anterior palatal fistulae.

  3. Dural arteriovenous fistula at the foramen magnum: Report of a case and clinical-anatomical review.

    Science.gov (United States)

    Llácer, José L; Suay, Guillermo; Piquer, José; Vazquez, Victor

    2016-01-01

    Arterial supply and venous drainage at the foramen magnum is variable. Two main forms of clinical presentation, intracranial and spinal, can be differentiated when a dural arteriovenous fistula (DAVF) is found at this level. We describe a case of a 68-year-old patient with a progressive paraparesis, diagnosed of dural arteriovenous fistula located at the posterior lip of foramen magnum. We review, in this setting, the vascular radiological anatomy of those fistulas and its important correlation with neurologic clinical symptoms. Copyright © 2016 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  4. Closure of difficult pharyngocutaneous fistula following salvage laryngectomy. Case report

    International Nuclear Information System (INIS)

    Suesada, Nobuko; Sakuraba, Minoru; Nagamatsu, Shogo; Miyamoto, Shimpei; Shinozaki, Takeshi; Hayashi, Ryuichi

    2013-01-01

    The patient was a 74-year-old man. A total laryngectomy was performed due to recurrence of laryngeal cancer after chemoradiotherapy (CRT). Postoperatively, a pharyngocutaneous fistula developed and patch-graft reconstruction using a pectoral major musculocutaneous flap was planned. However, due to expansion of the necrotic area, we needed to perform tubular reconstruction. Nevertheless, infection and pus discharge were observed and a second surgery was performed. Resection and reconstruction at the neck were considered impossible because advanced necrosis was seen at the cervical esophageal stump, and the operative procedure was changed to esophageal resection, gastric pull-up and free jejunum transfer. Although leakage was found at the jejunum-gastric anastomosis site by fluoroscopy on the 14th postoperative day, it disappeared through conservative therapy. In addition, oral ingestion was begun on the 28th postoperative day. At 6 months after the surgery, the patient was able to regularly intake food and no constriction of the tracheostoma was seen. In this case, unexpected expansion of the necrotic area was a significant problem. As for the causes, diminished blood flow to the esophagus due to total thyroidectomy and bilateral paratracheal lymph node dissection, and infection in the surrounding area, along with remarkable tissue damage with CRT were considered possible. In salvage surgery, attention will be necessary in evaluating necrotic range and selection of appropriate reconstructive procedure. (author)

  5. Intrarectal negative pressure system in the management of open abdomen with colorectal fistula: A case report☆

    Science.gov (United States)

    Yetişir, Fahri; Salman, A. Ebru; Mamedov, Ruslan; Aksoy, Mustafa; Yalcin, Abdussamet; Kayaalp, Cüneyt

    2014-01-01

    INTRODUCTION To present the management of open abdomen with colorectal fistula by application of intrarectal negative pressure system (NPS) in addition to abdominal NPS. PRESENTATION OF CASE Twenty-year old man had a history of injuries by a close-range gunshot to the abdomen eight days ago and he had been treated by bowel repairs, resections, jejunal anastomosis and Hartman's procedure. He was referred to our center after deterioration, evisceration with open abdomen and enteric fistula in septic shock. There were edematous, fibrinous bowels and large multiple fistulas from the edematous rectal stump. APACHE II, Mannheim Peritoneal Index and Björck scores were 18, 33 and 3, respectively (expected mortality 100%). After intensive care for 5 days, he was treated by abdominal and intrarectal NPS. NPS repeated for 5 times and the fistula was recovered on day 18 completely. Fascial closure was facilitated with a dynamic abdominal closure system (ABRA) and he was discharged on day 33 uneventfully. There was no herniation and any other problem after 12 months follow-up. DISCUSSION Management of fistula in OA can be extremely challenging. Floating stoma, fistula VAC, nipple VAC, ring and silo VAC, fistula intubation systems are used for isolation of the enteric effluent from OA. Several biologic dressings such as acellular dermal matrix, pedicled flaps have been used to seal the fistula opening with various success. Resection of the involved enteric loop and a new anastomosis of the intestine is very hard and rarely possible. In all of these reports, usually patients are left to heal with a giant hernia. In contrast to this, there is no hernia in our case during one year follow up period. CONCLUSION Combination of intra and extra luminal negative pressure systems and ABRA is a safe and successful method to manage open abdomen with colorectal fistula. PMID:24584042

  6. Different etiologies of an unusual disease: Colouterine fistula – Report of two cases

    Directory of Open Access Journals (Sweden)

    Rohit Aggarwal

    2018-01-01

    Full Text Available Colouterine fistula is an extremely rare condition, as the uterus is a thick, muscular organ. Here, we present two different etiologies for this rare condition—diverticulitis and malignancy. A 77-year-old female with colouterine fistula due to diverticulitis presented with complaints of lower abdominal pain localized particularly in the left iliac fossa and fever. Another case was of 73-year-old female with colouterine fistula due to malignancy who presented with abdominal pain, blood in stools, and whitish discharge from vagina. Both cases were evaluated with contrast-enhanced computed tomography (CECT. The presence of air and fluid within the uterus on ultrasound or CT scan, prompts the possibility of colouterine fistula with CECT providing accurate preoperative assessment.

  7. Post-traumatic cerebrospinal fluid fistula: a case report; Fistula liquorica pos-traumatica - relato de um caso

    Energy Technology Data Exchange (ETDEWEB)

    Tamburus, Wander Miguel; Figueiredo Wanderley, Eliana Christina; Maciel, Damacio Ramon Kaimen; Narciso, Avelino Jose Soares; Sendenski, Mauricio Michalak [Universidade Estadual de Londrina, PR (Brazil). Centro de Ciencias da Saude

    1996-10-01

    Fronto-basal fracture occurs in around 5% of cranioencephalic trauma. the involved structures are: arachnoid, dura-mater, osseous base and the mucosa, and there us contact between the brain and the environment. Even with rupture of all these structures cerebrospinal fluid leakage may not occur; regardless of this, there may be infectious complications, such as bacterial meningitis or brain abscess. the authors report the case of a patient with head injury and four bacterial meningitis, the diagnosis of post-traumatic liquoric fistula being made only through magnetic resonance imaging. (author) 10 refs., 1 fig.

  8. Intrarectal negative pressure system in the management of open abdomen with colorectal fistula: A case report.

    Science.gov (United States)

    Yetişir, Fahri; Salman, A Ebru; Mamedov, Ruslan; Aksoy, Mustafa; Yalcin, Abdussamet; Kayaalp, Cüneyt

    2014-01-01

    To present the management of open abdomen with colorectal fistula by application of intrarectal negative pressure system (NPS) in addition to abdominal NPS. Twenty-year old man had a history of injuries by a close-range gunshot to the abdomen eight days ago and he had been treated by bowel repairs, resections, jejunal anastomosis and Hartman's procedure. He was referred to our center after deterioration, evisceration with open abdomen and enteric fistula in septic shock. There were edematous, fibrinous bowels and large multiple fistulas from the edematous rectal stump. APACHE II, Mannheim Peritoneal Index and Björck scores were 18, 33 and 3, respectively (expected mortality 100%). After intensive care for 5 days, he was treated by abdominal and intrarectal NPS. NPS repeated for 5 times and the fistula was recovered on day 18 completely. Fascial closure was facilitated with a dynamic abdominal closure system (ABRA) and he was discharged on day 33 uneventfully. There was no herniation and any other problem after 12 months follow-up. Management of fistula in OA can be extremely challenging. Floating stoma, fistula VAC, nipple VAC, ring and silo VAC, fistula intubation systems are used for isolation of the enteric effluent from OA. Several biologic dressings such as acellular dermal matrix, pedicled flaps have been used to seal the fistula opening with various success. Resection of the involved enteric loop and a new anastomosis of the intestine is very hard and rarely possible. In all of these reports, usually patients are left to heal with a giant hernia. In contrast to this, there is no hernia in our case during one year follow up period. Combination of intra and extra luminal negative pressure systems and ABRA is a safe and successful method to manage open abdomen with colorectal fistula. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Vesicovaginal fistula after sexual intercourse. A case report

    International Nuclear Information System (INIS)

    Takeda, Toshikazu; Nishiyama, Toru; Ohara, Rei; Hasegawa, Shintaro

    2007-01-01

    A 53-year old female visited our hospital with a complaint of continuous urinary incontinence after sexual intercourse. She had been diagnosed with carcinoma of uterine cervix stage I b2 and had undergone radical hysterectomy and radiation therapy (45 Gy). Cystoscopy revealed vesicovaginal fistula in the trigone which measured almost 3 cm. We repaired it by transabdominal and vaginal routes 5 days after the injury. She was discharged with a Foley catheter. Three months after the operation, cystography revealed improvement of vesicovaginal fistula. (author)

  10. Enterocutaneous fistula associated with ePTFE mesh: case report and review of the literature.

    Science.gov (United States)

    Foda, M; Carlson, M A

    2009-06-01

    A case of enterocutaneous fistula secondary to the erosion of an expanded polytetrafluoroethylene (ePTFE) prosthesis into the jejunum is described. This case is unusual secondary to the long experience with ePTFE and the lack of published cases similar to this one. The technical details of this case reveal extenuating circumstances associated with the fistula formation, and it is concluded that this particular case does not provide sufficient evidence to implicate ePTFE, by itself, as an etiologic agent for gastrointestinal fistulization. In addition, the published safety record of ePTFE in abdominal wall surgery is reviewed.

  11. The "Fistula VAC," a technique for management of enterocutaneous fistulae arising within the open abdomen: report of 5 cases.

    Science.gov (United States)

    Goverman, Jeremy; Yelon, Jay A; Platz, John Joseph; Singson, Rufino C; Turcinovic, Michael

    2006-02-01

    Management of intestinal fistulae in open abdominal wounds remains a significant clinical challenge for those caring for patients surviving damage control abdominal operations. Breaking the cycle of tissue inflammation, infection, and sepsis, resulting from leakage of enteric contents, should be a major goal in the approach to these complex patients. We describe a technique utilizing vacuum assisted closure (VAC) which achieves control of enteric flow from fistulae in open abdominal wounds. The fistula-VAC is fashioned from standard sponge supplies, negative pressure pumps, and ostomy appliances. The fistula-VAC was changed every three days prior to split thickness skin grafting, and every five days following grafting. Five patients underwent application of the fistula-VAC. All patients had complete diversion of enteric contents. This enteric diversion allowed for successful skin grafting in all patients. Application of the fistula-VAC should be considered a useful option in treating patients with intestinal fistulae in open abdominal wounds.

  12. Simultaneous endovascular repair of an iatrogenic carotid-jugular fistula and a large iliocaval fistula presenting with multiorgan failure: a case report

    Directory of Open Access Journals (Sweden)

    Yuminaga Yuigi

    2012-01-01

    Full Text Available Abstract Introduction Iliocaval fistulas can complicate an iliac artery aneurysm. The clinical presentation is classically a triad of hypotension, a pulsatile mass and heart failure. In this instance, following presentation with multiorgan failure, management included the immediate use of an endovascular stent graft on discovery of the fistula. Case presentation A 62-year-old Caucasian man presented to our tertiary hospital for management of iatrogenic trauma due to the insertion of a central venous line into his right common carotid artery, causing transient ischemic attack. Our patient presented to a peripheral hospital with fever, nausea, vomiting, acute renal failure, acute hepatic dysfunction and congestive heart failure. A provisional diagnosis of sepsis of unknown origin was made. There was a 6.5 cm×6.5 cm right iliac artery aneurysm present on a non-contrast computed tomography scan. An unexpected intra-operative diagnosis of an iliocaval fistula was made following the successful angiographic removal of the central line to his right common carotid artery. Closure of the iliocaval fistula and repair of the iliac aneurysm using a three-piece endovascular aortic stent graft was then undertaken as part of the same procedure. This was an unexpected presentation of an iliocaval fistula. Conclusion Our case demonstrates that endovascular repair of a large iliac artery aneurysm associated with a caval fistula is safe and effective and can be performed at the time of the diagnostic angiography. The presentation of an iliocaval fistula in this case was unusual which made the diagnosis difficult and unexpected at the time of surgery. The benefit of immediate repair, despite hemodynamic instability during anesthesia, is clear. Our patient had two coronary angiograms through his right femoral artery decades ago. Unusual iatrogenic causes of iliocaval fistulas secondary to previous coronary angiograms with wire and/or catheter manipulation should be

  13. Acute gastric volvulus in operated cases of tracheoesophageal fistula

    Directory of Open Access Journals (Sweden)

    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.

  14. Acquired Salpingo-Enteric Fistula – A Case Report | Ogbeide ...

    African Journals Online (AJOL)

    There was a positive history of chronic pelvic inflammatory disease, myomectomy and appendicectomy. The result showed evidence of opacification of the right fallopian tube with contrast outlining the adjacent large bowels.Asymptomatic pelvic fistulas maybe a silent cause of infertility, and association can only be stated as ...

  15. A Case of Esophagopericardial Fistula as a Complication of Upper ...

    African Journals Online (AJOL)

    [10] The barium swallows done in this patient were normal and did not reveal the EPF (gross filling of the pericardial sac with contrast material) and is consistent with the reported barium swallow sensitivity of 69‑80[11] for the detection of esophagopericardial fistula. Upper gastro‑intestinal endoscopy (UGIE) may show the ...

  16. Enterocutaneous fistula: A review of 82 cases | Njeze | Nigerian ...

    African Journals Online (AJOL)

    After treatment for correction of fluid and electrolyte deficits, they were all tried on conservative therapy with enteral nutritional support as the main stay of management. Those, whose fistulas did not close, underwent surgical treatment. Total parenteral nutrition, octreotide, fibrin glue, and wound vacuum assisted closure ...

  17. Crohn's disease presenting as a recurrent perianal fistula: A case ...

    African Journals Online (AJOL)

    Crohn's disease (CD) is a multifactorial polygenic disease characterized by chronic inflammation of the gastrointestinal tract (GIT), often complicated by the development of intestinal strictures and/or formation of fistulas. Several diagnostic criteria have been proposed, usually relying on clinical, endoscopic, radiological or ...

  18. [Aortodigestive fistula and septic wound of the lower leg. A case report].

    Science.gov (United States)

    Sommier, B; Casoli, V; Gachie, E; Weigert, R; Castède, J-C

    2013-06-01

    An aortodigestive fistula can be revealed by a peripheral septic wound when patient have aortic endovascular prosthesis. Our clinical case is about a 69-year-old patient with an abscess of the lateral aspect of his left lower limb. He has been treated few years ago for an aorto-abdominal anevrysm by an aortobifemoral prosthesis. In spite of a negative initial assessment for an aortodigestive fistula, anaerobic germs were found into the abscess. The initial treatment associated debridement, negative pressure therapy, dermal substitute and a split thickness skin graft for the loss of cutaneous substance. Months later, in front of an unexplained skin healing delay and fever, we realised new assessment bringing to light an aortodigestive fistula. Furthermore, the local bacterial samples from the wound and the hemocultures found both a lot of Escherichia Coli. The change of the aorto-bifemoral prosthesis and the cure of the aortodigestive fistula allowed the complete healing of the loss of cutaneous substance of the leg. The aortodigestive fistulas have a very high mortality. Because of their difficult diagnosis, their clinical suspicion has to start a complete medical assessment. Every septic wound when patients have vascular prosthesis is suggestive of an aortodigestive fistula. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  19. 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

    2016-10-11

    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.

  20. A case report of spinal dural arteriovenous fistula: origins, determinants, and consequences of abnormal vascular malformations

    Directory of Open Access Journals (Sweden)

    Sherry M. Zakhary, DO

    2017-06-01

    Full Text Available A spinal dural arteriovenous fistula is an abnormally layered connection between radicular arteries and venous plexus of the spinal cord. This vascular condition is relatively rare with an incidence of 5–10 cases per million in the general population. Diagnosis of spinal dural arteriovenous fistula is differentiated by contrast-enhanced magnetic resonance angiography or structural magnetic resonance imaging, but a definitive diagnosis requires spinal angiography methods. Here, we report a case of a 67-year-old female with a spinal dural arteriovenous fistula, provide a pertinent clinical history to the case nosology, and discuss the biology of adhesive proteins, chemotactic molecules, and transcription factors that modify the behavior of the vasculature to possibly cause sensorimotor deficits.

  1. Management of gastro-bronchial fistula complicating a subtotal esophagectomy: a case report

    LENUS (Irish Health Repository)

    Martin-Smith, James D

    2009-12-24

    Abstract Background The development of a fistula between the tracheobronchial tree and the gastric conduit post esophagectomy is a rare and often fatal complication. Case presentation A 68 year old man underwent radical esophagectomy for esophageal adenocarcinoma. On postoperative day 14 the nasogastric drainage bag dramatically filled with air, without deterioration in respiratory function or progressive sepsis. A fiberoptic bronchoscopy was performed which demonstrated a gastro-bronchial fistula in the posterior aspect of the left main bronchus. He was managed conservatively with antibiotics, enteral nutrition via jejunostomy, and non-invasive respiratory support. A follow- up bronchoscopy 60 days after the diagnostic bronchoscopy, confirmed spontaneous closure of the fistula Conclusions This is the first such case where a conservative approach with no surgery or endoprosthesis resulted in a successful outcome, with fistula closure confirmed at subsequent bronchoscopy. Our experience would suggest that in very carefully selected cases where bronchopulmonary contamination from the fistula is minimal or absent, there is no associated inflammation of the tracheobronchial tree and the patient is stable from a respiratory point of view without evidence of sepsis, there may be a role for a trial of conservative management.

  2. Management of gastro-bronchial fistula complicating a subtotal esophagectomy: a case report.

    LENUS (Irish Health Repository)

    Martin-Smith, James D

    2009-01-01

    BACKGROUND: The development of a fistula between the tracheobronchial tree and the gastric conduit post esophagectomy is a rare and often fatal complication. CASE PRESENTATION: A 68 year old man underwent radical esophagectomy for esophageal adenocarcinoma. On postoperative day 14 the nasogastric drainage bag dramatically filled with air, without deterioration in respiratory function or progressive sepsis. A fiberoptic bronchoscopy was performed which demonstrated a gastro-bronchial fistula in the posterior aspect of the left main bronchus. He was managed conservatively with antibiotics, enteral nutrition via jejunostomy, and non-invasive respiratory support. A follow- up bronchoscopy 60 days after the diagnostic bronchoscopy, confirmed spontaneous closure of the fistula CONCLUSIONS: This is the first such case where a conservative approach with no surgery or endoprosthesis resulted in a successful outcome, with fistula closure confirmed at subsequent bronchoscopy. Our experience would suggest that in very carefully selected cases where bronchopulmonary contamination from the fistula is minimal or absent, there is no associated inflammation of the tracheobronchial tree and the patient is stable from a respiratory point of view without evidence of sepsis, there may be a role for a trial of conservative management.

  3. Coronary artery fistulas

    Directory of Open Access Journals (Sweden)

    V. M. Subbotin

    2015-01-01

    Full Text Available Coronary artery fistulas are classified as abnormalities of termination and referred to as major congenital anomalies. Most coronary artery fistulas are small, unaccompanied by clinical symptoms, and diagnosed by echocardiography or coronarography performed for an unrelated cause. Such fistulas usually do not cause any complications and can spontaneously resolve. However, larger fistulas are usually >3 tones the size of a normal caliber of a coronary artery and may give rise to clinical symptoms in these cases. The clinical symptoms of coronary artery fistulas may mimic those of various heart diseases depending on which chamber a fistula drains into. Most fistulas are congenital. Congenital coronary artery fistulas may occur as an isolated malformation or be concurrent with other cardiac anomalies, more frequently with critical pulmonary stenosis or atresia with an intact interventricular septum and pulmonary stenoses, Fallot's tetralogy, aortic coarctation, and left heart hypoplasia. When choosing a treatment modality, one should take into account the number of fistula communications, the feeding vessel, localization of drainage, degree of myocardial damage, and hemodynamic relevance of the shunt caused by the presence of a fistula. The goal of treatment is to obliterate a fistula by preserving normal coronary blood flow. The risk for persisting fistula should be balanced with the potential risk of complications related to a procedure of coronarography and fistula occlusion. Percutaneous transcatheter coil occlusion of coronary artery fistulas is the modality of choice in children with the suitable anatomy of fistula communications and without concomitant congenital heart diseases.

  4. [The congenital coronary artery fistula. Observations on seven cases (author's transl)].

    Science.gov (United States)

    Chioin, R; Stritoni, P; Fasoli, G; Schivazappa, L; Maddalena, F; Daliento, L; Boffa, G M

    1975-01-01

    The authors report seven cases of congenital coronary artery fistula observed in the Cardiology Department of Padua Medical School. The cardiopathy, the anatomo-histological characteristics, evolution and embriology are described. The anamnesic, clinical, electrocardiographic, X-Ray, phonocardiogram, haemodynamic, and contrastographic findings for each case are given. They are discussed and interpreted in the light of the pathophysiology of the disease.

  5. Cranial dural arteriovenous fistula as a rare cause of tinnitus – case report

    International Nuclear Information System (INIS)

    Kuśmierska, Małgorzata; Gać, Paweł; Nahorecki, Artur; Szuba, Andrzej; JaŸwiec, Przemysław

    2013-01-01

    Tinnitus, occurring at least once in a lifetime in about 10–20% of the population, is an important clinical problem with complex etiology. Rare causes of tinnitus include cranial dural arteriovenous fistulas (DAVFs), which are usually small lesions consisting of abnormal connections between branches of dural arteries and venous sinuses or veins. Authors present a case of a 44-year-old woman with persistent, unilateral, treatment-resistant pulsatile tinnitus caused by a small dural arteriovenous fistula revealed in computed tomography angiography. Computed tomography angiography is a useful diagnostic method that in some cases allows for establishing the cause of unilateral, pulsatile tinnitus

  6. [Bronchoesophageal fistula secondary to mediastinal lymph node tuberculosis: a case report and review of the literature].

    Science.gov (United States)

    Liao, Li-yue; Wu, Hua; Zhang, Nuo-fu; Liu, Chun-li; Li, Shi-yue; Gu, Ying-ying; Chen, Rong-chang

    2013-11-01

    To analyze the clinical features of 1 case of bronchoesophageal fistula (BEF) secondary to mediastinal lymph node tuberculosis. The clinical, auxiliary examinational and pathological data of 1 case with BEF were presented, and the literatures were reviewed. The patient was a 19 year old female, who was admitted to hospital because of fever and cough associated with liquid intake. It was diagnosed by chest CT scan, endobronchial ultrasound biopsy of mediastinal lymph nodes, and clinical testing (methylene blue). The BEF was closed after anti-tuberculosis therapy and preventing contamination of the fistula by indwelling stomach tube. Bronchoesophageal fistula secondary to mediastinal lymph node tuberculosis is rare. Chest CT scan, fiberoptic bronchoscopy, and clinical testing (methylene blue) are useful diagnostic tools for BEF.

  7. Salvage Procedure in Case of Urethrocavernous Fistula after Revision Surgery for Malfunctioning Three-Piece Penile Prosthesis

    Directory of Open Access Journals (Sweden)

    Enrico Caraceni

    2016-01-01

    Full Text Available Urethrocavernous fistula is a rare complication of penile prosthesis. Literature lacks any materials regarding this complication’s treatment. We report our experience with a 66-year-old man who developed urethrocavernous fistula after penile prosthesis implant. Our technique involves the careful closure of urethral and corpus cavernosum defects with application of TachoSil® above the sutures. After the salvage procedure, no recurrence of fistula occurred and patient was able to have sexual intercourse. We believe that our technique may be successfully used in case of urethrocavernous fistula after penile prosthesis implant.

  8. A case of intractable gastrocutaneous fistula after gastric pull-up reconstruction of the pharynx and esophagus

    International Nuclear Information System (INIS)

    Wada, Tadahiko; Tanaka, Shinzo; Hiratsuka, Yasuyuki; Kumabe, Yohei; Yamahara, Kohei; Koyama, Taiji

    2012-01-01

    Pharyngocutaneous or esophagocutaneous fistula formation is not a rare complication after surgical treatment of head/neck cancer. In cases having developed such fistula, conservative treatment with local manipulation or surgical closure of the fistula using a local or pedicled flap is often possible. We recently encountered a case with an intractable gastrocutaneous fistula which occurred a long time after gastric pull-up reconstruction of the pharynx and esophagus. The patient was a 58-year-old female. As treatment for hypopharyngeal and thoracic esophageal cancers, the patient underwent total resections of the laryngopharynx and esophagus and gastric pull-up reconstruction of the esophagus. Postoperatively, 50 Gy radiation was applied to the neck. Although there was no recurrence of cancer, a salivary fistula above the tracheostomy occurred six years after surgery. Closure of the fistula with a local flap was attempted twice, but did not succeed. The fistula was then closed with a deltopectoral (DP) flap, but a fistula recurred five months later. Finally, by resecting the cervical segment of the pulled-up stomach, the esophagus was reconstructed successfully with a free jejunal graft. An intractable fistula should be replaced using tissue with rich blood flow, such as a free jejunal graft. (author)

  9. Radiosurgical treatment of a carotid-cavernous fistula. Case report

    International Nuclear Information System (INIS)

    Barcia-Salorio, J.L.; Hernandez, G.; Broseta, J.; Ballester, B.; Masbout, G.

    1979-01-01

    This report presents the result obtained in the first patient with a Parkinson Type II spontaneous carotid-cavernous fistula (CCF) cured by means of selective gamma radiation from Co-60. The operation was performed with 25 entrances resulting in a total dose for the target of 2,500 rads. 90% doses were received in a 5 mm diameter spherical volume and 50% doses in a 8 mm volume. One year later, a control carotid angiography showed complete occlusion of the CCF and a normal permeability of the carotid artery. (Auth.)

  10. Choledochoduodenal fistula presenting with pneumobilia in a patient with gallbladder cancer: a case report

    Directory of Open Access Journals (Sweden)

    Dadzan Elham

    2012-02-01

    Full Text Available Abstract Introduction Spontaneous biliary tract fistulas are rare entities. Most of them are associated with long-standing gallstones (especially common bile duct stones, or recurrent biliary tract infections, some with more uncommon diseases such as gallbladder cancer. Some authors believe that back flow from fistulas predisposes patients to gallbladder cancer and some believe that cancer causes necrosis and fistula formation. Gallbladder cancer has a dismal prognosis and 85% of patients are dead within a year of diagnosis. A common complication of gallbladder cancer is obstruction of the common bile duct, which may produce multiple intra-hepatic abscesses in or near the tumor-laden gallbladder. Fistula formation may further complicate the clinical picture. Case presentation We present a case of choledochoduodenal fistula in a 60-year-old diabetic African-American woman with gallbladder cancer. The initial clinical presentation was confusing and complex. Our patient was also found to have a gallbladder fossa abscess that was drained percutaneously as another complicating factor relating to her cancer. She developed myocardial infarction, massive upper gastrointestinal bleeding and respiratory arrest during her stay in hospital. Computed tomography was very helpful in assessing our patient and we discuss how, in a patient with pneumobilia, it can be helpful for detecting fistula, air in bile ducts or to show contractions of the gallbladder. Conclusions We believe this case merits reporting as it shows an entity that is not frequently thought of, is hard to diagnose and can be fatal, as in our patient. Careful evaluation, and computed tomography studies and endoscopic retrograde cholangio-pancreatography are helpful in early diagnosis and finding better management options for these patients.

  11. [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.

  12. [Scrotal fistulas revealing mucinous adenocarcinoma of the scrotum: about a case].

    Science.gov (United States)

    El Alaoui, Abdelilah; El Boté, Hicham; Ziouani, Oussama; Dembele, Oussman; El Sayegh, Hachem; Iken, Ali; Benslimane, Lounis; Nouini, Yassine

    2017-01-01

    Scrotales fistulas are rare and often represent secondary lesions of tuberculosis. Mucinous adenocarcinomas are tumors containing at least 50% of extracellular mucus. They occur most commonly in the rectosigmoid; scrotal location is rare. We report the case of a 54-year old patient, with no particular past medical history, with secondary mucinous adenocarcinoma of the scrotum revealed by scrotal fistulas. The patient had suffered from recurrent scrotal fistulas for two years, with no other associated signs. Clinical examination showed multiple scrotal fistulas with discharge of thick pus. Rectal examination was normal. Urological examinations (IVU, UCRM, cystoscopy, …) were normal, the assessment of infectious diseases as well as the detection of BK virus in urine and sputum were negative. Biopsy of sample of scrotal tissue was in favor of moderately differentiated mucinous adenocarcinoma. Immunohistochemical examination was in favor of primary colorectal cancer. Patient's evolution was marked by the occurrence of complex anal fistulas, which appeared on MRI as active, supplying several pelvic peritoneal collections resulting in fleshy buds. There is no consensus on the therapeutic approach due to the rarity of this cancer. Surgical resection is the treatment of choice for this disease. Preoperative chemotherapy and radiation therapy are recommended for this type of cancer, but their role is not well established. The patient underwent primary neoadjuvant chemotherapy and radiation therapy, before abdominoperineal excision.

  13. ARTERIO-VENOUS FISTULA IN THE TEMPORAL REGIONS – A CLINICAL CASE

    Directory of Open Access Journals (Sweden)

    Irina Dobrin

    2011-12-01

    Full Text Available The arterio-venous fistulae in the temporal regions, to be first described by Bartholin around 1730, were considered as tardy post-traumatic lesions correlated with the impact of tough objects in the above-mentioned area. The superficial temporal arterio-venous axis is usually interested at the level of the pterional region, while establishment of some communication between the artery and the vein generates an arterio-venous fistula with a systolodiastolic murmur and the tendency for progressive growth. The study discusses a clinical case and its surgical solution.

  14. A Case of Dermatomyositis with Esophageal Fistula in Whom Blind Mucosal Biopsy Detected Occult Oropharyngeal Carcinoma

    Directory of Open Access Journals (Sweden)

    Miho Kabuto

    2014-11-01

    Full Text Available We present a case of anti-transcription intermediary factor 1 (anti-TIF-1 antibody-positive dermatomyositis with concomitant esophageal fistula and extensive truncal erythema. The characteristic cutaneous features and presence of anti-TIF-1 antibodies were predictive for internal malignancy. However, repeated examinations for internal malignancy showed none, and blind mucosal biopsy was needed to diagnose oropharyngeal carcinoma. We should note the possibility of occult nasopharyngeal carcinoma and consider performing blind mucosal biopsy in dermatomyositis with esophageal fistula, especially with extensive truncal erythema.

  15. Coronary artery fistulas: symptoms may not correlate to size. An emblematic case and literature review

    OpenAIRE

    Buccheri, D; Pisano, c; Piraino, D; Cortese, B; Dendramis, G; Chirco, PR; Balistreri, CR; Andolina, G; Argano, V; Ruvolo, G

    2015-01-01

    Fistulous communication of coronary with pulmonary arteries in the adults is a common type of coronary artery fistula (CAF)1—3. In most reported cases, the fistula usually arises from the proximal left and/or right coronary arteries via the anterior conal branches that connect to the anterior wall of the main pulmonary artery. These anteriorly located abnormal communications are usually asymptomatic and are incidentally found during an angiography of the coronary arteries in 0.2—0.3% of the e...

  16. An unusual case of fistula formation and thrombosis between arteriovenous graft and a native vein

    Directory of Open Access Journals (Sweden)

    Young Sub Kim

    2016-03-01

    Full Text Available Arteriovenous graft for hemodialysis vascular access is a widely used technique with many advantages. However, it has crucial complications with graft thrombosis and infection. We recently experienced an unusual case of arteriovenous graft complication involving graft thrombosis related to fistula formation between the graft and the natural vein with infection. We diagnosed this condition using Doppler ultrasound and computed tomography angiography. Successful surgical treatment including partial graft excision and creation of a secondary arteriovenous fistula using an inadvertently dilated cephalic vein was performed. The dialysis unit staff should keep this condition in mind and try to prevent this complication.

  17. Prenatal Diagnosis of Coronary Artery Fistula: A Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Mohamed Nagiub

    2014-11-01

    Full Text Available We report an antenatally diagnosed large distal coronary artery fistula (CAF arising from an aneurysmal dilation right coronary artery (RCA and draining in to the right ventricle (RV just below the septal leaflet of tricuspid valve posteriorly. A postnatal echocardiogram confirmed the diagnosis. On the second day of life, a percutaneous partial closure of the fistula was performed by placing a Flipper coil (Cook Medical, Bloomington, IN in the RCA just proximal to the drainage site in the cardiac catheterization laboratory. Follow-up echocardiogram on the day following the procedure showed improved forward flow in the descending aorta with decreased RV size. Our case report suggests that antenatal diagnosis of a CAF may aid in early intervention. Partial closure of the fistula in the cardiac catheterization laboratory is safe and effective.

  18. Case Report: Spontaneous cholecystocutaneous fistula, a rare cholethiasis complication [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Nunzio Maria Angelo Rinzivillo

    2017-09-01

    Full Text Available One of the most unusual complications in cholethiasis is spontaneous cholecystocutaneous fistula, which has only been reported a few times in the literature.  We report the case of a 76 year old man who presented with a right hypochondrium subcutaneous abscess, with pain evoked through palpation.  No comorbidity in the patient’s medical history were noted.   Confirmation of cholecystocutaneous fistula was made using the proper diagnostic process, which is computed tomography with contrast media, followed by hepatobiliary MRI. This confirmed the presence of a fistulous pathway between the gallbladder and the skin.  The patient underwent cholecystectomy surgery and open laparotomy with en block aponeurotic muscle, skin and fistula orifice excision.

  19. Tuberculosis presenting as isolated bronchonodal fistula in a patient with systemic lupus erythematosus: Case report.

    Science.gov (United States)

    Bae, Kyungsoo; Jeon, Kyung Nyeo; Kim, Ho Cheol; Suh, Young Sun; Lee, Gi Dong; Kim, Ju-Young; Song, Dae Hyun

    2017-11-01

    Lymph node is a preferred site for extrapulmonary tuberculosis (TB). In the thorax, mediastinal tuberculous lymph nodes can erode adjacent structures such as heart, aorta, and esophagus, forming fistula, and causing fatal consequences. However, tuberculous bronchonodal fistula as a complication of lymph node TB in adults is rarely known in terms of imaging or clinical findings. Here, a case of isolated tuberculous bronchonodal fistula appearing as the first presentation of TB in a 74-year-old male with systemic lupus erythematosus (SLE) is reported. A 74-year-old male with SLE visited the hospital with dry cough. In family history, his son was treated for pulmonary TB 9 years previously. Laboratory test revealed increased C-reactive protein level and erythrocyte sedimentation rate. Chest computed tomography (CT) scan revealed a necrotic lymph node in the right hilar area connected to the inferior wall of the right upper lobe bronchus and the lateral wall of bronchus intermedius. On bronchoscopy performed under guidance of 3-dimensionally reconstructed CT image, fistula formation between the right hilar lymph node and 2 bronchi (the right upper lobe and intermediate bronchus) was confirmed. Sputum culture revealed growth of Mycobacterium tuberculosis. Anti-TB medication with isoniazid, ethambutol, pyrazinamide, and moxifloxacin for 9 months. The patient's symptom was gradually improved. Follow-up bronchoscopy performed at 3 months after starting the medication revealed decreased size of the fistula. This is a rare case of bronchonodal fistula appearing as the first presentation of TB in a 74-year-old male patient with SLE. CT provided useful information regarding the origin and progress of the disease.

  20. A case of split notochord syndrome: a child with a neuroenteric fistula presenting with meningitis

    NARCIS (Netherlands)

    G.H. van Ramshorst (Gabrielle); M.H. Lequin (Maarten); G.M.S. Mancini (Grazia); C. van de Ven (C.)

    2006-01-01

    textabstractThe authors describe a case of split notochord syndrome with a neuroenteric fistula in a newborn presenting with meningitis. Associated anomalies included agenesis of the corpus callosum, short colon, malrotation, epispadias, and an abnormally high bifurcation of the abdominal aorta and

  1. [Recurrent brain abscess associated with congenital pulmonary arteriovenous fistula: a case report].

    Science.gov (United States)

    Shioya, Hitoshi; Kikuchi, Kenji; Suda, Yoshitaka; Shindo, Kenjiro; Hashimoto, Manabu

    2004-01-01

    We report a rare case of recurrent brain abscess associated with congenital pulmonary arteriovenous fistula. A 52-year-old man was admitted to our hospital in October, 1999 because of a sudden stroke-like onset of right hemiparesis, right hemiparesthesia, dysarthria and sensory aphasia. He had a history of previous brain abscess in the right cerebellar hemisphere. It had been removed in 1991. CT scan at the time of the current admission disclosed a low-density area in the left parietal region. The mass was ring-enhanced after injection of contrast medium. On MRI the mass lesion was depicted as low-intensity on T1-weighted image and high-intensity on T2-weighted image. The mass was ring-enhanced after administration of Gd-DTPA. In spite of conservative treatment the size of the abscess increased considerably with marked surrounding edema. The brain abscess was successfully treated with aspiration and drainage, and the residual mass was resected. The patient also had a history of arteriovenous fistula in the lower lobe of his right lung. This had been excised in 1965. However, he had no signs, symptoms or family histories of hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber disease). Contrast enhanced CT scan of the chest showed nodular lesions connected to vascular shadows in the right lower lung field. Pulmonary angiograms also revealed multiple arteriovenous fistulas in the lower lobe of the right lung. He was not dyspneic or cyanotic, but his hypoxia, polycythemia, and recurrent brain abscess were thought to be caused by pulmonary arteriovenous fistula. The fistulas were embolized with coils via a percutaneous catheter. Pulmonary arteriovenous fistula should be treated aggressively either by surgery and/or by coil embolization in order to prevent the complication of brain abscess.

  2. Urogenital fistulae: A prospective study of 50 cases at a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Mathur Rajkumar

    2010-01-01

    % illiterate and 69% were short Statured. Vesico vaginal fistulae (VVF was seen in 64% cases of which 50% were due to obstructed labor, 19% cases post LSCS and 31% cases post total abdominal hysterectomy (TAH. 68% of urogenital fistulae were between 1 to 3 cms. We obtained a 75% cure rate in UVF, 87.5% cure rate in RVF while a 93.75% cure rate was observed in patients with VVF. 76% of all patients were cured while 8% had a recurrence, probably due to the large size of fistula. Conclusion : Genital fistula is preventable, yet it remains a significant cause of morbidity among females of reproductive age group. Despite facilities available, certain conditions like physical, social, economic, illiteracy, and a very casual attitude towards maternal health and children birth practices limit utilization of services for women. It is important that the modern health care providers should be aware of these aspects, so that they can recognize services that are appropriate and acceptable to the people. Thus, one must agree that in cases of urogenital fistulae, "prevention is better than cure".

  3. Urogenital fistulae: A prospective study of 50 cases at a tertiary care hospital.

    Science.gov (United States)

    Mathur, Rajkumar; Joshi, Nitin; Aggarwal, Gaurav; Raikwar, Ramsharan; Shrivastava, Vaibhav; Mathur, Poonam; Raikwar, Poonam; Joshi, Rupali

    2010-05-01

    ) was seen in 64% cases of which 50% were due to obstructed labor, 19% cases post LSCS and 31% cases post total abdominal hysterectomy (TAH). 68% of urogenital fistulae were between 1 to 3 cms. We obtained a 75% cure rate in UVF, 87.5% cure rate in RVF while a 93.75% cure rate was observed in patients with VVF. 76% of all patients were cured while 8% had a recurrence, probably due to the large size of fistula. Genital fistula is preventable, yet it remains a significant cause of morbidity among females of reproductive age group. Despite facilities available, certain conditions like physical, social, economic, illiteracy, and a very casual attitude towards maternal health and children birth practices limit utilization of services for women. It is important that the modern health care providers should be aware of these aspects, so that they can recognize services that are appropriate and acceptable to the people. Thus, one must agree that in cases of urogenital fistulae, "prevention is better than cure".

  4. Cataract surgery in a case of carotid cavernous fistula

    Directory of Open Access Journals (Sweden)

    Akshay Gopinathan Nair

    2014-01-01

    Full Text Available A carotid-cavernous fistula (CCF is an abnormal communication between the cavernous sinus and the carotid arterial system. The ocular manifestations include conjunctival chemosis, proptosis, globe displacement, raised intraocular pressure and optic neuropathy. Although management of CCF in these patients is necessary, the ophthalmologist may also have to treat other ocular morbidities such as cataract. Cataract surgery in patients with CCF may be associated with many possible complications, including suprachoroidal hemorrhage. We describe cataract extraction surgery in 60-year-old female with bilateral spontaneous low-flow CCF. She underwent phacoemulsification via a clear corneal route under topical anesthesia and had an uneventful postoperative phase and recovered successfully. Given the various possible ocular changes in CCF, one must proceed with an intraocular surgery with caution. In this communication, we wish to describe the surgical precautions and the possible pitfalls in cataract surgery in patients with CCF.

  5. Giant intracranial aneurysm with fistula to the paranasal sinuses - a case report; Aneurisma gigante intracraniano com fistula para os seios paranasais - relato de um caso

    Energy Technology Data Exchange (ETDEWEB)

    Cabral, Luciano Gusmao; Monteiro, Soraya Silveira; Rossi, Luiz Antonio; Araujo, Marcelo Antonio Nobrega; Iagarachi, Celso Kendy; Oliveira, Luiz Antonio Nunes de [Hospital do Servidor Publico Estadual de Sao Paulo, SP (Brazil). Serv. de Radiologia

    1998-09-01

    The authors present a case of giant aneurysm of internal carotid artery with extensive bone erosion, which led to a fistula to the paranasal sinuses. The clinical aspects, radiological findings and differential diagnosis of giant intracranial aneurysms are discussed. (author) 9 refs., 5 figs.

  6. Gastro-tracheal fistula - unusual and life threatening complication after esophagectomy for cancer: a case report

    Directory of Open Access Journals (Sweden)

    Droissart Raphaël

    2009-11-01

    Full Text Available Abstract Background A gastro-tracheal fistula following esophagectomy for cancer is a rare but potentially lethal complication. We report the successful surgical closure after failed endoscopic treatment, of a gastro-tracheal fistula following esophago-gastrectomy for cancer after induction chemo-radiotherapy. Case presentation A 58 year-old male patient presented with a distal third uT3N1 carcinoma of the esophagus. After induction chemo-radiotherapy, he underwent an esophago-gastrectomy with radical lymphadenectomy and reconstruction by gastric pull-up. Immediate postoperative outcome was uneventful. On the 15th postoperative day however, our patient was readmitted in the Intensive Care Unit with severe bilateral basal pneumonia. Three days later a gastro-tracheal fistula was diagnosed upon gastroscopy and bronchoscopy. His good general condition allowed for an endoscopic primary approach which consisted in the insertion of a covered stent in the trachea along with clipping and glueing of the gastric fistular orifice. Two attempts proved unsuccessful. Conclusion After several weeks of conservative measures, surgical re-intervention through a right thoracotomy with transection of the fistula and closure by primary interrupted sutures of both fistular orifices along with intercostal muscle flap interposition led to excellent patient outcome. Oral feeding was started and our patient was discharged.

  7. Pharyngocutaneous fistula.

    Science.gov (United States)

    Mäkitie, Antti A; Irish, Jonathan; Gullane, Patrick J

    2003-04-01

    The occurrence of pharyngocutaneous fistula after oncologic head and neck surgery is a serious complication. It is the most common complication after major hypopharyngeal and laryngeal ablative surgery. The cause and management guidelines are still controversial. Contributing risk factors of impaired wound healing should be recognized in preoperative planning. Perioperative technical issues and preventive postoperative care play a major role in the prevention of fistulae, limiting the severity of the fistula and minimizing secondary complications. Surgical salvage of cancers treated with organ preservation approaches is associated with higher rates of postoperative complications, particularly in cases in which mucosal membranes are transgressed and surgically closed. Patients who require surgical repair are best treated by the use of regional myocutaneous flaps or free tissue transfers. This subset of patients is likely best treated in regional centers of excellence with well developed multidisciplinary programs for ablative and reconstructive head and neck surgery.

  8. Benign gastro-colic fistula in a woman presenting with weight loss and intermittent vomiting: a case report

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    Hii Michael W

    2011-07-01

    Full Text Available Abstract Introduction Benign gastro-colic fistula is a rare occurrence in modern surgery due to the progress in medical management of gastric ulcer disease. Here we report the first case of benign gastro-colic fistula occurring whilst on proton-pump inhibitor therapy. This is a case study of benign gastro-colic fistula and review of the available literature in regards to etiology, diagnosis, management and prognosis. Case presentation An 84-year-old woman of Caucasian background presented with 12 months of worsening abdominal pain, nausea, vomiting, diarrhea and weight loss on a background of known gastric ulcer disease. Conclusion The leading cause of gastro-colic fistulae has changed from benign to malignant due to improved medical management of gastric ulcer disease. The rarity and non-specific symptoms of gastro-colic fistula make the diagnosis difficult and it is best made by barium enema; however, computed tomography has not been formally evaluated. Surgical management with en bloc resection of the fistula tract is the preferred treatment. Benign gastro-colic fistulae are becoming exceedingly rare in the context of modern medical management of gastric ulcer disease. Surgical management is the gold standard for both benign and malignant disease.

  9. Posterior cranial fossa single-hole arteriovenous fistulae in children: 14 consecutive cases

    International Nuclear Information System (INIS)

    Yoshida, Y.; Weon, Y.C.; Sachet, M.; Mahadevan, J.; Alvarez, H.; Rodesch, G.; Lasjaunias, P.

    2004-01-01

    We report 14 consecutive children with 23 posterior cranial fossa arteriovenous fistula (AVF); six had multifocal lesions, involving the supratentorial brain in three and the spinal cord in one. There were two boys and four girls with a family history compatible with hereditary haemorrhagic telangiectasia. The diagnosis was made in infancy in eight cases and in a further six before the age of 12 years; mean age at diagnosis was 3.5 years. The male-to-female ratio was 1.8:1. Presenting features were macrocrania in four cases, haemorrhage or headache in three and nonhaemorrhagic neurological deficits or and cardiac overload in two. Dominant supply to the symptomatic fistula arose from the posterior inferior cerebellar artery in five cases, anterior inferior cerebellar artery in two and the upper basilar artery system in seven. All children were primarily treated by transarterial embolisation. We treated thirteen children (93%) by transarterial embolisation alone; one older child with a history of haemorrhage also underwent radiosurgery. We obtained 100% exclusion of the fistula(e) in six children, 95-80% in five, 80-50% in one and <50% in one. Of the incompletely treated cases, three had conservative management, and two with 80% and one with 60% reduction of their lesion are scheduled for elective treatment; two partially treated case died. There was no morbidity due to the endovascular procedures. Follow-up since referral is 6 months-10 years (mean 4.5 years). Ten children are neurologically normal, two have persistent (pre-existing) neurological deficits and two are dead. (orig.)

  10. Pancreaticopleural fistulas of different origin: Report of two cases and a review of literature

    International Nuclear Information System (INIS)

    Wypych, K.; Lasek, W.; Serafin, Z.; Strzesniewski, P.; Galazka, P.; Nierzwicka, K.; Prokurat, A. I.; Matuszczak, W.; Bak, M.

    2011-01-01

    Background: Pancreaticopleural fistula (PPF), a form of internal pancreatic fistula, is a rare complication of acute or chronic pancreatitis or pancreatic trauma. Case Report: We report two cases of PPF resulting in formation of pleural pancreatic pseudocysts. A 35-year old male alcoholic patient with a history of recurrent episodes of acute pancreatitis was admitted due to a severe dyspnea. A CT scan showed a significant left pleural effusion with a total left lung atelectasis, compression of the mediastinum, and dislocation of the left diaphragm. A follow-up CT showed a fistula between the abdominal pancreatic pseudocyst and the left pleural cavity. The second case was a 13-year-old male patient, who was admitted for a splenic stump excision. Two weeks after the surgery the patient presented a massive pleural amylase-rich effusion. CT exam suggested a PPF, which was indirectly confirmed by a thoracoscopy. Conclusions: PPF should be considered in cases of massive pleural effusion and encapsulated pleural fluid collections in patients with a history of acute pancreatitis and surgery involving pancreas. (authors)

  11. Pancreaticopleural fistulas of different origin: Report of two cases and a review of literature

    Science.gov (United States)

    Wypych, Katarzyna; Serafin, Zbigniew; Gałązka, Przemysław; Strześniewski, Piotr; Matuszczak, Włodzimierz; Nierzwicka, Katarzyna; Lasek, Władysław; Prokurat, Andrzej I.; Bąk, Marek

    2011-01-01

    Summary Background: Pancreaticopleural fistula (PPF), a form of internal pancreatic fistula, is a rare complication of acute or chronic pancreatitis or pancreatic trauma. Case Report: We report two cases of PPF resulting in formation of pleural pancreatic pseudocysts. A 35-year-old male alcoholic patient with a history of recurrent episodes of acute pancreatitis was admitted due to a severe dyspnea. A CT scan showed a significant left pleural effusion with a total left lung atelectasis, compression of the mediastinum, and dislocation of the left diaphragm. A follow-up CT showed a fistula between the abdominal pancreatic pseudocyst and the left pleural cavity. The second case was a 13-year-old male patient, who was admitted for a splenic stump excision. Two weeks after the surgery the patient presented a massive pleural amylase-rich effusion. CT exam suggested a PPF, which was indirectly confirmed by a thoracoscopy. Conclusions: PPF should be considered in cases of massive pleural effusion and encapsulated pleural fluid collections in patients with a history of acute pancreatitis and surgery involving pancreas. PMID:22802835

  12. Enterobiliary Fistula as a Complication of Eosinophilic Gastroenteritis: a Case Report

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    Kim, Han Myun; Woo, Ji Young [Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul (Korea, Republic of)

    2008-06-15

    Eosinophilic gastroenteritis is an uncommon disease with variable clinical features characterized by eosinophilic infiltration. Clinical manifestations range from non-specific gastrointestinal complaints such as nausea, vomiting, crampy abdominal pain, and diarrhea to specific findings such as malabsorption, protein loosing enteropathy, luminal obstruction, eosinophilic ascites and effusion. We report here on a case of eosinophilic gastroenteritis causing enterobiliary fistula which is an extremely unusual complication

  13. Sigmoid colocolic fistula caused by intrauterine device migration: a case report.

    Science.gov (United States)

    Weerasekera, Amila; Wijesinghe, Pravin; Nugaduwa, Nilhan

    2014-03-04

    The intrauterine device is a form of contraception with a long duration of action and few systemic side effects. Migration into the abdominal cavity may occur early or years after insertion giving rise to bowel obstruction, perforation, ischemia, mesenteric injury, strictures or fistulae. Colocolic fistula formation is a rare but serious complication of intrauterine device migration, which may lead to difficulties in diagnosis and device retrieval. We report the case of a 29-year-old Sri Lankan woman who became pregnant 5 years after intrauterine device insertion. The device could not be located during pregnancy. She was asymptomatic and defaulted follow up during the antenatal period. She had an uncomplicated vaginal delivery. A subsequent laparotomy for device retrieval failed due to technical difficulties. A repeat laparotomy identified a sigmoid colocolic fistula with adhesions to the fallopian tube. The device was removed and colonic defects primarily closed following which the patient made an uneventful recovery. All translocated intrauterine devices should be removed regardless of type and location. This case illustrates that they may cause complex bowel lesions leading to serious technical difficulties during retrieval. With the increasing use of minimally invasive approaches for intrauterine device retrieval, a low threshold for open surgery in complicated cases is advocated.

  14. A Congenital Anterior Urethrocutaneous Fistula in a Boy Whose Mother Was Exposed to Ionizing Radiations: Case Report and Literature Review

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    C. Spinelli

    2013-01-01

    Full Text Available Anterior congenital urethrocutaneous fistula is a rare anomaly that may present in an isolated fashion or in association with other anomalies of the genital urinary tract or anorectal malformations. A case of congenital anterior urethrocutaneous fistula nonassociated with other congenital anomalies in a 3-year-old male whose mother has been exposed to Chernobyl's nuclear fallout is described. The patient was successfully operated with no recurrence. We report a review of the literature about etiology and surgical strategy including the role of ionizing radiations. The congenital anterior urethrocutaneous fistula represents a rare malformation. The etiopathogenesis is unknown.

  15. A case of delayed anastomotic fistula occurred nine years after adjuvant radiotherapy following rectal cancer surgery

    International Nuclear Information System (INIS)

    Matsumoto, Tomoko; Fukao, Takashi; Kuriyama, Shiho; Ohtawa, Yasuyuki; Waku Toshihiko

    2017-01-01

    The patient was a 72-year-old man who underwent a low anterior resection for rectal cancer in 2007 (RbRa, pT4a, pN1, cM0, pStage 3a). With the surgically stripped surface testing positive, the pelvic cavity was subjected to 50 Gy of radiation as part of adjuvant radiotherapy. In December 2015, the patient presented with anal pain and bloody stool.A CT scan revealed a pelvic abscess accompanied by gas patterns around the anastomotic site, and a colonoscopy detected formation of a fistula at the anastomotic site. Although CT-guided drainage was performed in response, a new abscess was formed promptly. In April 2016, laparoscopic colostomy with double orifices was performed on the transverse colon. Thereafter the abscesses in the buttocks required four sessions of incision and drainage. The condition improved with no purulent discharge after December 2016. As of 11 months after the colostomy, the pelvic abscess is gradually contracting, though some fistulas have remained. The patient has been followed up on an ambulatory basis.This case is considered to be of an intrapelvic abscess associated with the delayed anastomotic fistula occurred after a lapse of 9 years following irradiation. (author)

  16. Surgical management of aneurysms of arteriovenous fistulae in hemodialysis patients: A case series

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    Christopher SP Valentine

    2010-03-01

    Full Text Available Christopher SP Valentine, Olugbenga AworantiDepartment of Surgery, Cornwall Regional Hospital, Montego Bay, JamaicaBackground: One of the complications of arteriovenous (AV fistulae used for hemodialysis is aneurysm formation and subsequent risk for rupture. Surgery is one of the modalities utilised to treat this condition.Methods: A retrospective review of medical records was done to identify patients managed surgically at our institution over a four-year period. The surgical procedures varied from aneurysmectomy alone, to partial aneurysmectomy with preservation of the fistula, to aneurysmectomy and creation of a new fistula.Results: Seven patients who had undergone AV fistula aneurysm were identified. The usual presentation was of a pulsatile, expansile mass at the site of the AV fistula scar associated with pain. Two patients presented with bleeding. Patients in whom preservation of the fistula was attempted had poor patency of the fistula postoperatively. All patients in whom aneurysmectomy with creation of a new fistula was done had a functional fistula postoperatively.Discussion: Others have described surgical techniques for fistula preservation, but these have necessitated a significant delay until use of the fistula. Arterial blood flow in a new fistula increases gradually for up to 10 days, then tapers off. Therefore, it should be possible to begin use of the fistula at this time.Conclusions: AV fistula aneurysms may be treated by aneurysmectomy and creation of a new fistula. This may also reduce the waiting time before the fistula can be used for dialysis.Keywords: arteriovenous fistula, aneurysm, hemodialysis aneurysm, pseudoaneurysm

  17. Congenital posterior urethroperineal fistula: a review and report of the 25th case in literature.

    Science.gov (United States)

    Bello, Jibril Oyekunle

    2014-12-01

    Duplications of the urethra are rare, but the congenital posterior urethroperineal fistula (CUPF) is an even rarer anomaly. CUPF resembles type II A2, Y-duplication described by Effmann but differs significantly because it has a normal functional dorsal urethra and a ventral hypoplastic accessory urethra. Excision or fulguration of the accessory urethra results in the resolution of patient's symptoms. The 25th case in English literature is reported with a review of literature; the addition of CUPF to Effmann classification as "type II A2, Y-hypoplastic ventral urethra" is proposed. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Colovesical fistulas

    International Nuclear Information System (INIS)

    Krco, M.J.; Jacobs, S.C.; Malangoni, M.A.; Lawson, R.K.

    1984-01-01

    Colovesical fistulas were identified in 42 patients. Diverticulitis was the underlying cause in 40 per cent of the patients. Carcinoma of the colon or cervix caused 33 per cent of the fistulas. Cystoscopy was the most effective procedure in diagnosing the fistulas. Surgical therapy had to be individualized to the patient's condition. Fistulas secondary to radiation were associated with a high complication rate

  19. Two Anomalies in One: A Rare Case of an Intrahepatic Gallbladder with a Cholecystogastric Fistula

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    Mohammad F. Ali

    2017-03-01

    Full Text Available The gallbladder can be situated in a variety of anomalous positions. An intrahepatic gallbladder – the second most common ectopic location of the gallbladder – is one that is completely embedded within the liver parenchyma. Described in the literature as early as 1935, intrahepatic gallbladders predominantly result from a developmental anomaly but in some instances have been reported to be secondary to chronic inflammation. The significance of an intrahepatic gallbladder lies in the fact that 60% of the cases are associated with gallstones and may present a challenge for the general surgeon during cholecystectomy and other biliary operations in addition to causing misdiagnosis on imaging. Intrahepatic gallbladders are unusual, but the incidence of an intrahepatic gallbladder with a cholecystogastric fistula is rare. Cholecystogastric fistulas commonly are a complication of long-term cholelithiasis or chronic cholecystitis with subsequent gallstone ileus. Herein, we present the case of an 80-year-old man who presented with 2 months of progressive weakness, fatigue, decreased appetite, and intermittent right-sided abdominal pain, and was found to have a markedly distended and irregular intrahepatic gallbladder measuring 12.2 × 11.5 × 13.4 cm on CT, as well as a cholecystogastric fistula on esophagogastroduodenoscopy. During esophagogastroduodenoscopy, the gallbladder was entered directly via the fistulous tract. The patient was on i.v. antibiotics with tube feeds via a nasojejunal tube initially, followed by p.o. which he tolerated. He was eventually discharged with referral for surgical evaluation. Given the potential for cholelithiasis and fistulation, physicians should have a high index of suspicion and recommend timely endoscopic and/or surgical management to avoid future complications.

  20. Temporary ileostomy for the preservation of colon fistula in patients with postoperative complications: case report

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    Solaine Chiminácio De Oliveira Patrício

    2011-09-01

    Full Text Available 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 some cases, the general state of the patient compromises the spontaneous closure. In this study, after one month of nutritional support and medicine treatment, the spontaneous closure of the colon fistula did not occur, thus, a surgical intervention was necessary to solve the case.Dentre as complicações pós-operatórias do aparelho digestório, as fístulas apresentam alta incidência. As alterações decorrentes dessas fístulas são muito importantes, pois podem determinar o agravamento do estado geral do paciente e o desenvolvimento de insuficiências orgânicas múltiplas. O presente trabalho relata o caso de um paciente com complicações relevantes após a realização de uma ileostomia temporária para preservação do cólon fistulizado. A maioria (90-95% das fístulas do trato digestório tem resolução espontânea; entretanto, em alguns casos, o estado geral do paciente compromete o fechamento espontâneo. No caso em estudo, após um mês de suporte nutricional e tratamento medicamentoso, o fechamento espontâneo da fístula de cólon não ocorreu, sendo necessária a intervenção cirúrgica para resolução do caso.

  1. Radiation-induced rectal cancer originating from a rectocutaneous fistula. Report of a case

    International Nuclear Information System (INIS)

    Yokoyama, Shozo; Takifuji, Katsunari; Arii, Kazuo; Tanaka, Hajime; Matsuda, Kenji; Higashiguchi, Takashi; Yamaue, Hiroki

    2004-01-01

    This report describes a patient with radiation-induced rectal cancer with an unusual history. A 51-year-old man was admitted in 2000 because of ichorrhea of the skin on the left loin. The patient had received irradiation for a suspicious diagnosis of a malignant tumor in the pelvic cavity in 1975. A subcutaneous abscess in the right loin appeared in 1989, and rectocutaneous fistula was noted in 1992. Moreover, radiation-induced rectal cancer developed in 2000. Plain computed tomography and magnetic resonance imaging of the pelvis demonstrated a presacral mass and tumor in the rectum. Finally, we diagnosed the presacral mass to be an abscess attached to the center of the rectal cancer. The rectum was resected by Miles' operation and a colostomy of the sigmoid colon was also performed. Many cases of radiation-induced rectal cancer have been reported. However, this is a rare case of radiation-induced rectal cancer originating from a presacral abscess and rectocutaneous fistula. (author)

  2. Colocutaneous fistula: a rare postoperative complication after surgical treatment of an irreducible left inguinal hernia Case Report.

    Science.gov (United States)

    Cadariu, Florentina; Enache, Alexandra; Avram, Mihaela; Olariu, Sorin

    2016-02-18

    The colo-cutaneous fistula is an extremely rare post-operative complication of hernias. This type of complication, besides the surgical aspects, raises also a medical-legal problem regarding the production of the fistula and its consequences. The authors present the clinical case of a 65 years old man, J.N., from a rural background, who presented himself in the ambulatory with a colo-cutaneous fistula as a complication which debuted a few weeks after a surgical intervention for an irreducible left inguinal hernia. He was submitted to a surgical reintervention with good results. The main particularity of the present case is the association of the colo-cutaneous fistula with the presence of the oxyuris helmintiasis in the fistulos secretions. Even though it was rather difficult to obtain the patient's consent for the surgical treatment, the intervention had very good results leading to the healing of the patient. Colo-cutaneous fistula, Enterobius vermicularis (oxyuris helmintiasis), Post-operative complications of hernia.

  3. Case Report: An unusual case of Cervico-cutaneous fistula | Ghose ...

    African Journals Online (AJOL)

    A lady presented with 6 months of amenorrhea and cyclical menstruation through an opening in the abdominal wall for the same duration, following septic abortion. Examination and investigations revealed an extraperitoneal Cervicocutaneous fistula, which was excised in toto. She had an uneventful recovery and resumed ...

  4. Detachable Balloon Embolization of an Arterioportal Fistula Following Liver Biopsy in a Liver Transplant Recipient: A Case Report and Review of Literature

    International Nuclear Information System (INIS)

    Botelberge, Thomas; Vlierberghe, Hans van; Voet, Dirk; Defreyne, Luc

    2005-01-01

    We report a case of an intrahepatic arterioportal fistula in a 61-year-old female liver transplant recipient. The patient presented with massive ascites 7 months after a percutaneous liver biopsy. A large fistula between the right hepatic artery and the right portal vein was diagnosed on color Doppler ultrasound and confirmed on arteriography. The fistula was successfully embolized with the detachable balloon technique and the ascites resolved. Symptomatic intrahepatic arterioportal fistula in a liver transplant recipient following percutaneous biopsy is rare. Clinical manifestations, surgical or endovascular therapy, and outcome are discussed. The literature on this subject is reviewed

  5. Recurrent pancreatic fistula occurring after nephrectomy in patients with a renal hydatid cyst: a case report

    Science.gov (United States)

    Ceylan, Cavit; Odabaş, Öner; Doğan, Serkan; Yığman, Metin

    2013-01-01

    Pancreatic fistula (PF) is an important complication that may develop during intra-abdominal surgeries and following distal pancreas trauma. In the early period, drainage from the surgical site and increased amylase production based on the biochemical examination of the drainage fluid are the factors for diagnosis. In contrast, in association with fluid collected from the surgical site, intra-abdominal abscess and high fever may lead to the diagnosis in the late period. Endoscopic retrograde cholangiopancreatography (ERCP) for the treatment of intra-abdominal fluid collection after PF and intra-abdominal percutaneous stent placement as well as the placement of a pancreatic stent in the pancreatic channel may be alternative methods to stop drainage. However, the complete resolution of fluid drainage may take months. In our case, drainage from the pancreatic fistula area took longer to resolve than the periods previously reported in the English literature. The tail of the pancreas can be injured during the extraction of especially aggressive and metastatic masses from organs near to the distal pancreas. Injury to the tail of the pancreas can also occur during the extraction of benign-like renal hydatid cysts and/or malignant left kidney masses. However, PF can be treated with noninvasive methods, such as percutaneous treatment and ERCP. PMID:26328082

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Xanthogranulomatous prostatitis with prostato-rectal fistula: a case report and review of the literature

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    Xing L

    2016-09-01

    Full Text Available Liyong Xing, Zhifei Liu, Gang Deng, Huan Wang, Yanfeng Zhu, Peng Shi, Bingyue Huo, Yindong Li Department of Urology, Tangshan People’s Hospital, Tangshan, People’s Republic of China Purpose: Xanthogranulomatous prostatitis (XP is a rare form of nonspecific granulomatous prostatitis that can clinically mimic high-grade prostatic carcinoma. It is difficult to diagnose it definitely in clinical settings. Methods: We report a case of XP with prostate-rectal fistula and review the relevant literatures. Result: A 75-year-old man presented with rectal bleeding when he urinated. A locally advanced carcinoma of prostate was suspected initially following the physical, imaging, and hematologic examinations. Subsequently on histopathological and immunohistochemical staining after needle biopsy of the prostate, a diagnosis of XP was made definitely. The patient was catheterized temporarily and treated with tamsulosin and estrogen. The patient underwent uneventful recovery after this conservative therapy. Conclusion: Histologic and immunohistochemical analyses are valuable in differentially diagnosing XP from high-grade prostate carcinoma. Treatment strategy of XP in principle is recommended to be the conservative method. Long-term follow-up earns are highly regarded considering the possibility of coexisting prostate cancer. Keywords: xanthogranulomatous prostatitis, prostate-rectal fistula

  8. Iatrogenic dural arteriovenous fistula after radical neck dissection for metastatic malignant disease: A case report.

    Science.gov (United States)

    Ngerageza, Japhet Gideon; Horiuchi, Tetsuyoshi; Murata, Takahiro; Aoyama, Tatsuro; Hongo, Kazuhiro

    2016-04-01

    A case of dural arteriovenous fistula (dAVF) developed after radical neck dissection for lymph node metastasis 2 years after oral surgery for tongue cancer. The patient was asymptomatic during follow-up visits with no evidence of metastasis on follow-up CT scan of the neck. However, diagnostic angiography showed left internal carotid artery (ICA) stenosis and dAVF involving the posterior meningeal artery and transverse sinus at the left posterior fossa with cortical venous reflux (Cognard type III). They were treated with carotid stenting and surgery, respectively. The postoperative course was uneventful. Follow-up angiography revealed obliteration of the dAVF. This was a rare case of iatrogenic dAVF after surgical ligation of venous outflow during radical neck dissection. The surgical plan is presented along with a literature review regarding the development of iatrogenic dAVFs induced by direct surgical trauma. © 2015 Wiley Periodicals, Inc.

  9. Mucinous adenocarcinoma arising from recurrent perianal fistula in patient with Crohn's disease: case report

    Directory of Open Access Journals (Sweden)

    Suelene Suassuna Silvestre de Alencar

    2014-07-01

    Full Text Available Introduction: Anal carcinoma is a rare variant of epithelial tumors of the anal canal. When associated with chronic and active anal fistulas, usually this is an aggressive cancer that has difficult diagnosis and poor prognosis. Anal fistulas are a common manifestation of Crohn's disease (CD. This study aims to report a case of mucinous adenocarcinoma originating from recurrent perianal fistula in patients with CD. Case report: A man of 43 years, with melanoderma, complaining of perianal tumors, anal pain and mucopurulent secretion, the patient was diagnosed with fistulae. Colonoscopy revealed a chronic inflammatory process associated with villous polypoid lesion in the colonic and rectal mucosa. In a new episode, where it was diagnosed, chronic colitis of rectum and sigmoid was being prescribed sulfasalazine with improvement. There were relapses and the patient underwent repeated fistulectomias. After investigation, CD was diagnosed. Computed tomography (CT of abdomen and pelvis showed multiple perineal and gluteal collections, and the patient underwent abdominoperineal resection of the rectum. Anatomopathological exam showed invasive mucinous adenocarcinoma. A new CT showed residual growth of the lesion. The patient was referred to the oncology referral service, where chemotherapy and radiotherapy were planned. The patient developed unfavorably, and his death occurred two months after treatment. Resumo: Introdução: Carcinoma anal é uma rara variante de tumores epiteliais do canal anal. Quando associado a fístulas anais crônicas e ativas, geralmente é um câncer agressivo que possui difícil diagnóstico e mau prognóstico. Fístulas anais são uma manifestação comum da doença de Crohn (DC. Este estudo tem como objetivo relatar um caso de adenocarcinoma mucinoso originado de fístula perianal recidivante em paciente com DC. Relato de caso: Homem de 43 anos, com melanoderma e queixas de tumorações na região perianal, dor anal e secre

  10. Cholecystocolic fistula from colonic diverticular disease with concomitant choledocholithiasis: A case report

    Directory of Open Access Journals (Sweden)

    Marc Paul Jose Lopez

    2018-03-01

    Full Text Available We present a 79 year-old female who consulted for abdominal pain. There was evidence of sigmoid diverticulitis with colonic obstruction and biliary-enteric fistula formation, on the imaging. The patient underwent a Hartmann’s Procedure, resection of cholecystocolic fistula, and intraoperative choledochoscopy with common bile duct stone extraction. The pathophysiology and management of cholecystocolic fistula are discussed. [Arch Clin Exp Surg 2018; 7(1.000: 33-36

  11. A case of pancreatico-colo-cutaneous fistula; management guided by endoscopic retrograde cholangio-pancreatography.

    OpenAIRE

    Chung, J. B.; Lee, D. K.; Kim, M. W.; Kang, J. K.

    1989-01-01

    A report of a 67-year-old man, who had been suffering from an enterocutaneous fistula after a left hemicolectomy due to colon cancer is presented. He had sudden intermittent upper abdominal pain and a high amylase level in the drainage fluid. The fistulogram showed a colocutaneous fistula with an abnormal cavity in the left upper quadrant. ERCP was performed to demonstrate the relationship between the pancreatic duct and the colocutaneous fistula connected with the abnormal cavity, and showed...

  12. Imperforate anus with a rectovestibular fistula and pseudotail: a case report

    Directory of Open Access Journals (Sweden)

    Jackson Gretchen P

    2010-10-01

    Full Text Available Abstract Introduction Human tails and pseudotails are rare sacrococcygeal lesions that are associated with a wide variety of anomalies and syndromes. Anorectal malformations are also relatively uncommon congenital defects that often occur in conjunction with syndromes or other congenital abnormalities. The anomalies associated with both disorders determine the timing and approach to surgical correction. We present an unusual case of a patient with both imperforate anus and a pseudotail in the absence of a syndrome or other associated anomalies and we emphasize the necessity of a thorough preoperative evaluation. Case presentation A Caucasian girl was born at term after an uncomplicated pregnancy and was noted at birth to have a skin-covered posterior midline mass and imperforate anus with a fistula to the vaginal vestibule. Ultrasound and magnetic resonance imaging revealed a predominately fatty lesion without presacral extension and ruled out associated spinal and cord abnormalities. The patient underwent diversion with colostomy and a mucous fistula in the newborn period as a fistulogram demonstrated a long fistulous tract to normal rectum and it was anticipated that anoplasty and resection of the mass would require extensive posterior dissection. The sacrococcygeal mass was removed during posterior sagittal anorectoplasty at the age of six weeks which was determined to be a pseudotail because of the composition of brown fat and cartilage. The patient is now 14 months old with normal bowel function after a colostomy takedown. Conclusion A comprehensive preoperative assessment and thoughtful operative plan were necessary in this unusual case because of the extensive differential diagnosis for sacrococcygeal masses in the newborn and the frequency of anomalies and syndromes associated with tail variants and imperforate anus. The pediatricians and neonatologists who initially evaluate such patients and the surgeons who correct these disorders

  13. Successful conservative treatment of enterocutaneous fistula with cyanoacrylate surgical sealant: case report.

    Science.gov (United States)

    Musa, N; Aquilino, F; Panzera, P; Martines, G

    2017-01-01

    Enterocutaneous (EC) fistula is an abnormal communication between the gastrointestinal tract and the skin. The majority of EC fistulas result from surgery. Only 15-25% of EC fistulas are spontaneous and they often result from underlying diseases such as Crohn's disease, radiation and chemotherapy. A 62-year old woman who, in 2012, underwent Pylorus-preserving cephalic pancreaticoduodenectomy (PPPD sec. Traverso-Longmire), due to an advanced pancreatic ductal adenocarcinoma (pT3N1M1). After surgery, the patient underwent chemotherapy with folfirinox regimen. In December 2016, as a result of the appearance of metastatic liver lesions and perianastomotic recurrence, the patient underwent second line treatment with Gemcitabine and pab-paclitaxel. After five months from the beginning of this new second line therapy she presented an EC fistula. The fistula of the patient was successfully treated with total parenteral nutrition and with percutaneous injection of cyanoacrylic sealant. The result suggests the advisability of percutaneous injection of sealant devices, such as cyanoacrylate glue; in order to successfully control stable Enterocutaneous fistulas with acceptable morbidity and mortality especially in particular situations, such as, with low output EC fistulas without signs of complications or on patients considered not suitable for surgery, a conservative approach could ensure the control of the fistula. This approach is easy and safe, viable and useful for future trials on the efficacy in conservative treatment of EC fistula.

  14. Vesicovaginal Fistula

    African Journals Online (AJOL)

    user1

    incidence of vesicovaginal fistula among populations. Globally, over two million women are estimated to be living with vesicovaginal fistula and majority are in. Sub-Saharan Africa and South Asia.6 The reported incidence rates of vesicovaginal fistula in West Africa range between 1– 4 per 1,000 deliveries.7–9 An annual.

  15. A rare cause of progressive paraparesis and urinary retention: Spinal dural arteriovenous fistula- Case report

    Directory of Open Access Journals (Sweden)

    Sırma Geyik

    2016-12-01

    Full Text Available Spinal arteriovenous fistulas (AVF, are rarely seen clinical pathology, have serious morbidity in cases without treatment although spinal AVF are the most common types of spinal arteriovenous malformation. Fifty years old male patient suffered from urine retention and paraparesis after lifted a heavy object. Spinal magnetic resonance images (MRI showed diffuse hyper intense lesion from midthoracic spinal cord segment to conus medullaris in T2A sequance. Spinal angiography revealed a long segmental dorsal AVF on the right side of T 7-8 level in spinal cord. Because of the low flow and a small AVF neurosurgical Department decided to perform an operation for spinal AVF. We should keep in mind spinal AVF, in which prognosis is well after prompt and appropriate theraphy, as a differential diagnosis in patients presented with progressive spinal symptoms.

  16. Contrast enhanced ultrasonography versus MR angiography in aortocaval fistula: case report.

    Science.gov (United States)

    Bhatia, Mona; Platon, Alexandra; Khabiri, Ebrahim; Becker, Christoph; Poletti, Pierre-Alexandre

    2010-06-01

    Aortocaval fistula (ACF) is a rare, life threatening complication of abdominal aortic aneurysms. Time to diagnosis is crucial as preoperative diagnosis and early surgical intervention significantly improve the outcome. The clinical spectrum being varied, the challenge of prompt and reliable diagnosis rests on emergency radiology. While the gold standard for detecting ACF today is CT angiography (CTA), frequently complicating renal insufficiency discourages the use of iodinated contrast making MR angiography (MRA) a useful alternative. Contrast enhanced ultrasound (CEUS) provides a promising new diagnostic option allowing rapid, non invasive and bedside diagnosis, especially in hemodynamically unstable patients. We present a case of prompt diagnosis of ACF by CEUS in comparison to modern MRA, thus establishing the new potential role of CEUS.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. A rare case of Amyand’s hernia presenting as an enterocutaneous fistula

    Directory of Open Access Journals (Sweden)

    L Flood

    2010-09-01

    Full Text Available The finding of the vermiform appendix in an inguinal hernia has an incidence of approximately 1%. The condition is given the eponymous name Amyand’s hernia. However in just 0.08% the condition is complicated by an acute appendicitis. The clinical presentation varies, depending on the extent of inflammation of the appendix and is most often misdiagnosed as an incarcerated inguinal hernia. As such it is rarely recognised prior to surgical exploration. We report a case of Amyand’s hernia in an 85 year old woman, which presented as a right groin enterocutaneous fistula. CT scanning illustrated a fistulous tract in the right groin, which communicated with the caecum and the peritoneal cavity. She underwent laparotomy, which revealed that the appendix appeared inflamed, lay in the inguinal canal and was the origin of the enterocutaneous communication.

  19. Experimental model of arteriovenous fistula in pigs

    International Nuclear Information System (INIS)

    Suh, Dae Chul; Seo, Dong Man; Kim, Hyun Jin and others

    1997-01-01

    To establish an experimental model of arteriovenous fistula in pigs. Ten fistulas were created in eight pigs, and angiography was performed 3 to 5 days after surgery. A follow-up angiogram of three fistulas was obtained 2 to 12 weeks later. In one animal, pathologic examination showed occlusion 8 weeks after a successful operations. Eight angiograms of nine fistulas in seven pigs were obtained; one animal died due to cardiac failure. In six pigs, high-flow fistulas were shown to be present, and in two, the fistulas were slow flow; a pseudoaneurysm was seen in one. A follow-up angiogram obtained in three cases showed occlusion of the fistula. Pathologic examination of one animal showed fibrosis in the occluded portion of the fistula. An arteriovenous fistula model was surgically established in 80% of cases; during follow-up, three fistulas were seen to be occluded due to fibrosis. This model can therefore be used within one week of surgery

  20. A congenital external carotid artery-external jugular vein arteriovenous fistula was successfully treated by coil embolization (case report and literature review).

    Science.gov (United States)

    Cui, Deqiu; Li, Jingwei; Zeng, Gao; Zhi, Xinglong; Du, Jianxin

    2017-09-01

    Congenital arteriovenous fistula involving the external carotid system is rare. This paper reports a case of congenital external carotid artery-external jugular vein arteriovenous fistula admitted to Xuanwu Hospital, and reviews the literature. The patient was a boy, 9 years old, with a history of pulsatile mass and thrill in the right neck since his birth. External carotid artery-external jugular vein fistula was confirmed by the digital subtraction angio-graphy. And coil embolization was done later. Postoperative immediate angiography confirmed the complete occlusion of the fistula, and partial branch of the external carotid artery can be seen. The abnormal clinical manifestation disappeared after the procedure without any complications. This case and relevant literatures remind us that congenital external carotid artery-external jugular vein arteriovenous fistula has its unique features, and it can be treated by coil embolization safely and effectively.

  1. Prevention of obstetric fistula: A case for the universal application of ...

    African Journals Online (AJOL)

    The pathophysiology of obstetric fistula and its social sequelae are explained. The role of the Partograph as the most cost effective approach for the prevention of obstructed labour and fistula are carefully examined. A detailed description of how the Partograph is used for labour care is presented and the barriers to the ...

  2. A-V Fistulae from Arrow Injuries: A Report of Two Cases ...

    African Journals Online (AJOL)

    Of these, one involved the temporal vessels, which led to a temporo-temporal A-V fistula causing the patient continuous noisy headache. The late complication was only recognized about two years post injury. Another arrow shot injury involved femoral vessels and resulted in femoro-femoral A-V fistula, which came to be ...

  3. A case of ileo-cutaneou fistula due to radiation enteritis

    Energy Technology Data Exchange (ETDEWEB)

    Oyama, Tsukasa; Oguchi, Yoshiro; Nakaba, Hiroyuki (Kure National Hospital, Hiroshima (Japan)) (and others)

    1992-07-01

    Radiation enteritis can cause late complications including stenosis, perforation, fistulization, and bleeding, which sometimes necessitate surgical treatment, but a complication of ileocutaneous fistula is rarely reported. In this paper, an excellent result of an operation for ileocutaneous fistula due to radiation enteritis is described. A 68-year-old woman had undergone extended total histerectomy and radiation therapy on uterine cervical cancer. After the operation and the radiation therapy, frequent abdominal pain bothered her and then the intestinal fistula ensued resulted in the fistulization. The fistula was located between two stenotic lesions of the intestine caused by radiation enteritis. Resection of ileum including the two stenotic lesion and the fistula and end-to-end anastomosis relieved the symptoms and the treatment course has been satisfactory. The two stenotic lesions were resected because it was suggested that the two stenotic lesions directly led the fistulization. She is now followed asymptomatically. (author).

  4. Immediate ureterovaginal fistula following oocyte retrieval: A case and systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Elysia Sophie Spencer

    2017-01-01

    Full Text Available The aim of this study is to report a case of acute ureterovaginal fistula (UVF formation with immediate symptomatic presentation after transvaginal ultrasound-guided oocyte retrieval (TVOR for in vitro fertilization (IVF and to perform a systematic literature review of ureteral injuries during TVOR. A 33-year-old woman with a history of anovulatory infertility presented with severe abdominal pain and vaginal leakage immediately following TVOR for IVF. We systematically reviewed the current literature regarding ureteral injury resulting from TVOR and present a case of timely identification and management of a UVF followed by a successful pregnancy. Computed tomography cystogram with intravenous contrast and left retrograde pyelogram confirmed the diagnosis of UVF which was managed by placement of the left ureteral stent. The IVF cycle was converted to a freeze-all cycle. The ureteral stent was removed 4 weeks later, and a subsequent frozen embryo transfer cycle resulted in pregnancy. We present the 13th case of ureteral injury and the fourth case of UVF following TVOR. UVF formation is a rare complication after TVOR and may result in serious long-term morbidity if it is not identified and treated promptly. Clinicians must exercise a high degree of suspicion and prompt evaluation for potential ureteral injuries in women presenting with abdominal pain, urinary symptoms, or vaginal leakage following TVOR.

  5. Immediate ureterovaginal fistula following oocyte retrieval: A case and systematic review of the literature.

    Science.gov (United States)

    Spencer, Elysia Sophie; Hoff, Heather S; Steiner, Anne Z; Coward, Robert Matthew

    2017-01-01

    The aim of this study is to report a case of acute ureterovaginal fistula (UVF) formation with immediate symptomatic presentation after transvaginal ultrasound-guided oocyte retrieval (TVOR) for in vitro fertilization (IVF) and to perform a systematic literature review of ureteral injuries during TVOR. A 33-year-old woman with a history of anovulatory infertility presented with severe abdominal pain and vaginal leakage immediately following TVOR for IVF. We systematically reviewed the current literature regarding ureteral injury resulting from TVOR and present a case of timely identification and management of a UVF followed by a successful pregnancy. Computed tomography cystogram with intravenous contrast and left retrograde pyelogram confirmed the diagnosis of UVF which was managed by placement of the left ureteral stent. The IVF cycle was converted to a freeze-all cycle. The ureteral stent was removed 4 weeks later, and a subsequent frozen embryo transfer cycle resulted in pregnancy. We present the 13 th case of ureteral injury and the fourth case of UVF following TVOR. UVF formation is a rare complication after TVOR and may result in serious long-term morbidity if it is not identified and treated promptly. Clinicians must exercise a high degree of suspicion and prompt evaluation for potential ureteral injuries in women presenting with abdominal pain, urinary symptoms, or vaginal leakage following TVOR.

  6. Medullary Venous Hypertension Secondary to a Petrous Apex Dural Arteriovenous Fistula: A Case Report

    Directory of Open Access Journals (Sweden)

    Meghan Murphy

    2012-11-01

    Full Text Available Background: Dural arteriovenous fistulae (dAVF are common intracranial vascular lesions typically becoming symptomatic with cortical venous hypertension and possible hemorrhage. Here, we present a case illustration of a petrous apex dAVF with marked medullary venous hypertension and a unique clinical presentation. Methods: Case report. Results: A 72-year-old female, whose clinical progression was significant for altered mental status and progressive weakness, presented with diplopia, right leg paresis, and ataxia. Magnetic resonance imaging revealed edema involving the medulla. On digital subtraction cerebral angiogram, the patient was found to have a petrous apex dAVF, Cognard type IV. Following treatment with Onyx embolization, her symptoms rapidly improved, with complete resolution of diplopia and drastic improvement of her ataxia. Conclusion: The importance of this case is in the presentation and deterioration of the clinical exam, resembling an acute ischemic event. Further, this case illustrates that dAVF may cause venous hypertension with rapid onset of focal neurologic symptoms not exclusive to cortical locations.

  7. Successful management of an aortoesophageal fistula caused by a fish bone – case report and review of literature

    Directory of Open Access Journals (Sweden)

    Li Alan

    2009-05-01

    Full Text Available Abstract We report a case of aortoesophageal fistula (AEF caused by a fish bone that had a successful outcome. Aortoesophageal fistula is a rare complication of foreign body ingestion from which few patients survive. Over one hundred cases of AEF secondary to foreign body ingestion have been documented but only seven, including our case, have survived over 12 months. Treatment involved stabilising the patient with a Sengstaken-Blakemore tube and insertion of a thoracic aortic endovascular stent-graft. Unfortunately the stent became infected and definitive open surgical repair involved removing the stent, replacing the aorta with a homograft and coverage with a left trapezius flap while under deep hypothermic arrest.

  8. [A case of dural arteriovenous fistula associated with bilateral thalamic lesions].

    Science.gov (United States)

    Yamamoto, Takahiro; Watanabe, Masaki; Miura, Akiko; Hirahara, Tomoo; Hirano, Teruyuki; Uchino, Makoto

    2010-10-01

    We report a 51-year-old man with a dural arteriovenous fistula (DAVF) associated with bilateral thalamic lesions. He was admitted to our hospital because of cognitive disorder. T2-weighted MRI and fluid-attenuated inversion recovery (FLAIR) sequence of the brain revealed symmetric hyperintense lesions of bilateral thalamus and abnormal flow void that represents the enlarged veins. Cerebral angiography demonstrated DAVF in the superior petrosal sinus (SPS). It was mainly supplied by the internal carotid arteries. The strait sinus was not revealed, and the venous drainage was retrograde into the internal cerebral vein. Therefore the mechanism of cognitive disorder in this case was considered to be vasogenic edema of the bilateral thalamus due to DAVF of SPS. We decided to treat the DAVF by embolization via the feeding arteries approach, because strait sinus was not revealed and venous approach was difficult. After embolization, the size of DAVF was remarkably reduced. His cognitive disorder was markedly improved and the hyperintense area on T2-weighted MRI and FLAIR sequence had disappeared. Cognitive disorder due to DAVF of SPS is very rare. It is also difficult to diagnose bilateral thalamic lesions as DAVF, but it may be reversible by DAVF treatment. Thus, early diagnosis and treatment is important. Like this case, abnormal flow void that represents the enlarged veins could help to diagnose bilateral thalamic lesions due to DAVF.

  9. The path of least resistance: A case of cervical stenosis and uterocutaneous fistula

    Directory of Open Access Journals (Sweden)

    Steven Neil Shephard

    2015-10-01

    Full Text Available Uterocutaneous fistula is exceedingly rare, and uniformly follows some type of operative procedure. In this case, a young woman underwent a cesarean delivery at an outlying clinic in rural Nigeria, following which she developed amenorrhea and cyclic pelvic pain. In attempts to resolve her condition, a second laparotomy was performed at the same medical center. She presented to us 2 weeks later, at which time an opening was present at the healing laparotomy scar, severe vaginal scarring and cervical stenosis were present, and marked hematometra was seen on ultrasound. Following a procedure to open her cervix, she began menstruating through a fistulous tract in her abdomen, which we subsequently excised and closed with no further problems for the patient. This case highlights the challenge in developing countries of surgical complications resulting from a lack of appropriately trained physicians in rural medical centers. We suggest that focus on excellent training of our young physicians and the creation of incentives to place and keep fully qualified physicians in such hospitals will improve this situation.

  10. Direct cervical vertebro-venous fistula with radiculopathy and MRI changes resolving after successful endovascular embolisation: a report of two cases

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, C.G.; Husami, Y.; Colquhoun, I.R. [Dept. of Imaging, Charing Cross Hospital, London (United Kingdom); Byrne, J.V. [Dept. of Neuroradiology, Radcliffe Infirmary, Oxford (United Kingdom)

    2001-12-01

    We report two cases of rare direct cervical vertebro-venous fistula (VVF) presenting with chronic radiculopathy as part of the symptom complex. We describe the MRI and intra-arterial angiography findings before and after successful embolisation. These demonstrate occlusion of the fistula with collapse and thrombosis of the draining extradural venous plexus and, in one case, resolution of MRI signal abnormality in the cervical spinal cord. (orig.)

  11. Direct cervical vertebro-venous fistula with radiculopathy and MRI changes resolving after successful endovascular embolisation: a report of two cases

    International Nuclear Information System (INIS)

    Taylor, C.G.; Husami, Y.; Colquhoun, I.R.; Byrne, J.V.

    2001-01-01

    We report two cases of rare direct cervical vertebro-venous fistula (VVF) presenting with chronic radiculopathy as part of the symptom complex. We describe the MRI and intra-arterial angiography findings before and after successful embolisation. These demonstrate occlusion of the fistula with collapse and thrombosis of the draining extradural venous plexus and, in one case, resolution of MRI signal abnormality in the cervical spinal cord. (orig.)

  12. Squamous cell carcinoma (Marjolin's ulcer in an orocutaneous fistula of a large mandibular ameloblastoma: a case report

    Directory of Open Access Journals (Sweden)

    Nthumba Peter M

    2011-08-01

    Full Text Available Abstract Introduction Ameloblastomas are rare lesions constituting 1% of all jaw tumors. Oral squamous cell carcinomas are common lesions; these constitute about 90% of all oral cancers. Concurrent tumors consisting of ameloblastoma and squamous cell carcinoma are extremely rare. Case presentation This case report describes a 35-year-old African man who presented with a large mandibular tumor with an orocutaneous fistula that was found to be an ameloblastoma on histopathological examination, with concurrent squamous cell carcinoma histology within the fistula. This presentation was consistent with a Marjolin's ulcer within an ameloblastoma. Conclusion Ameloblastomas and Marjolin's ulcers require different management strategies. Careful histopathological examination of surgical specimens is key to patient outcome, as treatment of these patients depends on an accurate diagnosis.

  13. Prune belly syndrome with urethral hypoplasia and vesico-cutaneous fistula: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Osama M Sarhan

    2013-01-01

    Full Text Available Association between Prune belly syndrome (PBS and urethral hypoplasia is an unusual condition. It is usually fatal unless there is a communication between the fetal bladder and the amniotic sac. We report a case of PBS with urethral hypoplasia and congenital vesico-cutaneous fistula in a male neonate. Patient underwent cutaneous vesicostomy and was discharged for close follow up of his renal function and for future reconstruction.

  14. Prune belly syndrome with urethral hypoplasia and vesico-cutaneous fistula: A case report and review of literature.

    Science.gov (United States)

    Sarhan, Osama M; Al-Ghanbar, Mustafa S; Nakshabandi, Ziad M

    2013-10-01

    Association between Prune belly syndrome (PBS) and urethral hypoplasia is an unusual condition. It is usually fatal unless there is a communication between the fetal bladder and the amniotic sac. We report a case of PBS with urethral hypoplasia and congenital vesico-cutaneous fistula in a male neonate. Patient underwent cutaneous vesicostomy and was discharged for close follow up of his renal function and for future reconstruction.

  15. Coloenteric fistula in a young patient with recurrent diverticulitis: A case report and review of the literature.

    Science.gov (United States)

    Ahmad, D S; Quist, E E; Hutchins, G F; Bhat, I

    2016-10-01

    The development of colonic diverticula is common in developed countries and complications of colonic diverticulosis are responsible for a remarkable burden of the disease. The natural history and management of complicated and recurrent diverticulitis in young patients are still a matter of debate. Coloenteric fistula is a rare complication of diverticulitis in young adults. In this report, and utilising a case study, we will review the natural history, outcome and management of acute diverticulitis in the young.

  16. Spinal Dural Arteriovenous Fistula (SDAVF in a Patient with Progressive Paraparesia: A Case Report

    Directory of Open Access Journals (Sweden)

    Mehrdokht Mazdeh

    2016-07-01

    Full Text Available Background: Spinal dural arteriovenous fistula (SDAVF is a known cause of nontraumatic slow progressive araparesia and is frequently overlooked because its clinical features overlap with more common causes of myelopathy and also neuroimaging may be normal. Case Report: A 53 year-old man with developed weakness of both lower limbs had symptoms begun spontaneously 3.5 month before admission and progressed from 1 month ago with bowel and bladder incontinence. The patient's physical examination was normal and neurologic testing revealed lower extremity motor strength of 3/5. Deep tendon reflexes were decreased and superficial abdominal reflexes were absent. Sensation of pinprick and temperature was absent distal to the T4-T5 level. Vibration and proprioception were decreased to the ankle and saddle anesthesia and the patient was non ambulatory. Laboratory routine and specific tests for vitamin B12 level, hepatitis, HIV, HTLV1, 2 were negative. MRI of spine with and without contrast raised the possibility of dural arteriovenous malformation extended from T3 level to conus medullaris which was confirmed by angiography. The patient referred to neurosurgeon for deciding route of treatment. Conclusion: SDAVF can be a significant non traumatic slowly progressive cause of myelopathy. The majority of the affected patients are males older than 50 years of age. Rapid diagnosis in these patients leads to significant improvement.

  17. Esophageal atresia with or without tracheophgeal fistula: success and failure in 94 cases

    International Nuclear Information System (INIS)

    Al-Salem, Ahmed H.; Tayeb, M.; Khogair, S.; Roy, A.; Al-Jishi, N.; Alsenan, K.; Shaban, H.; Ahmad, M.

    2006-01-01

    The management of newborns with esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) has evolved considerably over the years. Currently an overall survival of 85% to 90% has been reported from developed countries. In developing countries, several factors contribute to higher mortalities rates. We describe our experience with 94 consecutive cases of FA with or without TEF. We retrospectively studied 94 patients with EA with or without TEF treated at our hospital over a period of 15 years. Medical records were reviewed for age at diagnosis, sex, birth weight, associated anomalies, aspiration pneumonia, method of diagnosis, treatment, postoperative complications and outcome. Ninety-four newborns (55 males and 39 females) with EA/TEF were treated at our hospital. Their mean birth weight was 2.2 kg (700g to 3800g). Age at diagnosis ranged from birth to 7 days. At the time of admission 37 (39.4%) had aspiration pneumonia. Associated anomalies were seen in 46 (49%) patients. Thirteen patients had major associated anomalies that contributed to mortality. Postoperative complications were similar to those from developed countries but overall operative mortality (30.8%) was high. The overall mortality was high but excluding major congenital malformations, sepsis was the most frequent cause of death. Factors contributing to mortality included prematurely, delay in diagnosis with an increased incidence of aspiration pneumonia and a shortage of qualified nurses. To improve overall outcome, factors contributing to sepsis should be evaluated and efforts and efforts should be made to overcome them. (author)

  18. [MASSIVE HEMORRHAGE FROM THE FISTULA FORMATION BETWEEN CUTANEOUS URETEROSTOMY AND INFERIOR EPIGASTRIC ARTERY: A CASE REPORT].

    Science.gov (United States)

    Fujinami, Hiroyuki; Shibuya, Tadamasa; Mori, Kenichi; Shin, Toshitaka; Sumino, Yasuhiro; Sato, Fuminori; Mimata, Hiromitsu; Sato, Yoshiyasu; Matsubara, Takanori; Sakamoto, Sadaaki; Kamei, Noritaka; Hongo, Tetsuo

    2015-04-01

    A 87-year-old man received radical nephroureterectomy for right renal pelvic cancer in 2009 and left cutaneous ureterostomy after radical cystectomy for bladder cancer in 2013. He visited the hospital for exchanging a 7 or 8 Fr single-J catheter every 2 to 4 weeks. Eleven months after the 2nd operation, massive bleeding from the stoma occurred when ureteral catheter was exchanged. Contrast-enhanced computed tomography showed that left inferior epigastric artery was located close to left ureter. Angiography of the left inferior epigastric artery didn't show an obvious fistula, but revealed the stoma was surrounded by ramified new blood vessels from left inferior epigastric artery. We suspected a rupture of the vessels and performed embolization for the branch of inferior epigastric artery to left ureter. This embolization made it possible for the bleeding to be controlled. Massive bleeding from the branch of inferior epigastric artery is very rare, and we report the case and review the literature.

  19. Colocutaneous fistula complicating sigmoid diverticulitis

    OpenAIRE

    Charalabopoulos, Alexandros; Misiakos, Evangelos; Macheras, Anastasios

    2011-01-01

    Colocutaneous fistula is a very rare complication of colonic diverticular disease. Herein we describe a case with a fistula connecting the sigmoid with the left flank area complicating diverticulitis of the sigmoid colon. An 85-year-old female patient with a history of acute diverticulitis 3 months earlier, was admitted with a subcutaneous abscess in the left flank. The abscess was drained and subsequently a colocutaneous fistula was established. At operation the sigmoid colon with the fistul...

  20. De novo formation of a large cavernoma associated with a congenital torcular dural arteriovenous fistula: case report.

    Science.gov (United States)

    Brinjikji, Waleed; Flemming, Kelly D; Lanzino, Giuseppe

    2017-05-01

    The authors report a case of a developmentally normal child with a congenital complex torcular dural arteriovenous fistula (DAVF) who later, in his teenage years, developed several vermian cavernomas within a large cerebellar developmental venous anomaly (DVA). The patient had initially presented with an abnormally large head circumference but no neurological deficits. He underwent several partial embolization procedures in an attempt to decrease the blood supply of the fistula over the course of 8 years. Nine years following initial presentation, he presented with a fourth ventricular hemorrhage, due to development of a new vermian cavernoma adjacent to a previously known vermian DVA and suffered subsequent mild left-sided hemiataxia from which he later recovered. CT angiographic images demonstrated that the vermian DVA drained into the left transverse sinus, which also drained the torcular arteriovenous fistula. A routine follow-up MRI examination 10 years following initial presentation demonstrated interval development of several large cavernomas in the cerebellum, all within the DVA. The patient had no new symptoms at that time and was neurologically intact. This case report highlights the de novo development of multiple cavernous malformations potentially secondary to DAVF-induced venous congestion in a preexisting DVA.

  1. Vesicovaginal fistula in Uganda.

    Science.gov (United States)

    McCurdie, Fiona Katherine; Moffatt, Joanne; Jones, Kevin

    2018-03-09

    Kitovu Hospital in Masaka, Uganda, is a leading obstetric fistula repair centre in the country with the highest rates of fistula in the world. In this retrospective case review, the regional incidence and causative factors were studied in patients with vesicovaginal fistula (VVF) who were admitted at Kitovu Hospital. Fistula history included severity (ICIQ score), causes and outcomes of VVF were measured. Women suffered with symptoms of VVF for an average of 4.97 years with an average ICIQ severity score of 7.21. Patients travelled an average distance of 153 km and the majority travelled by public transport. Rates of prolonged labour were high. 69% of fistula-causing delivery resulted in stillbirth and 12% resulted in early neonatal death. Following surgery, 94% of patients were dry on discharge. Impact statement What is already known on this subject? Vesicovaginal fistula (VVF) is a severe, life-changing injury. Although largely eradicated from the Western world thanks to modern obstetric practice, VVF is still highly prevalent in developing countries where factors such as young childbearing age and poor access to emergency obstetric care increase the incidence (Wall et al. 2005 ). At the current rate of fistula repair, it is estimated that it would take 400 years to treat those already suffering with fistula, providing that no new cases emerged (Browning and Patel 2004 ). What do the results of this study add? The Ugandan women in this study reiterate tales of foetal loss, social isolation and epic journeys in search of fistula repair, as previously described in the literature. The study offers some hope for prompt help-seeking during labour and after fistulas are developed. It demonstrates the success of fistula repairs at Kitovu Hospital but highlights the paucity of service provision across Uganda. What are the implications of these findings for clinical practice and/or further research? Further epidemiological research is required to quantify the true

  2. Tubercular fistula-in-ano

    International Nuclear Information System (INIS)

    Bokhari, I.; Shah, S.S.H.; Khan, A.

    2008-01-01

    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)

  3. Laparoscopic Management of Diverticular Colovesical Fistula: Experience in 15 Cases and Review of the Literature

    Science.gov (United States)

    Marney, Lucy A.; Ho, Yik-Hong

    2013-01-01

    Colovesical fistulas secondary to diverticular disease may be considered a contraindication to the laparoscopic approach. The feasibility of laparoscopic management of complicated diverticulitis and mixed diverticular fistulas has been demonstrated. However, few studies on the laparoscopic management of diverticular colovesical fistulas exist. A retrospective analysis was performed of 15 patients with diverticular colovesical fistula, who underwent laparoscopic-assisted anterior resection and bladder repair. Median operating time was 135 minutes and median blood loss, 75 mL. Five patients were converted to an open procedure (33.3%) with an associated increase in hospital stay (P = 0.035). Median time to return of bowel function was 2 days and median length of stay, 6 days. Overall morbidity was 20% with no major complications. There was no mortality. There was no recurrence during median follow-up of 12.4 months. These results suggest that laparoscopic management of diverticular colovesical fistulas is both feasible and safe in the setting of appropriate surgical expertise. PMID:23701143

  4. Management of a case of colovesical fistula with fecaluria as first sign

    Directory of Open Access Journals (Sweden)

    Gingu C

    2015-04-01

    Full Text Available Introduction. Fecaluria and pneumaturia are the patognomonic signs of an abnormal communication between the bladder and the intestinal tract. Therefore, when a history of digestive signs, symptoms or digestive diseases is missing, this borderline pathology leads the patients in the care of urologists. From diagnosis to treatment the management of these cases can be difficult and challenging. Materials and Methods. A 48 year old patient, without any significant medical history, presented to the emergency room for fecaluria, pneumaturia and an episode of haematuria. He had no prior digestive symptoms. The contrast enhanced abdominal and pelvic CT scan revealed a pelvic mass involving the sigmoid colon and the dome and the posterior wall of the bladder. The cystoscopy objectifies a tumor mass involving the right postero-lateral bladder wall, with extravasation of faeces. A biopsy was taken and the frozen section found mainly uncertain inflammatory type tissue. A colonoscopy couldn’t be done because of an impassable obstacle at 15 cm from the anus. Together with general surgeons we decided for en bloc resection of the tumor with partial cystectomy, right ureterocystoneostomy and rectosigmoid resection with mechanic end to end anastomosis. Results. The postoperative period was uneventful. The histopathological examination revealed an abscessed sigmoid diverticulum with vesico-sigmoid fistula and perilesional inflammatory tissue. Two years after the surgery the patient is asymptomatic with a normal function of the right kidney and restored bladder capacity. Conclusions. Being a borderline pathology, patients with fecaluria and pneumaturia and lack of digestive symptoms are referred and managed by the urologists. Despite extensive investigations, even when preoperative biopsies reveal inflammatory tissue the patients should be treated as oncologic cases. A close cooperation with general surgeons for en bloc multiorgan resection within oncologic

  5. Surgical repair of rectovaginal fistula using gracilis muscular flap. A case report

    International Nuclear Information System (INIS)

    Inoue, Yasuhiro; Ooi, Masataka; Takeuchi, Kenji; Honzumi, Makoto; Fukunishi, Shigeji

    1999-01-01

    A 78 year-old female suffered from vaginal discharge of flatus and stool for 20 years after the radiation therapy for cervical cancer. Digital and endoscopic examination of the rectum and the vagina disclosed a large, short rectovaginal fistula at the level of the cervix. Since laparotomy and low anterior resection of the rectum were impossible, a perineal approach was adopted. After perineal skin incision, the fistula was resected and the defects of the rectum and the vagina were closed. Gracilis muscular flap was anchored between the two closures. Though the closure of the rectal side was torn, her postoperative course was uneventful. Endoscopic examination 24 days after the operation confirmed healing of the dehiscence. The results verified the usefulness of the perineal approach using the gracilis muscular flap as an alternative method to low anterior resection for troublesome radiation induced rectovaginal fistula. (author)

  6. Surgical repair of rectovaginal fistula using gracilis muscular flap. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Yasuhiro; Ooi, Masataka; Takeuchi, Kenji; Honzumi, Makoto [Nabari City Hospital, Mie (Japan); Fukunishi, Shigeji

    1999-07-01

    A 78 year-old female suffered from vaginal discharge of flatus and stool for 20 years after the radiation therapy for cervical cancer. Digital and endoscopic examination of the rectum and the vagina disclosed a large, short rectovaginal fistula at the level of the cervix. Since laparotomy and low anterior resection of the rectum were impossible, a perineal approach was adopted. After perineal skin incision, the fistula was resected and the defects of the rectum and the vagina were closed. Gracilis muscular flap was anchored between the two closures. Though the closure of the rectal side was torn, her postoperative course was uneventful. Endoscopic examination 24 days after the operation confirmed healing of the dehiscence. The results verified the usefulness of the perineal approach using the gracilis muscular flap as an alternative method to low anterior resection for troublesome radiation induced rectovaginal fistula. (author)

  7. A Case Report of Coronary Arteriovenous Fistulas with an Unruptured Coronary Artery Aneurysm Successfully Treated by Surgery

    Directory of Open Access Journals (Sweden)

    Nobuhiro Takeuchi

    2012-01-01

    Full Text Available A 58-year-old female with a history of Wolff-Parkinson-White syndrome presented at our institution with palpitations and chest pain. Electrocardiography revealed paroxysmal supraventricular tachycardia with a heart rate of 188 beats/min. Antiarrhythmic drugs were ineffective, and tachycardia was resolved by electrical cardioversion. Transthoracic echocardiography revealed abnormal vessels around the right coronary artery (RCA and pulmonary artery (PA; in addition, we suspected coronary arteriovenous fistula (CAVF. Coronary angiography and coronary computed tomography revealed dilated fistula vessels, with a 1 cm saccular aneurysm around the RCA, originating from the proximal RCA and left anterior descending artery into the main trunk of PA. Therefore, we confirmed the diagnosis of CAVF with an unruptured aneurysm. We surgically ligated and clipped the fistula vessels and resected the aneurysm. The resected aneurysm measured  cm in size. Pathological examination of the resected aneurysm revealed hypertrophic walls comprising proliferating fibroblasts cells thin elastic fibers. Very few atherosclerotic changes manifested in the aneurysm walls. We report the case of a patient with CAVF and an unruptured coronary artery aneurysm who was successfully treated by surgery.

  8. Pelvic Ultrasound Findings in Women with Obstetric Fistula: A Cross-Sectional Study of Cases and Controls

    Directory of Open Access Journals (Sweden)

    Jeffrey P. Wilkinson

    2018-01-01

    Full Text Available Objective. Obstetric fistula (OF is a morbid condition caused by prolonged obstructed labor. Women with OF experience profound injury and have high rates of infertility and poor obstetric outcomes. We examined endovaginal ultrasound parameters in women with and without OF. Design/Setting/Sample/Methods. This cross-sectional study enrolled women evaluated at the Fistula Care Centre in Lilongwe, Malawi. Eligibility criteria included age 18–45, prior pregnancy, and a uterus on ultrasound. Participants underwent endovaginal ultrasound with measurement of cervical dimensions. Comparisons were done using t-tests and Fisher's exact test. Among women with OF, linear regression was used to assess whether fistula stage was associated with cervical length. Results. We enrolled 98 cases and 12 controls. Women with OF had shorter cervical lengths (18.8 mm versus 27.3 mm, p < 0.01, as well as shorter anterior (7.0 mm versus 9.3 mm, p < 0.01 and posterior (9.5 mm versus 11.0 mm, p < 0.04 cervical stroma, compared to controls. Conclusion. Women with OF have shorter cervical lengths and anterior and posterior cervical stroma, when compared to women without OF. This may offer a partial explanation for subfertility and poor obstetric outcomes in OF patients. Additional studies to clarify the role of ultrasound in OF patients and prediction of future fertility are warranted.

  9. [Pancreaticoduodenectomy performed in a patient with transverse colon cancer associated with a duodenal fistula - a case report].

    Science.gov (United States)

    Koumori, Keisuke; Makino, Hironobu; Kametaka, Hisashi; Fukada, Tadaomi; Seike, Kazuhiro; Koyama, Takashi

    2014-11-01

    A 71-year-old man with a positive fecal occult blood test was diagnosed with transverse colon cancer and referred to our hospital. Colonoscopy revealed type II transverse colon cancer with circumferential involvement. Contrast-enhanced computed tomography (CT)revealed a tumor with an unclear boundary in the pancreas. No metastases to the liver or lungs were detected, and there were no significantly enlarged regional lymph nodes. During open surgery, the tumor of the transverse colon was found to have formed a mass in the pancreatoduodenum, and it was difficult to separate them. As curative resection was considered possible, resections of both the pancreatoduodenum and transverse colon cancer were performed. Laboratory findings revealed fistula formation between the transverse colon cancer and the duodenum. The cancer was diagnosed as stageII, T4bN0M0, and R0 surgery was successfully performed. The patient was alive without recurrence 14- months after the surgery. Colorectal cancer is more likely to advance locally and directly invade the surrounding organs. However, fistula formation with the duodenum has rarely been reported, occurring at an estimated incidence of 0.1%. Such tumors are typically large; however, metastases rates to the lymph nodes are low. Histopathological examination of the resected specimen revealed a severe inflammatory adhesion, and fistula formation between the traverse colon and the duodenum. There was no evidence of invasion of the lymphatic system or blood vessels, which enabled us to perform a high curative surgery. We propose that it is important to consider high curative resection with positive lymph node dissection for cases of colorectal cancer associated with duodenal fistula formation.

  10. Multiple anastomotic complications following repair of oesophageal atresia with tracheoesophageal fistula: A report of two cases

    Directory of Open Access Journals (Sweden)

    Prashant Jain

    2011-01-01

    Full Text Available This report describes the clinical course and management of two children with multiple anastomotic complications following primary repair of oesophageal atresia (EA with distal tracheoesophageal fistula (TEF. These included anastomotic leak and stricture, oesophageal perforation during antegrade dilatation, and finally a recurrent fistula between the oesophagus and the tracheo-bronchial tree. Ultimately, after multiple operative interventions, a successful outcome was achieved in both patients with preservation of the native oesophagus. The anastomotic complications following primary repair of EA with TEF are discussed, with special reference to difficulties in the management of recurrent TEF.

  11. Congenital pial arteriovenous fistula in the temporal region draining into cavernous sinus: A case report

    International Nuclear Information System (INIS)

    Zhang, Ziyin; Wang, Chaohua; Zhang, Changwei; Xie, Xiaodong; Wang, Kun; Tang, Jianjian

    2013-01-01

    This report concerns a 4-month-old infant with progressive prominent and redness of his left eye since birth. This report concerns a 4-month-old infant with progressive prominent redness of his left eye since birth. Angiography revealed a congenital pial arteriovenous fistula between the temporal branch of the left posterior cerebral artery and left cavernous sinus through the sphenoparietal sinus, a condition not reported in the literature. The fistula was successfully occluded with two micro-coils by vertebrobasilar approach.

  12. Surgical mistake causing an high recto-vaginal fistula. A case report with combined surgical and endoscopic approach: therapeutic considerations

    Science.gov (United States)

    2013-01-01

    Background Rectovaginal fistulas (RVFs) have multiple causes, size and location on which the surgical treatment depends. Description The Authors consider different approaches to RVFs and describe a clinical case of recurrent high RVF. Conclusions Most RVFs can be successfully repaired, although many interventions may be necessary. A colostomy with delayed repair may improve RVFs outcome. Moreover, several authors indicate Mucosal Advancement Flap and Babcock-Bacon technique as the treatments of choice respectively for low and high RVFs (complex and recurrent) and emphasize the placement of endoscopic prothesis in cases of difficult healing of the anastomosis. PMID:24266908

  13. A Case of Abdominal Abscess in Crohn’s Disease: Successful Endoscopic Demonstration of an Obscure Enteric Fistula by Dye Injection via a Percutaneous Drainage Catheter

    Directory of Open Access Journals (Sweden)

    Toshihide Hamada

    2009-05-01

    Full Text Available Abdominal and pelvic abscesses occur in approximately 10–30% of Crohn’s disease patients during the course of the disease; most of these abscesses have an enteric communication. For this condition, percutaneous abscess drainage (PAD rather than emergency surgery has recently been recognized as a valuable procedure for initial treatment. However, in cases wherein the abscess is accompanied by an enteric fistula, the recurrence of abscess might be inevitable without the management of the enteric fistula. Therefore, demonstration and evaluation of the enteric fistula is essential to prevent abscess recurrence; however, this is not necessarily a simple procedure. Here, we report abdominal abscess accompanied by a rectal fistula in a patient with Crohn's disease; this condition was successfully treated by PAD. Furthermore, PAD was also useful in identifying the fistula by colonoscopy involving dye injection via the drainage catheter. To our knowledge, no previous literature has reported the use of dye injection via the drainage catheter for identifying a fistula during endoscopic examination. We present here the radiographic, sonographic, and endoscopic findings of this case.

  14. [Intracranial dural arteriovenous fistulae. Experience after 81 cases and literature review].

    Science.gov (United States)

    Paredes, Igor; Martinez-Perez, Rafael; Munarriz, Pablo M; Castaño-Leon, Ana María; Campollo, Jorge; Alén, Jose F; Lobato, Ramiro D; Lagares, Alfonso

    2013-01-01

    To analyse the clinical, radiological and therapeutic variables of intracranial dural arteriovenous fistulae (DAVF) treated at our institution, and to assess the validity of the Borden and Cognard classifications and their correlation with the presenting symptoms. The DAVF identified were retrospectively analysed. They were classified according to their location, drainage pattern and the Borden and Cognard classifications. We recorded the different treatments, their complications and efficacy. There were 81DAVF identified between 1975 and 2012. The cavernous sinus (CS) location was the most frequent one. The Borden and Cognard classifications showed an interobserver Kappa index of 0.72 and 0.76 respectively. The odds ratio of aggressive presentation in the presence of cortical venous drainage (CVD) was 19.3 (2.8-132.4). No location, once adjusted by venous drainage pattern, showed significant association with an aggressive presentation. Endovascular transarterial treatment of cavernous sinus DAVF achieved symptomatic improvement of 78%, with a complication rate of 5%. The DAVF of non-CS locations, with CVD, treated surgically were angiographically shown cured in 100% of the cases, with no treatment-related complications. The presence of CVD was significantly associated with aggressive presentations. The Borden and Cognard classifications showed little interobserver variability. Endovascular treatment for CS DAVF is safe and relatively effective. Surgical treatment of non-CS DAVF with CVD is safe, effective and the first choice treatment in our environment. Copyright © 2012 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  15. Fecal Fistula Communicating with a Femur Shaft Fracture Secondary to a Malpositioned Suprapubic Catheter: A Case Report.

    Science.gov (United States)

    Guled, Uday; Goni, Vijay G; Honnurappa, Arjun R H; John, Rakesh; Vardhana, Harsha; Sharma, Gaurav; Pattabhiraman, Kirubakaran S

    2015-10-06

    Suprapubic catheter (SPC) insertion is a common urological procedure. Though considered a simple and safe procedure, complications are bound to occur if proper precautions are not taken during the procedure. The reported complications include gross hematuria, post-obstruction diuresis, insertion site skin-related complications, and intra-abdominal visceral injuries. Iatrogenic bowel injuries have been reported to occur as a complication in around 2.5% of cases. We report a very rare case of a bowel injury due to improper insertion of a SPC leading to fecal matter tracking along the muscle planes to reach the fracture site of the femur shaft and formation of an external fecal fistula along the lateral aspect of thigh, which according to us is the first reported case in the literature. This case report shows the devastating complication of a technically simple procedure done in an improper manner and successful management of a rare case of femur fracture with communicating fecal fistula. The purpose of this case report is to highlight the importance of taking proper precautions before the procedure.

  16. Congenital broncho-oesophageal fistula

    African Journals Online (AJOL)

    1983-04-09

    Apr 9, 1983 ... A case of broncho-oesophageal fistula causing bronchiectasis of the left· lung is reported. Oesophagorespiratory fistulas without atresia of the oesophagus often have an insidious clinical course and most commonly present in adulthood. This rare congenital anomaly should be considered as a cause of ...

  17. 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.

  18. Rectovaginal Fistula

    Science.gov (United States)

    ... Vaginal discharge Rectovaginal fistula Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  19. A Case of Successful Ablation of a Gastrophrenic Fistula with n-Butyl-2-Cyanoacrylate

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    Ashish Mahajan

    2008-01-01

    Full Text Available A 79-year-old woman with a fistula between a subphrenic abscess and the fundus of the stomach was successfully treated with n-Butyl-2-Cyanoacrylate. Conservative management had failed. Clinical presentation, treatment progress and imaging findings by computed tomography scan, ultrasound, gastroscopy and fluoroscopy are presented, along with a brief review of the relevant literature.

  20. Oro-cutaneous fistula of dental origin: Report of a case and review of ...

    African Journals Online (AJOL)

    Oro-cutaneous fistula of dental origin is uncommon, unsightly, and sometimes distressing and frustrating to the patient. The major sources of dental infection causing this condition are periapical following pulpal necrosis, and periodontal. The continued leakage of purulent material from the oral cavity to the face and the ...

  1. Spontaneous scrotal faecal fistula in a neonate: report of a case ...

    African Journals Online (AJOL)

    A 21 day old boy with spontaneous scrotal faecal fistula following a neglected strangulated right inguinal hernia is reported. He had necrotizing fasciitis of the right scrotum with sparing of the testis. He successfully had debridement, herniotomy and bowel resection with end-to-end anastomosis. This is a rare occurrence in ...

  2. Behavior of pharyngocutaneous fistula

    International Nuclear Information System (INIS)

    Reynaldo Gonzalez, Maria de los Angeles; Trinchet Soler, Rafael; Perez Fernandez, Julia; Alvarez Borges, Francisco Emilio

    2010-01-01

    INTRODUCTION. The pharyngocutaneous fistula is clinically detected by appearance of saliva together with deglutition. It is more frequent in postoperative period of total laryngectomies and may to appear in a spontaneous way by dehiscence of pharyngeal suture provoked by deglutition movements of patient or to go with a infection or necrosis. METHODS. A descriptive and bilateral study was conducted on the behavior of pharyngocutaneous fistulas in Cervicofacial Oncology Surgery Service of ''Vladimir Ilich Lenin'' University Hospital in Holguin province. Study sample included all patients operated on by total laryngectomy from 2003 to 2008. There was a total 158 patients and all underwent a manual closure of hypofarynx. RESULTS. Fistulas were present in the 5,6% of cases. The 77,7% of patients had underwent radiotherapy before surgery and the 66,4% of them underwent tracheostomies at surgical operation. In all patients operated on by pharyngotome there was postsurgical sepsis and feeding was started at 10 and 12 days in the 88,4% of cases. CONCLUSIONS. The wide predominance of male patients is directly related to usual toxic habits in this sex. Presurgical tracheostomy is accepted by surgeons as a risk factor for development of fistula, but in present paper wasn't significant. Onset of oral feeding in patients presenting with layngectomies must to fluctuate between 10 and 14 days, never before, but there isn't a hypopharynx healing allowing the foods passage. Also, so it is possible to avoid the appearance of complications like the pharyngocutaneous fistulas. (author)

  3. Congenital parotid fistula

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    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.

  4. A longitudinally extensive myelopathy associated with multiple spinal arteriovenous fistulas in a patient with Cowden syndrome: a case report.

    Science.gov (United States)

    Barreras, Paula; Gailloud, Philippe; Pardo, Carlos A

    2018-01-01

    Cowden syndrome is an autosomal dominant syndrome characterized by multiple hamartomas and an increased cancer risk. It is associated with mutations in the phosphatase and tensin homologue (PTEN) gene that encodes a tumor suppressant phosphatase. The study aimed to report an unusual case of multiple spinal epidural arteriovenous fistulas in a patient diagnosed with Cowden syndrome. This is a case report. The patient is a 57-year-old woman. We report the case of a 57-year-old woman with a history of multiple cancers, with acute exacerbation of lower extremity weakness and numbness that had progressed over a month. Magnetic resonance imaging showed abnormal signal in the thoracolumbar spinal cord, with enhancement after contrast administration. A spinal angiogram confirmed the presence of multiple spinal epidural arteriovenous fistulas. Genetic testing confirmed the diagnosis of Cowden syndrome with a mutation in intron 3 of the PTEN gene. Spinal vascular malformations occur in patients with Cowden syndrome, and they can be multifocal and locally aggressive. It is important to raise the suspicion of Cowden syndrome in patients with spinal cord vascular anomalies and a history of multiple cancers, as the correct genetic diagnosis may have implications for management and cancer screening. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Successful Pregnancy Following Repair of Vesicouterine Fistula Following Repeat Caesarean Section: A Case Report

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    Dilruba Akter

    2012-06-01

    Full Text Available A lady, para 2, both delivered by caesarean section for prolonged labour, presented with the complaints of menouria and infertility for 3 years following her last caesarean section. She had history of haematuria during menstruation and her menstrual flow is scanty. Her first baby was female and alive, but her second baby was stillborn following prolonged and obstructed labour. This has been continuously blamed by family and others for happening that events. Her fistula was confirmed by ultrasound scan, histerography and cystoscopy. The vesicouterine fistula was treated by local repair with omental patch through transperitoneal approach. Pregnancy following one year of successful repair has turned her from miserable to happiness in life.DOI: http://dx.doi.org/10.3329/bsmmuj.v5i1.11030 BSMMU J 2012; 5(1:76-78 

  6. External Carotid-Internal Jugular Fistula as a Late Complication After Carotid Endarterectomy: A Rare Case

    International Nuclear Information System (INIS)

    Bakar, Bulent; Cekirge, Saruhan; Tekkok, Ismail Hakki

    2011-01-01

    A 66-year-old man presented with mild amnesia, progressive fatigue, ataxia, visual hallucinations, and debility. His past medical history included right-sided carotid endarterectomy performed elsewhere 6 years previously. Cranial magnetic resonance imaging showed left parieto-occipital arteriovenous malformation-like tortous vessels, venous congestion, and ischemic areas. Cerebral angiography showed right-sided compound external carotid artery-internal jugular vein (IJV) fistula, and distal occlusion of the right IJV. Transvenous embolization via contralateral IJV was performed, and the fistula, together with fistulous portion of the distal IJV, was sealed using coils. Two years later, patient is well with normal neurologic examination findings. The presence of an arteriovenous communication after vascular surgery is a serious complication with potential long-term effects and therefore should be diagnosed and treated as promptly as possible.

  7. Successful Pregnancy Following Repair of Vesicouterine Fistula Following Repeat Caesarean Section: A Case Report

    OpenAIRE

    Dilruba Akter; Salahuddin Shah; Ferdousi Islam; Saria Tasnim

    2012-01-01

    A lady, para 2, both delivered by caesarean section for prolonged labour, presented with the complaints of menouria and infertility for 3 years following her last caesarean section. She had history of haematuria during menstruation and her menstrual flow is scanty. Her first baby was female and alive, but her second baby was stillborn following prolonged and obstructed labour. This has been continuously blamed by family and others for happening that events. Her fistula was confirmed by ultras...

  8. An unusual case of left main coronary artery aneurysm with right ventricle fistula

    Directory of Open Access Journals (Sweden)

    Shweta Nathani

    2012-01-01

    Full Text Available A 4-year-old boy presented with repeated respiratory tract infections. Echocardiography showed dilation of the left main coronary artery with flow into the Right Ventricular Outflow Tract (RVOT. Diagnosis of Left Coronary Artery Aneurysm (LMCA with RVOT fistula was made. A surgical repair of LMCA aneurysm by two-patch technique was performed. The patient had an excellent outcome postoperatively and is asymptomatic on follow-up.

  9. Gastrocolic fistula secondary to adenocarcinoma of the transverse colon: a case report.

    Science.gov (United States)

    Vergara-Fernández, Omar; Gutiérrez-Grobe, Ylse; Lavenant-Borja, María; Rojas, Carlos; Méndez-Sánchez, Nahum

    2015-10-27

    Gastrocolic fistula is a rare complication of adenocarcinoma of the colon. Despite radical resections, these patients usually have a poor prognosis with a mean survival of 23 months and long-term survival is rarely reported. A 48-year-old Latino-American man presented with watery diarrhea, diffuse abdominal pain and weight loss for 3 months. A computed tomography scan revealed a mass in the splenic flexure that had infiltrated his stomach and diaphragm. Panendoscopy and colonoscopy confirmed the presence of a fistula between the distal transverse colon and the stomach, which was secondary to a colon cancer. His colon, stomach and left diaphragm were resected en bloc. A histological examination revealed a moderately differentiated adenocarcinoma of the colon that had infiltrated the full width of the gastric wall with 37 negative lymph nodes and clear surgical margins. Adjuvant chemotherapy with capecitabine and oxaliplatin was administered after surgery. Our patient is alive and without any recurrence 5 years after surgery. En bloc resection with adjuvant chemotherapy offers the best treatment option for gastrocolic fistulas. This is one of the patients with greater survival reported in the medical literature.

  10. Case of anal fistula with Fournier's gangrene in an obese type 2 diabetes mellitus patient.

    Science.gov (United States)

    Yoshino, Hiroshi; Kawakami, Kyoko; Yoshino, Gen; Sawada, Katsuhiro

    2016-03-01

    A 64-year-old man was admitted to Shin-suma General Hospital, Kobe, Japan, complaining of a 3-day history of scrotal swelling and high fever. He had type 2 diabetes mellitus. On examination, his body temperature had risen to 38.5 °C. Examination of the scrotum showed abnormal enlargement. Laboratory data were as follows: white cell count 35,400/μL and glycated hemoglobin 9.6%. Anal fistula was found in an endorectal ultrasound. Computed tomography scan showed a relatively high density of subcutaneous tissue and elevated air density. Thus, he was diagnosed with Fournier's gangrene. On the fourth hospital day, the patient underwent debridement of gangrenous tissue. Seton surgery was carried out for anal fistula on the 34th hospital day. He responded to the treatment very well. He was discharged on the 33rd postoperative day. Once Fournier's gangrene has been diagnosed, considering the association of anal fistula and perianal abscess is important.

  11. Dural Arteriovenous Fistula Could Be Due to Hemodynamic Disturbance in Dural Physiological Shunts? Histopathological Study and a Case Report.

    Science.gov (United States)

    Nagm, Alhusain; Horiuchi, Tetsuyoshi; Kanaya, Kohei; Hongo, Kazuhiro

    2016-06-01

    Histopathologic studies of dural arteriovenous fistulas (dAVFs) are important for clarifying the pathogenesis. We present a case of Cognard type IV dAVF with detailed histopathologic studies in correlation with radiologic and intraoperative findings. An otherwise asymptomatic 53-year-old man presented with chronic headache. Neurologic examination revealed no abnormalities. Neuroimaging and cerebral catheter angiographic studies disclosed a left frontoparietal dAVF close to the middle third of the superior sagittal sinus, fed by the left superficial temporal and bilateral middle meningeal arteries and draining into ectatic cortical and dural veins. No evidence of superior sagittal sinus thrombosis or occlusion was seen. Intraoperatively, the parietal branch of the left superficial temporal artery penetrated the skull vault to feed the fistula; arterialized cortical and draining dural veins were also noted. Complete obliteration of the dAVF with removal of the affected dura mater was achieved safely. Histopathologic studies in serial sections documented a shunt point between the dural artery and the dural vein within the dura mater and a draining point between the dural and cortical veins. On the basis of clinical, angiographic, intraoperative, and histologic findings in our case, we strongly excluded acquired etiologies. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Post-ERCP pancreatogastric fistula associated with an intraductal papillary-mucinous neoplasm of the pancreas – a case report and literature review

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    Yasuda Yoshikazu

    2005-10-01

    Full Text Available Abstract Background Fistula formation has been reported in intraductal papillary-mucinous neoplasms (IPMNs with or without invasion of the adjacent organs. The presence or absence of invasion is mostly determined by postoperative histological examination rather than by preoperative work-up. Case presentation A 72 year-old Japanese woman showed remarkable dilatation of the main pancreatic duct (MPD in the distal region of the pancreas. Subsequent ERCP also showed MPD dilatation, after which the patient suffered moderate pancreatitis. A subsequent gastroscopy revealed a small ulceration that had not been observed in a gastroscopy performed 3 months prior. Mucinous discharge from the ulceration suggested it might be the orifice of a fistula connected to the MPD. En bloc resection including the distal region of the pancreas, spleen, stomach and part of the transverse colon was performed under the pre- and intraoperative diagnosis of an invasive malignant IPMN. However, histopathology revealed the lesion to be of "borderline malignancy" without apparent invasion of the stomach. Light microscopy showed inflammatory cellular infiltrates (mainly neutrophils around the pancreatogastric fistula, but there was no evidence of neoplastic epithelia lining the fistulous tract. Conclusion This case highlights that a pancreatogastric fistula can develop after acute inflammation of the pancreas in the absence of cancer invasion. Further information regarding IPMN-associated fistulae is necessary to clarify the pathogenesis, diagnosis, appropriate surgical intervention and prognosis for this disorder.

  13. Granulomatous hepatitis, choroiditis and aortoduodenal fistula complicating intravesical Bacillus Calmette-Guérin therapy: Case report

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    Antoine John

    2011-09-01

    Full Text Available Abstract Background Intravesical instillation of Bacillus Calmette-Guérin (BCG is the treatment of choice for superficial bladder carcinoma. Complications of BCG therapy include local infections and disseminated BCG infection with multiple endorgan complications. Case Presentation We report a case of disseminated, post-treatment BCG infection that initially presented with granulomatous hepatitis and choroiditis. After successful anti-mycobacterial therapy and resolution of the hepatic and ocular abnormalities, the patient developed an acute upper gastrointestinal hemorrhage from an aortoduodenal fistula that required emergency surgery. The resection specimen revealed multifocal, non-caseating granulomas, indicating mycobacterial involvement. Conclusions This case highlights the varied end organ complications of disseminated BCG infection, and the need for vigilance even in immuno-competent patients with a history of intravesical BCG treatment.

  14. Surgical Management of Calcified Liver Hydatid Cyst Complicated with Thoracobiliary Fistula: A Case Series and Literature Review

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    Mohsen Sokouti

    2016-06-01

    Full Text Available Thoracobiliary fistula is a rare complication of hydatid cyst of the liver especially in the calcified form. Surgery is the only medical option. The treatment consists of radical surgical procedures in the majority of the patients. Conservative surgical treatments are performed with high mortality rate. Herein, we will describe two patients of calcified hydatid cysts of the liver whose condition becomes complicated with Thoracobiliary fistula. The first patient was treated with right thoracotomy and resection of pleural hydatid cysts. Then, were evacuated the ruptured laminated membrane and daughter cysts of infected hepatic hydatid cysts through diaphragmatic opening and sub diaphragmatic drainage of the calcified liver hydatid cyst. The second patient was also treated with right thoracotomy, resection of pulmonary hydatid cysts, evacuation of ruptured bile stained laminated membrane and daughter cysts of hepatic hydatid cysts through diaphragmatic opening and sub diaphragmatic drainage of the calcified cyst cavity. Our patients underwent conservative surgery which posed a severe risk. Both cases are discussed together with review of the literature.

  15. Gastrointestinal fistula

    Science.gov (United States)

    ... to look in the stomach or small bowel Barium enema to look in the colon CT scan of the abdomen to look for fistulas between loops of the intestines or areas of infection Fistulogram, in which contrast dye is injected into the opening of the ...

  16. A Case of Pulmonary Hypertension Due to Fistulas Between Multiple Systemic Arteries and the Right Pulmonary Artery in an Adult Discovered for Occulted Dyspnoea.

    Science.gov (United States)

    Li, Ji-Feng; Zhai, Zhen-Guo; Kuang, Tu-Guang; Liu, Min; Ma, Zhan-Hong; Li, Yi-Dan; Yang, Yuan-Hua

    2017-08-01

    Pulmonary hypertension (PH) can be caused by a fistula between the systemic and pulmonary arteries. Here, we report a case of PH due to multiple fistulas between systemic arteries and the right pulmonary artery where the ventilation/perfusion scan showed no perfusion in the right lung. A 32-year-old male patient was hospitalised for community-acquired pneumonia. After treatment with antibiotics, the pneumonia was alleviated but dyspnoea persisted. Pulmonary hypertension was diagnosed using right heart catheterisation, which detected the mean pulmonary artery pressure as 37mmHg. The anomalies were confirmed by contrast-enhanced CT scan (CT pulmonary angiography), systemic arterial angiography and pulmonary angiography. Following embolisation of the largest fistula, the haemodynamics and oxygen dynamics did not improve, and even worsened to some extent. After supportive therapy including diuretics and oxygen, the patient's dyspnoea, WHO function class and right heart function by transthoracic echocardiography all improved during follow-up. Pulmonary hypertension can be present even when the right lung perfusion is lost. Closure of fistulas by embolisation, when those fistulas act as the proliferating vessels, may be harmful. Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  17. Volcano-like intermittent bleeding activity for seven years from an arterio-enteric fistula on a kidney graft site after pancreas-kidney transplantation: a case report

    Directory of Open Access Journals (Sweden)

    Schölmerich Jürgen

    2010-11-01

    Full Text Available Abstract Introduction We report the first case of a patient who underwent simultaneous kidney and pancreas transplantation and who then suffered from repeated episodes of severe gastrointestinal bleeding over a period of seven years. Locating the site of gastrointestinal bleeding is a challenging task. This case illustrates that detection of an arterio-enteric fistula can be very difficult, especially in technically-challenging situations such as cases of severe intra-abdominal adhesions. It is important to consider the possibility of arterio-enteric fistulas in cases of intermittent bleeding episodes, especially in transplant patients. Case presentation A 40-year-old Caucasian man received a combined pancreas-kidney transplantation as a result of complications from diabetes mellitus type I. Thereafter, he suffered from intermittent clinically-relevant episodes of gastrointestinal bleeding. Repeat endoscopic, surgical, scintigraphic, and angiographic investigations during his episodes of acute bleeding could not locate the bleeding site. He finally died in hemorrhagic shock due to arterio-enteric bleeding at the kidney graft site, which was diagnosed post-mortem. Conclusions In accordance with the literature, we suggest considering the removal of any rejected transplant organs in situations where arterio-enteric fistulas seem likely but cannot be excluded by repeat conventional or computed tomography-angiographic methods. Arterio-enteric fistulas may intermittently bleed over many years.

  18. Peptic ulcers accompanied with gastrointestinal bleeding, pylorus obstruction and cholangitis secondary to choledochoduodenal fistula: A case report.

    Science.gov (United States)

    Xi, Bin; Jia, Jun-Jun; Lin, Bing-Yi; Geng, Lei; Zheng, Shu-Sen

    2016-01-01

    Peptic ulcers are an extremely common condition, usually occurring in the stomach and proximal duodenum. However, cases of peptic ulcers accompanied with multiple complications are extremely rare and hard to treat. The present case reinforces the requirement for the early recognition and correct treatment of peptic ulcers accompanied with multiple complications. A 67-year-old man presented with recurrent abdominal pain, fever and melena. The laboratory results showed anemia (hemoglobin 62 g/l) and hypoproteinemia (23 g/l). Abdominal imaging examinations revealed stones in the gallbladder and right liver, with air in the dilated intrahepatic and extrahepatic bile ducts. Endoscopic retrograde cholangiopancreatography failed due to a deformed pylorus. The patient was finally diagnosed with peptic ulcers accompanied with gastrointestinal (GI) bleeding, pylorus obstruction and cholangitis secondary to a choledochoduodenal fistula during an emergency pancreatoduodenectomy, which was performed due to a massive hemorrhage of the GI tract. The patient recovered well after the surgery.

  19. Two-dimensional power Doppler-three-dimensional ultrasound imaging of a cesarean section dehiscence with utero-peritoneal fistula: a case report

    Directory of Open Access Journals (Sweden)

    Royo Pedro

    2009-01-01

    Full Text Available Abstract Introduction An imaging diagnosis after an iterative cesarean delivery is reviewed demonstrating a fine ultrasound-pathologic correlation. Case presentation A 33-year-old woman (G3, P3 presented referring intense dysmenorrhea and intermenstrual spotting since her third cesarean delivery, 1 year before. A cesarean section dehiscence with utero-peritoneal fistula was diagnosed by transvaginal ultrasound. Conclusion We can conclude that transvaginal two-dimensional power Doppler and three-dimensional ultrasound are highly accurate in detecting cesarean section dehiscence and uterine fistula.

  20. 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.

  1. A recurrent empyema with peripheral bronchopleural fistulas treated by retrograde bronchial sealing with Gore Tex plugs: a case report.

    Science.gov (United States)

    Ahn, Jin-Young; Kim, Dohun; Hong, Jong-Myeon; Kim, Si-Wook

    2015-12-01

    Bronchopleural fistulae (BPF) are communications between the bronchial tree and the pleural spaces. This anomaly is associated with significant morbidity and mortality, and its management in some patients remains a major therapeutic challenge for clinicians. Here we report a case involving a 62-year-old man with chronic empyema associated with multiple BPF caused by severe necrotizing pneumonia with parapneumonic effusion in the left lower lobe. His BPF were treated by decortication and retrograde surgical sealing with Gore-Tex plugs that were sutured to the parenchyma and bronchus and reinforced by glue and an intercostal muscle flap. The air leakage stopped immediately after surgery and the chronic empyema resolved. His subsequent postoperative course was uneventful, and he was discharged 14 days after surgery. At the 8-month follow-up visit, stable surgical outcomes with no BPF recurrence were observed. In summary, we described a novel and easy surgical technique for the repair of intractable peripheral BPF in select patients.

  2. A rare case of aortic sinuses of valsalva fistula to multiple cardiac chambers secondary to periannular aortic abscess formation from underlying Brucella endocarditis

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    Sabzi, Feridoun

    2015-11-01

    Full Text Available The concomitant presence of abnormal connection from three aortic valsalva sinuses to cardiac chambers is a rare complication of native aortic endocarditis. This case report presents a 37-year-old Iranian female patient who had native aortic valve endocarditis complicated by periannular abscess formation and subsequent perforation to multi-cardiac chambers associated with congestive heart failure and left bundle branch block. Multiple aorto-cavitary fistulas to right atrium, main pulmonary artery, and formation of a pocket over left atrial roof were detected by transthoracic echocardiogram (TTE. She had received a full course of antibiotics therapy in a local hospital and was referred to our center for further surgery. TTE not only detected multiple aorto-cavitary fistulas but also revealed large vegetation in aortic and mitral valve leaflets and also small vegetation in the entrance of fistula to right atrium. However, the tricuspid valve was not involved in infective endocarditis. She underwent open cardiac surgery with double valve replacement with biologic valves and reconstruction of left sinus of valsalva fistula to supra left atrial pocket by pericardial patch repair. The two other fistulas to main pulmonary artery and right atrium were closed via related chambers. The post-operative course was complicated by renal failure and prolonged dependency to ventilator that was managed accordingly with peritoneal dialysis and tracheostomy. The patient was discharged on the 25 day after admission in relatively good condition. The TTE follow-up one year after discharge revealed mild paravalvular leakage in aortic valve position, but the function of mitral valve was normal and no residual fistulas were detected.

  3. Characteristics, diagnosis and treatment of hypoglossal canal dural arteriovenous fistula: report of nine cases

    Energy Technology Data Exchange (ETDEWEB)

    Manabe, Shinji; Satoh, Koichi; Matsubara, Shunji; Satomi, Junichiro; Hanaoka, Mami; Nagahiro, Shinji [University of Tokushima, Department of Neurosurgery, Tokushima (Japan)

    2008-08-15

    We report the characteristics, diagnosis and treatment of dural arteriovenous fistula (DAVF) of the hypoglossal canal in nine patients with this relatively rare vascular disorder. Of 248 patients with intracranial DAVFs managed at our institution, nine patients (3.6%; four men, five women; mean age 62 years) were diagnosed with hypoglossal canal DAVF. We investigated patient characteristics with respect to clinical symptoms, neuroradiological findings, efficacy and complications related to endovascular treatment. Seven patients had experienced head injury. All patients presented with pulsatile tinnitus. One patient displayed ipsilateral hypoglossal nerve palsy before treatment. MR angiography showed a 'magic wand' appearance between the affected hypoglossal canal and the internal jugular vein in four patients. Angiography demonstrated an AV fistula on the medial aspect of the superior jugular bulb, mostly arising from the bilateral occipital, ascending pharyngeal and vertebral arteries with drainage to the internal jugular vein via the anterior condylar vein. Contralateral carotid injection accurately clarified the shunting point. Five patients underwent endovascular treatment: transarterial embolization (TAE; n=2), transvenous embolization (TVE; n=2), and TAE/TVE (n=1). Complete shunt obliteration was achieved in four patients and shunt reduction in one. The remaining four patients were treated conservatively and the shunt had disappeared at follow-up. Postoperative hypoglossal nerve palsy occurred in one patient after TVE, possibly due to coil overpacking. The incidence of hypoglossal canal DAVF was not very low in our series. Contralateral carotid injection is an essential examination to provide an accurate diagnosis. TVE should be considered when access is available, although TAE is also appropriate for shunt reduction. (orig.)

  4. Characteristics, diagnosis and treatment of hypoglossal canal dural arteriovenous fistula: report of nine cases

    International Nuclear Information System (INIS)

    Manabe, Shinji; Satoh, Koichi; Matsubara, Shunji; Satomi, Junichiro; Hanaoka, Mami; Nagahiro, Shinji

    2008-01-01

    We report the characteristics, diagnosis and treatment of dural arteriovenous fistula (DAVF) of the hypoglossal canal in nine patients with this relatively rare vascular disorder. Of 248 patients with intracranial DAVFs managed at our institution, nine patients (3.6%; four men, five women; mean age 62 years) were diagnosed with hypoglossal canal DAVF. We investigated patient characteristics with respect to clinical symptoms, neuroradiological findings, efficacy and complications related to endovascular treatment. Seven patients had experienced head injury. All patients presented with pulsatile tinnitus. One patient displayed ipsilateral hypoglossal nerve palsy before treatment. MR angiography showed a ''magic wand'' appearance between the affected hypoglossal canal and the internal jugular vein in four patients. Angiography demonstrated an AV fistula on the medial aspect of the superior jugular bulb, mostly arising from the bilateral occipital, ascending pharyngeal and vertebral arteries with drainage to the internal jugular vein via the anterior condylar vein. Contralateral carotid injection accurately clarified the shunting point. Five patients underwent endovascular treatment: transarterial embolization (TAE; n=2), transvenous embolization (TVE; n=2), and TAE/TVE (n=1). Complete shunt obliteration was achieved in four patients and shunt reduction in one. The remaining four patients were treated conservatively and the shunt had disappeared at follow-up. Postoperative hypoglossal nerve palsy occurred in one patient after TVE, possibly due to coil overpacking. The incidence of hypoglossal canal DAVF was not very low in our series. Contralateral carotid injection is an essential examination to provide an accurate diagnosis. TVE should be considered when access is available, although TAE is also appropriate for shunt reduction. (orig.)

  5. Treatment of foregut fistula with biologic plugs.

    Science.gov (United States)

    Filgate, Rhys; Thomas, Alan; Ballal, Mohammad

    2015-07-01

    Enteric fistulas are a recognised complication of various diseases and surgical interventions. Non-operative medical management will result in closure of 60-70% of all fistulas over a six- to eight-week period, those that fail non-operative management will require operative intervention if they are to close. We present a series of upper gastrointestinal fistula managed with endoscopic intervention and insertion of biological fistula plug over a 3-year period across three Hospitals, both public and private, in Western Australia. Over a three-year period, 14 patients were referred for treatment of acute or persistent foregut fistulas. All fistulas were managed with endoscopic intervention and insertion of a porcine small intestine sub-mucosa plug (Biodesign (®) Cook medical Inc., Bloomington, IN, USA). No patients with fistula were excluded. Data were collected on patient demographics and underlying diagnosis. The biological plugs were deployed using three different endoscopic techniques (direct deployment via the endoscope, catheter-assisted endoscopic deployment, or a pull through via a guide wire using a rendezvous technique). Fourteen patients with foregut fistula were treated using biological plugs. The age of the fistulas treated ranged from 14 days to 3 years. The fistulas were predominantly gastric in origin (eight cases). Three oesophageal, one gastro-pleural-bronchial, and two jejunal fistulas were also managed using this technique. Of the 14 fistulas treated using this method, 13 resolved following the treatment. Median time to closure of the fistula was 2 days (range 1-120 days). Three patients required more than one intervention to complete closure. Biological plugs offer a further option for management of the traditionally difficult foregut fistula, without major morbidity associated with other treatment modalities. It is limited to the ability to deploy the plug endoscopically.

  6. Computed tomography in the diagnosis of pulmonary arteriovenous fistulae: a report of two cases; La TC en el diagnostico de las fistulas arteriovenosas pulmonares. A proposito de dos casos

    Energy Technology Data Exchange (ETDEWEB)

    Cuesta Lopez, C.; Blanco de Martinez, C.; Montes Garcia, A.; Fernandez Marino, B. [Hospital General de Asturia. Oviedo (Spain)

    2002-07-01

    Pulmonary arteriovenous fistula is not clinically recognized until the patient reaches adulthood in most cases. The symptoms, when present may not be specific, and include hemoptysis, epistaxis and low oxygen saturation, among others. Plain radiography shows a round or oval lobulated mass of uniform density, an image that is often diagnostic since the arterial and venous vessels are visible. Contrast-enhanced helical computed tomography and magnetic resonance angiography are ideal techniques for pretreatment evaluation, showing the nutrient artery from the lung hilum and the draining vein toward left atrium. Excellent results are obtained with coil embolization. (Author) 8 refs.

  7. Retrospective Analysis of Patients with Genitourinary Fistula

    Directory of Open Access Journals (Sweden)

    Serdar Başaranoğlu

    2017-12-01

    Full Text Available Objective: To present the outcomes of patients treated at a tertiary center for a diagnosis of genitourinary fistula secondary to gynecological and obstetric etiologies. Study Design: In this retrospective study, analysis was made of 18 patients with a diagnosis of genitourinary fistula in a tertiary center between January 2006 and June 2016. Patient data were taken from the archives and patient histories. A record was made of examinations, diagnostic methods such as cystoscopy and fistulography and appropriate medical treatments, demographic data, intraoperative and post-operative complications, duration of hospital stay, surgical operations and types, diameter and location of fistulas. Results: Of the 18 cases, 14 were secondary to obstetric trauma. In 10 of these 14 cases, fistula had developed after difficult vaginal delivery and in four cases, after caesarean section. Four of the 18 cases were secondary to gynecological surgeries, namely hysterectomy and cystocele repairs. Vesicovaginal fistulas were repaired transvaginally while vesicouterine fistulas and bilateral ureterovaginal fistulas were repaired transabdominally. The mean hospital stay was 3.8±1.5 days (2-7 days. Patients were followed up closely in the first 3 months and recurrence developed in only one case. Conclusion: Fistulas secondary to gynecological procedures are uncommon while fistulas secondary to inadequate perineal care, insufficient labor monitoring and difficulties in vaginal delivery techniques are more prevalent in Turkey. Thorough evaluation, using all diagnostic tools for complete diagnosis, understanding the pathophysiology and choosing the best surgical procedure are mandatory to obtain good outcomes after the surgical

  8. Automated double-cone-beam CT fusion technique. Enhanced evaluation of glue distribution in cases of spinal dural arteriovenous fistula (SDAVF) embolisation

    Energy Technology Data Exchange (ETDEWEB)

    Farago, Giuseppe [Foundation Neurological Institute ' ' C. Besta' ' , Department of Interventional Neuroradiology, Milan (Italy); Fondazione IRCCS Istituto Neurologico Carlo Besta, Department of Interventional Neuroradiology, Milan (Italy); Caldiera, V. [Foundation Neurological Institute ' ' C. Besta' ' , Department of Interventional Neuroradiology, Milan (Italy); Antozzi, C.; Bellino, A. [Foundation Neurological Institute ' ' C. Besta' ' , Department of Neuroimmunology and Neuromuscular Diseases, Milan (Italy); Innocenti, A. [Foundation Neurological Institute ' ' C. Besta' ' , Department of Neuro-Oncology, Milan (Italy); Ciceri, E. [Foundation Neurological Institute ' ' C. Besta' ' , Department of Interventional Neuroradiology, Milan (Italy); Azienda Ospedaliera Universitaria Integrata Borgo Trento, Department of Neuroradiology, Verona (Italy)

    2017-05-15

    Spinal dural arteriovenous fistulas (SDAVFs) are acquired diseases that represent the majority of all arteriovenous spinal shunts, leading to progressive and disabling myelopathy. Treatment is focused on accurately disconnecting the fistula point. We present our experience with the double-cone-beam CT fusion technique successfully applied to evaluate treatment results in a series of SDAVFs. Between November 2011 and December 2015 we performed double-DynaCT acquisition (pre- and post-embolisation) in 12 cases of SDAVF. A successful DynaCT fusion technique was only achieved in the group of patients with pre- and post-treatment images acquired at the same time as the treatment session, under general anaesthesia (4/12). DynaCT performed on different days proved to be inadequate for the automated fusion technique because of changes in the body position (8/12). A pre-treatment flat-panel cone-beam CT with contrast, at the time of diagnostic angiography, can be very helpful to detect the correct level of the fistula and the relationship between the fistula and the surrounding structures. In case of the endovascular approach, additional post-treatment native acquisition merged with the pre-treatment acquisition (double-cone-beam CT fusion technique) permits to immediately evaluate the distribution of the glue cast and to confirm the success of the procedure. (orig.)

  9. Intractable Posterior Epistaxis due to a Spontaneous Low-Flow Carotid-Cavernous Sinus Fistula: A Case Report and a Review of the Literature

    Directory of Open Access Journals (Sweden)

    A. Giotakis

    2015-01-01

    Full Text Available We report a case of a 90-year-old patient with intractable posterior epistaxis presenting as the only symptom of a nontraumatic low-flow carotid-cavernous sinus fistula. Purpose of this case report is to introduce low-flow carotid-cavernous sinus fistula in the differential diagnosis of intractable posterior epistaxis. We provide a literature review for the sequence of actions for the confrontation of posterior epistaxis. We also emphasize the significance of the radiological diagnostic and therapeutic procedures in the management of posterior epistaxis due to pathology of the cavernous sinus. The gold-standard diagnostic procedure of carotid-cavernous sinus fistula is digital subtraction angiography (DSA. DSA with coils is also the state-of-the-art therapy. By failure of DSA, neurosurgery or stereotactic radiosurgery (SRS may be used as alternatives. SRS may also be used as enhancement procedure of the DSA. Considering the prognosis of a successfully closed carotid-cavernous sinus fistula, recanalization occurs only in a minority of patients. Close follow-up is advised.

  10. A case of separation surgery with drainage tube-less (DRESS) esophagostomy for advanced cancer with a respiratory fistula.

    Science.gov (United States)

    Tanoue, Yukinori; Takeno, Shinsuke; Kawano, Fumiaki; Tashiro, Kousei; Hamada, Rouko; Miyazaki, Yasuyuki; Nanashima, Atsushi

    2018-02-13

    An esophagorespiratory fistula (ERF) can cause severe pneumonia or a lung abscess which progresses to life-threatening sepsis. A case of a patient with esophageal cancer and an esophagopulmonary fistula (EPF) who underwent separation surgery with drainage tube-less (DRESS) esophagostomy and was promptly started on definitive chemoradiotherapy (CRT) is reported. A 79-year-old man visited a clinic with a month-long history of dysphagia. Esophageal cancer at the middle thoracic esophagus was detected, and invasion of the left main bronchus and lower lobe of the right lung was seen on contrast-enhanced computed tomography (CT). Three weeks later, the patient was transferred to our hospital. CT showed a lung abscess in the lower lobe of the right lung that continued into the adjacent esophageal cancer. Due to the EPF, the patient underwent emergency surgery that consisted of esophageal separation surgery and double bilateral esophagostomy and enterostomy. Definitive CRT for the esophageal cancer was started from postoperative day 25. At six-month follow-up, the patient achieved relapse-free survival. Separation surgery with a DRESS esophagostomy provides good control of inflammation because of division of the respiratory tract from the alimentary tract, which allows prompt initiation of CRT. Alternatively, a DRESS esophagostomy allows patients to be free from any tube trouble. Separation surgery with a DRESS esophagostomy for an ERF is a promising method to improve patient quality of life that is less invasive, controls inflammation, and facilitates subsequent definitive CRT. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. Cholecystoduodenal fistula in a porcelain gallbladder

    Energy Technology Data Exchange (ETDEWEB)

    Delpierre, I.; Tack, D.; Delcour, C. [Department of Radiology, CHU-Hopital Civil de Charleroi, 92 Boulevard Janson, 6000 Charleroi (Belgium); Moisse, R. [Department of Gastroenterology, CHU-Hopital Civil de Charleroi, 92 Boulevard Janson, 6000 Charleroi (Belgium); Boudaka, W. [Department of Surgery, CHU-Hopital Civil de Charleroi, 92 Boulevard Janson, 6000 Charleroi (Belgium)

    2002-09-01

    Calcification of the gallbladder wall (porcelain gallbladder) is rare. Its appearance is quite characteristic on plain films, ultrasonography and computed tomography. Sporadic cases of cholecystitis have been described in porcelain gallbladders. Enterobiliary fistula may complicate acute or chronic cholecystitis in non-calcified gallbladder. We report a unusual case of acute cholecystitis with cholecystoduodenal fistula in a porcelain gallbladder. (orig.)

  12. Automated double-cone-beam CT fusion technique. Enhanced evaluation of glue distribution in cases of spinal dural arteriovenous fistula (SDAVF) embolisation.

    Science.gov (United States)

    Faragò, Giuseppe; Caldiera, V; Antozzi, C; Bellino, A; Innocenti, A; Ciceri, E

    2017-05-01

    Spinal dural arteriovenous fistulas (SDAVFs) are acquired diseases that represent the majority of all arteriovenous spinal shunts, leading to progressive and disabling myelopathy. Treatment is focused on accurately disconnecting the fistula point. We present our experience with the double-cone-beam CT fusion technique successfully applied to evaluate treatment results in a series of SDAVFs. Between November 2011 and December 2015 we performed double-DynaCT acquisition (pre- and post-embolisation) in 12 cases of SDAVF. A successful DynaCT fusion technique was only achieved in the group of patients with pre- and post-treatment images acquired at the same time as the treatment session, under general anaesthesia (4/12). DynaCT performed on different days proved to be inadequate for the automated fusion technique because of changes in the body position (8/12). A pre-treatment flat-panel cone-beam CT with contrast, at the time of diagnostic angiography, can be very helpful to detect the correct level of the fistula and the relationship between the fistula and the surrounding structures. In case of the endovascular approach, additional post-treatment native acquisition merged with the pre-treatment acquisition (double-cone-beam CT fusion technique) permits to immediately evaluate the distribution of the glue cast and to confirm the success of the procedure. • SDAVF treatment must be aimed to occlude the fistula point shunt. • Native post-operative cone-beam CT permits high-spatial-resolution imaging of the embolic cast. • The automated double-cone-beam CT fusion technique (pre/post) accurately demonstrates intravascular glue distribution after embolisation. • Patient movements should be avoided to obtain good technical results.

  13. Fístula axilo-cava para hemodiálise: relato de caso Axillary arteriovenous fistula for hemodialysis: case report

    Directory of Open Access Journals (Sweden)

    Yosio Nagato

    2009-12-01

    Full Text Available Na confecção de fístula arteriovenosa (FAV para hemodiálise, condutos venosos autógenos demonstram performance superior quando comparados com material protético em relação à perviedade primária ou secundária. A prótese de politetrafluoroetileno (PTFE é reservada para casos de falência de material autógeno e é geralmente utilizada em fístulas em membros superiores. Descrevemos o caso de uma paciente de 52 anos que, após falência de acessos para hemodiálise e impossibilidade de realização de diálise peritoneal em razão de peritonite bacteriana, foi submetida à confecção de FAV entre a artéria axilar direita e a veia cava inferior com prótese de PTFE de 6 mm. O acesso foi utilizado para hemodiálise 1 mês após sua criação e permanece pérvio após 24 meses. Até o momento, não houve complicações infecciosas, sinais de insuficiência cardíaca ou síndrome de roubo em membro superior direito.With regards to the creation of an arteriovenous fistula (AV fistula for hemodialysis, autogenous venous grafts clearly show high performance when compared with prosthetic material in terms of primary or secondary patency. Polytetrafluoroethylene (PTFE grafts for the reconstruction of AV fistulae must be restricted to cases of failure of the autogenous material, which is generally used in upper limb fistulae. We describe a case of a 52-year-old patient, who, after access failure for hemodialysis and the impossibility of performing peritoneal dialysis due to bacterial peritonitis, underwent the reconstruction of an AV fistula between the right axillary artery and the cava vein using a 6-mm PTFE prosthesis. One month after surgery, this AV fistula started to be used for hemodialysis. The AV fistula remains patent 24 months after its creation. No infectious complications, cardiac insufficiency symptoms, or steal syndromes of right upper limb were detected.

  14. Gracilis muscle interposition with primary rectal without urethral repair for moderate sized rectourethral fistula caused by brachytherapy for prostate cancer: a case report

    Directory of Open Access Journals (Sweden)

    Samalavicius Narimantas

    2012-09-01

    Full Text Available Abstract Introduction There is a 0.16% chance of a rectourethral fistula after prostate brachytherapy monotherapy using Palladium-103 or Iodine-125 implants. We present an unusual case report of a rectourethral fistula following brachyradiotherapy monotherapy for prostate adenocarcinoma. It was also associated with unusual management of the fistula. Case presentation A 58-year-old Caucasian man underwent brachyradiotherapy monotherapy as definitive treatment for verified intracapsular prostate adenocarcinoma receiving 56 Iodine-125 implants using a transrectal ultrasound-guided technique. The patient started to complain of severe perineal pain and mild rectal bleeding 15Â months after brachyradiotherapy. A biopsy of mucosa of his anterior rectal wall was performed. A moderate sized rectourethral fistula was confirmed 23Â months after implantation of Iodine-125 seeds. Laparoscopic sigmoidostomy and suprapubic cystostomy were then performed. Long-term cortisone applications in combination with 30 sessions of hyperbaric oxygen therapy, and antibacterial therapies were initiated due to necrotic infection. A gracilis muscle interposition to create a partition between the patient's rectum and urethra in conjunction with primary rectal repair but without urethral repair were performed 6 months later. The 3cm rectal defect was repaired via a 3cm-long horizontal perineal incision. The 1.5cm urethral defect just below the prostate was not repaired. The patient underwent an optic internal urethrotomy 3Â months later for a 1.5cm-long urethral stricture. Several planned preventive urethral buginages were performed to avoid urethral stricture recurrence. At 12Â months postoperatively, there were no signs of a fistula and cancer recurrence. He now has a normal voiding and anal continence. Conclusion Severe rectal pain, bleeding, and local anterior necrotic proctitis are predictors of a rectourethral fistula. Urinary and fecal diversion is the first

  15. Successful airway management in a patient with tracheal stenosis and tracheoesophageal fistula: a case report.

    Directory of Open Access Journals (Sweden)

    Hamid Reza Davari

    2014-07-01

    Full Text Available A twenty-year-old girl was referred with tracheal stenosis (TS which was a consequence of prolonged intubation after head injury because of previous car accident. The patient was aphasic and had normal respiration. Fiberoptic bronchoscopy showed complete tracheal obstruction at second tracheal ring level. Distal trachea was normal through tracheostomy tube. Removal of the tracheostomy tube and blind reinsertion with a new one was complicated with hypoxia and respiratory distress. Fibrotic bronchoscopy revealed large tracheoesophageal fistula (TEF below tracheal obstruction. Reinsertion of the tracheostomy tube by fiber optic bronchoscope was successful. Multidetector CT scan was performed on the same day with confirmation of TS combined with TEF. Surgery was performed on the next day. No clinical evidence of TEF was found in back history. Inadequate evaluation of the whole length of the trachea during the first bronchoscopy was the reasons for missing TEF. TEF should be considered in patients with TS in spite of no typical symptom such as food aspiration or pulmonary infections.

  16. Intracranial arteriovenous malformation and dural arteriovenous fistula embedded in a meningioma—case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Moujahed Labidi

    2015-12-01

    Full Text Available The association between a vascular malformation and a meningioma is a rare occurrence intracranially. We document the case of a 59-year-old man who presented with a right parietal extra-axial mass with headaches and seizures. Hemangiopericytoma was initially suspected on the basis of an unusual vascular pattern and rapid lesion progression. Angiography revealed abnormal vessels and an early draining vein associated with the mass. Arterial feeders were primarily from the middle cerebral artery with discrete contribution from both middle meningeal arteries. Craniotomy and Simpson 0 resection of the lesion were undertaken and revealed the coexistence of a dural based tumor with an AVM and a dural arteriovenous fistula (dAVF. Histology and immunohistochemistry were consistent with the diagnosis of meningioma and associated AVM. This case represents the eleventh report of an AVM associated with a meningioma, among which only 6 were contiguous. Such cases illustrate the pathogenic roles of angiogenesis and inflammation that is common to AVMs, dAVF and meningiomas.

  17. Single-Session Hematoma Removal and Transcranial Coil Embolization for a Cavernous Sinus Dural Arteriovenous Fistula: A Technical Case Report.

    Science.gov (United States)

    Akamatsu, Yosuke; Sato, Kenichi; Endo, Hidenori; Matsumoto, Yasushi; Tominaga, Teiji

    2017-08-01

    Patients with cavernous sinus dural arteriovenous fistulas (CS dAVFs) with cortical venous varix are indicated for aggressive treatment because of the associated risk for intracranial hemorrhage. We present a case of surgical transvenous embolization in an 84-year-old woman with CS dAVF who presented with massive intracerebral hematoma. Cerebral angiograms revealed the dural AVF drained only into the superficial middle cerebral vein. Because an emergent mass reduction and prevention of rebleeding were necessary, single-session hematoma removal and transcranial embolization of a CS dAVF were performed in the neurosurgical operating room, using a mobile C-arm fluoroscopy. After the right frontotemporal craniotomy, intracerebral hematoma was removed and coil packing of the affected cavernous sinus was successfully performed via the dilated superficial middle cerebral vein. The transcortical vein approach enables occlusion of CS dAVF with isolated cortical venous drainage and may be a valuable alternative approach for some cases needed emergency craniotomy. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Documented development of a dural arteriovenous fistula in an infant subsequent to sinus thrombosis: case report and review of the literature

    International Nuclear Information System (INIS)

    Morales, Humberto; Jones, Blaise V.; Leach, James L.; Abruzzo, Todd A.

    2010-01-01

    Controversy exists as to whether sinus thrombosis is the cause or the result of dural arteriovenous fistula (DAVF) and to whether DAVF are congenital or acquired lesions, especially in children. An infant presented with rupture of an anterior communicating artery aneurysm diagnosed with computed tomography angiography and catheter angiography. Pretreatment hospital course was complicated by extensive dural sinus thrombosis. Subsequent arteriography showed a new adult-type dural arteriovenous fistula to the previously thrombosed right sigmoid sinus. This is the first report of definitive angiographic documentation of the development of an adult-type DAVF after recanalization of a thrombosed dural sinus in a child. This case confirms the acquired etiology of at least one type of DAVF in children, even at this young age. We review the previously documented cases of formation of DAVF subsequent to sinus thrombosis with serial angiography in adults. (orig.)

  19. Use of OTSC Device System for Closure of Fistulas in the Alimentary Tract – A Case Series

    Directory of Open Access Journals (Sweden)

    Truptesh H. Kothari

    2014-01-01

    Conclusion: With several new devices being introduced, it is difficult to judge the implementation of one tool over the others. This device has shown promising results for fistula closure if used knowing the limitation of the product.

  20. Uteroabdominal Wall Fistula After Cesarean Section in a Patient With Prior Colorectal Resection for Endometriosis: A Case Report and Systematic Review.

    Science.gov (United States)

    Chattot, Chloé; Aristizabal, Patrick; Bendifallah, Sofiane; Daraï, Emile

    Uteroabdominal wall fistula (UAWF) is a very rare complication of cesarean section. We report an unusual case of a UAWF occurring in a 37-year-old woman 4 years after a cesarean section and previous radical surgery for deep infiltrating endometriosis with bowel resection. The patient presented with persistent purulent discharge of the Pfannenstiel scar and noted that the discharge was blood stained during menstruation. Magnetic resonance imaging confirmed the diagnosis of UAWF. Surgery was performed by laparotomy and was complicated by a postoperative rectovaginal fistula, which was successfully treated by the placement of a biological mesh via the vagina route. The postoperative course was favorable at 6 months with disappearance of painful symptoms and good quality of the colorectal anastomosis. A systematic review was conducted, and 18 case reports were found from 1939 to 2016. This case report highlights the risk of postdelivery complications in women with deep infiltrating endometriosis and colorectal involvement, especially after cesarean section. Persistent abdominal discharge in this context should suggest a diagnosis of UAWF despite its low incidence. Finally, the vaginal route for rectovaginal fistula might be considered an option for patients with prior multiple laparotomies. Copyright © 2017 AAGL. Published by Elsevier Inc. All rights reserved.

  1. Use of Vacuum-assisted closure in management of open abdominal wound with multiple enterocutaneous fistulae during chemotherapy: A case report

    Science.gov (United States)

    Fujino, Shiki; Miyoshi, Norikatsu; Ohue, Masayuki; Noura, Shingo; Fukata, Tadafumi; Yagi, Toshiya; Fujiwara, Yoshiyuki; Yano, Masahiko

    2015-01-01

    Introduction Vacuum-assisted closure (VAC) is useful for treating complex wounds because it promotes granulation. In the present report, a successful case of VAC used for an open abdominal wound with enterocutaneous fistulae after multiple intestinal perforations during chemotherapy is described. Presentation of case A 73-year-old man was admitted to our hospital with severe abdominal pain. He underwent surgical resection for ascending colon cancer 4 years ago and was administered chemotherapy with bevacizumab for recurrence. Physical examination and computed tomography revealed perforation of the intestine, and an emergency operation was performed. Following this procedure, other intestinal perforations occurred, resulting in an open abdominal wound at postoperative day (POD) 10. To isolate enteric contents and promote granulation, VAC was applied to the abdominal wound with enterocutaneous fistulae. Oral intake started at POD 21 and the wound size became smaller. Further, an ostomy bag was directly attached to the most oral perforation site. The patient recovered from life-threatening events without severe infection and was transferred to another hospital close to his home at POD 180. Discussion Gastrointestinal perforation is known to be one of the fatal adverse events of bevacizumab. In this case four gastrointestinal perforations were observed. Isolation of enteric contents is important to heal the wound and VAC is an effective therapy for the management of open abdominal wounds even with enterocutaneous fistulae. Conclusion Innovative VAC use for the management of open abdominal wounds can improve the nutritional status and overall wound healing of the patient. PMID:26599504

  2. Traumatic Intrarenal Arteriovenous Fistula Treated by Conservative ...

    African Journals Online (AJOL)

    1974-06-01

    Jun 1, 1974 ... with these vascular lesions.' Varela' in 1928 reported the first case of intrarenal arteriovenous fistula. Arteriovenous fistula of the kidney is an ... and penetrating abdominal trauma, this lesion will be encountered with increasing frequency. Selective renal artery catheterisation aids materially in making the.

  3. Operative treatment of radiation-induced fistulae

    International Nuclear Information System (INIS)

    Balslev, I.; Harling, H.

    1987-01-01

    Out of 136 patients with radiation-induced intestinal complications, 45 had fistulae. Twenty-eight patients had rectovaginal fistulae while the remainder had a total of 13 different types of fistulae. Thirty-seven patients were treated operatively and eight were treated conservatively. Thirty-three patients were submitted to operation for rectal fistulae. Of these, 28 were treated by defunctioning colostomy, three were treated by Hartmann's method and resection and primary anastomosis was carried out in two patients. In the course of the period of observation, 35% of the patients developed new radiation damage. The frequency in the basic material without fistulae was 21% (0.05< p<0.10). Following establishment of defunctioning colostomy on account of rectovaginal fistulae in 25 patients, eight patients developed new fistulae, Significantly more patients with fistulae died of recurrence as compared with patients with other lesions (p<0.01). Defunctioning colostomy in the treatment of rectal fistula is a reasonable form of treatment in elderly patients and in case of recurrence. Younger patients should be assessed in a special department in view of the possibility of a sphincter-preserving procedure following resection of the rectum and restorative anastomosis. (author)

  4. Operative treatment of radiation-induced fistulae

    Energy Technology Data Exchange (ETDEWEB)

    Balslev, I.; Harling, H.

    1987-01-01

    Out of 136 patients with radiation-induced intestinal complications, 45 had fistulae. Twenty-eight patients had rectovaginal fistulae while the remainder had a total of 13 different types of fistulae. Thirty-seven patients were treated operatively and eight were treated conservatively. Thirty-three patients were submitted to operation for rectal fistulae. Of these, 28 were treated by defunctioning colostomy, three were treated by Hartmann's method and resection and primary anastomosis was carried out in two patients. In the course of the period of observation, 35% of the patients developed new radiation damage. The frequency in the basic material without fistulae was 21% (0.05fistulae in 25 patients, eight patients developed new fistulae, Significantly more patients with fistulae died of recurrence as compared with patients with other lesions (p<0.01). Defunctioning colostomy in the treatment of rectal fistula is a reasonable form of treatment in elderly patients and in case of recurrence. Younger patients should be assessed in a special department in view of the possibility of a sphincter-preserving procedure following resection of the rectum and restorative anastomosis. 11 refs.

  5. [Dural arteriovenous fistula involving the superior sagittal and transverse-sigmoid sinuses, treated by thrombolysis: case report].

    Science.gov (United States)

    Arai, T; Ohno, K; Yoshino, Y; Tanaka, Y; Nariai, T; Hirakawa, K; Nemoto, S

    1997-07-01

    A rare case of dural arteriovenous fistula (DAVF) in the superior sagittal sinus (SSS), the transverse sinus and the sigmoid sinus is reported. A 64-year-old man, who had had an episode of temporary visual disturbance after moderate fever for a week about 20 years before, was aware of loss of visual acuity and reduced field of view in the right eye. When he was introduced to our outpatient service, increased intracranial pressure (ICP) was detected by lumbar puncture. Cerebral angiograms showed bilateral DAVFs both in the posterior fossa and the SSS concomitant with thrombosis in the transverse sinus, sigmoid sinus and SSS. Afterwards, endovascular transarterial embolization through bilateral occipital, posterior auricular and left middle meningeal, superior temporal arteries was carried out. In addition, transvenous thrombolytic therapy using a catheter inserted into SSS resulted in the improvement of his visual problems. Although he was discharged at once, he was readmitted to our department with Foster Kennedy syndrome and increased ICP. Cerebral angiograms showed recurrence of both DAVF and sinus thrombosis. Transarterial embolization was performed again resulting in a significant reduction of DAVF, and his visual acuity was recovered to a moderate degree. The origin of DAVF is still controversial. Although two theories, "congenital" and "acquired", are put forward, it has been thought that both factors play important roles. In our case, the patient had stenosis in the jugular canal portions of the sigmoid sinus. In addition, sinus thrombosis seemed to have occurred. It is thought that increased intrasinus pressure may have lead to communication with surrounding arteries through existing dural vessels. We applied transvenous thrombolytic therapy in this case. Our result suggests that we should consider this therapy for some cases of DAVF.

  6. [A Case of Carcinoma Associated with an Anal Fistula Repaired Using a Hatchet Flap after Neoadjuvant Chemoradiotherapy].

    Science.gov (United States)

    Kuroda, Masatoshi; Ikeda, Eiji; Yokoyama, Nobuji; Kenmotsu, Masaichi; Takagi, Shoji; Yamano, Toshihisa

    2016-11-01

    The patient was a 53-year-old man who complained of perianal pain. He had a 20-year history of an anal fistula. There was a 10 cm tumor with mucin-like discharge on the left side of the anus. His CEA level was high, at 7.3 ng/mL, and T2-weighted MRI revealed a multilocular cystic tumor with high signal intensity. The second biopsy result indicated mucinous adenocarcinoma. We performed neoadjuvant chemoradiotherapy. The chemotherapy regimen was TS-1 with radiation therapy, along with 4-port irradiation(50.4 Gy)of the primary tumor, located at the interior of the pelvis and inguinal lymph nodes. At the time of treatment completion, a partial response(PR)was observed, and a complete response(CR)was obtained after 6 months. We performed laparoscopic abdominoperineal resection. The large defect in the perianal skin and the pelvic cavity was repaired using a hatchet flap. The final diagnosis was confirmed as mucinous adenocarcinoma, pT4b, ly0, v0, N0, pPM0, pDM0, pRM0, pStage II . The patient was discharged 20 days after surgery. There is no indication of recurrence of the cancer after 1 year, and he continues to visit the outpatient clinic for regular follow-ups. Neoadjuvant chemoradiotherapy was effective in this case.

  7. Open wound management of esophagocutaneous fistula in unstable cervical spine after corpectomy and multilevel laminectomy: A case report and review of the literature.

    Science.gov (United States)

    Elgafy, Hossein; Khan, Mustafa; Azurdia, Jacob; Peters, Nicholas

    2017-08-18

    A 67-year-old female patient developed an esophagocutaneous fistula 4 mo after C4 and C5 partial corpectomy. Plain radiograph and computed tomography (CT) scan of cervical spine showed inferior screws pullout with plate migration that caused the esophageal perforation. Management included removal of anterior hardware, revision C4-5 corpectomy, iliac crest strut autograft and halo orthosis immobilization. The fistula was treated using antibiotics and a 10-french gauge rubber tube for daily irrigation and Penrose drain. At 3 mo, the esophagocutaneous fistula healed and the patient resumed oral feeding. Six months follow-up CT scan showed sound fusion with graft incorporation. At two-year follow-up, patient denied any neck pain or dysphagia. This case report presents a successful outcome of a conservative open wound management without attempted repair. The importance of this case report is to highlight this treatment method that may be considered in such a rare complication particularly if surgical repair failed.

  8. “Spontaneous” CSF Fistula due to Transtegmental Brain Herniation in Combination with Signs of Increased Intracranial Pressure and Petrous Bone Hyperpneumatization: An Illustrative Case Report

    Science.gov (United States)

    Rivera, Diones; Fermin-Delgado, Rafael; Stoeter, Peter

    2014-01-01

    Background and Importance Transtegmental brain herniation into the petrous bone is a rare cause of rhinoliquorrhea. Our case presents a combination of several typical clinical and imaging findings illustrating the ongoing etiologic discussion of such cerebrospinal fluid (CSF) fistulas. Clinical Presentation A 53-year-old man presented with nasal discharge after a strong effort to suppress coughing. Imaging revealed a transtegmental herniation of parts of the inferior temporal gyrus into the petrous bone and in addition a combination of signs of chronically increased intracranial pressure and a hyperpneumatization of the petrous bone. The fistula was closed by a middle cranial fossa approach. Conclusion The case illustrates the two main predisposing factors for development of petrous bone CSF fistulas: increased intracranial pressure and thinning of the tegmental roof due to extensive development of air cells. Because the CSF leakage repair does not change the underlying cause, patients have to be informed about the possibility of developing increased intracranial pressure and recurrences of brain herniations at other sites. PMID:25485224

  9. Radiological findings in biliary fistula and gallstone ileus

    International Nuclear Information System (INIS)

    Oikarinen, H.; Paeivaensalo, M.; Tikkakoski, T.; Saarela, A.

    1996-01-01

    Purpose: Biliary fistual and gallstone ileus are rarely found. The diagnosis is difficult and may be delayed until operation. We reviewed the radiological findings in a retrospective material. Material and Methods: The cases of 16 patients treated for biliary fistula were analyzed with respect to findings at imaging. Ten patients had a spontaneous fistula. Nine of them had an internal bilioduodenal fistula and one had an external fistula with stones passing through a subcutaneous abscess. Five patients also had gallstone ileus and one patient a rare gastric outlet obstruction caused by a gallstone (Bouveret's syndrome). Six patients had an iatrogenic fistula. One of them had internal bile ascites and 5 an external fistula, one of which was a biliocystic fistula resulting from attempted hepatic cyst sclerotherapy. Results: Various imaging modalities were used and there was often a delay in the diagnosis. Imaging did not show the fistula itself in any of the spontaneous cases. However, a nonvisualized or shrunken gallbladder seen at US often coexisted in these cases. CT yielded the diagnosis in one case of gallstone ileus, and a Gastrografin metal yielded it in the case of Bouveret's syndrome. Fistulography and cholangiography provided a correct diagnosis of fistula in all cases of iatrogenic biliocutaneous fistulas. Conclusion: Patients with biliary fistula usually undergo examinations with nonspecific results. The imaging findings could be more specific if the possibility of this diagnosis were remembered. (orig.)

  10. Radiological findings in biliary fistula and gallstone ileus

    Energy Technology Data Exchange (ETDEWEB)

    Oikarinen, H. [Univ. Hospital, Oulu (Finland). Dept. of Diagnostic Radiology; Paeivaensalo, M. [Univ. Hospital, Oulu (Finland). Dept. of Diagnostic Radiology; Tikkakoski, T. [Univ. Hospital, Oulu (Finland). Dept. of Diagnostic Radiology; Saarela, A. [Univ. Hospital, Oulu (Finland). Dept. of Surgery

    1996-11-01

    Purpose: Biliary fistual and gallstone ileus are rarely found. The diagnosis is difficult and may be delayed until operation. We reviewed the radiological findings in a retrospective material. Material and Methods: The cases of 16 patients treated for biliary fistula were analyzed with respect to findings at imaging. Ten patients had a spontaneous fistula. Nine of them had an internal bilioduodenal fistula and one had an external fistula with stones passing through a subcutaneous abscess. Five patients also had gallstone ileus and one patient a rare gastric outlet obstruction caused by a gallstone (Bouveret`s syndrome). Six patients had an iatrogenic fistula. One of them had internal bile ascites and 5 an external fistula, one of which was a biliocystic fistula resulting from attempted hepatic cyst sclerotherapy. Results: Various imaging modalities were used and there was often a delay in the diagnosis. Imaging did not show the fistula itself in any of the spontaneous cases. However, a nonvisualized or shrunken gallbladder seen at US often coexisted in these cases. CT yielded the diagnosis in one case of gallstone ileus, and a Gastrografin metal yielded it in the case of Bouveret`s syndrome. Fistulography and cholangiography provided a correct diagnosis of fistula in all cases of iatrogenic biliocutaneous fistulas. Conclusion: Patients with biliary fistula usually undergo examinations with nonspecific results. The imaging findings could be more specific if the possibility of this diagnosis were remembered. (orig.).

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

    International Nuclear Information System (INIS)

    Liu, H.M.; Shih, H.C.; Huang, Y.C.; Wang, Y.H.

    2001-01-01

    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.)

  12. 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.)

  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. A case with fistula formation between a perinephric retroperitoneal abscess and the duodenum: successful outcome after conservative management.

    Science.gov (United States)

    Matsuki, Masahiro; Takahashi, Satoshi; Hisasue, Shin-Ichi; Muranaka, Takashi; Takayanagi, Akio; Maehana, Takeshi; Uehara, Teruhisa; Masumori, Naoya; Tsukamoto, Taiji

    2011-08-01

    A 67-year-old woman diagnosed with pyonephrosis and perinephric abscess because of an impacted urinary stone in the pelvicoureteric junction was admitted to the hospital with a high-grade fever. Although construction of a right nephrostomy for drainage of the abscess improved her general condition, she had a fever again 2 weeks after the initial treatment. Computed tomography revealed a persistent perinephric retroperitoneal abscess and a second drainage procedure was performed. Then, imaging examination revealed fistula formation between the cavity of the perinephric retroperitoneal abscess and the duodenum. The patient received conservative management including percutaneous drainage, discontinuation of oral intake, and antimicrobial chemotherapy. Three days after the second drainage and discontinuation of oral intake, imaging examination revealed complete closure of the fistula. Fistula formation between a perinephric abscess and the duodenum is very rare but a favorable outcome was obtained by our conservative management.

  15. Martius procedure revisited for urethrovaginal fistula

    Directory of Open Access Journals (Sweden)

    N P Rangnekar

    2000-01-01

    Full Text Available Background: Urethrovaginal fistula is a dreadful com-plication of obstetric trauma due to prolonged labour or obstetric intervention commonly seen in developing coun-tries. Due to prolonged ischaemic changes, the fistula is resistant to healing. The strategic location of the fistula leads to postoperative impairment of continence mecha-nism. Anatomical repair was previously the commonest mode of surgical management, but was associated with a miserable cumulative cure rate ranging from 16-60%. Hence we tried to study the efficacy of Martius procedure in the management of urethrovaginal fistula. Material and Methods: We studied the outcome of 12 urethrovaginal fistulae, all caused by obstetric trauma, treated surgically with Martius procedure in 8 and with anatomical repair in 4, retrospectively. 9 patients had re-current fistulae while I patient had multiple fistulae. Pa-tients were followed up for the period ranging from 6 months to 4′/2 years for fistula healing, continence and postoperative complications like dvspareunia. Results: Cumulative cure rate ofMartius procedure was 87.5% with no postoperative stress incontinence, while fistula healing rate of anatomical repair was only 25% (I patient out of 4 which was also complicated by Intrin-sic Sphincter Deficiency (ISD. In case of recurrent fistu-lae the success rate of anatomical repair was 0% compared to 83.33% with Martius procedure. Conclusions: Martius procedure has shown much bet-ter overall cure rate compared to anatomical repair be-cause - a it provides better reinforcement to urethral suture line, b it provides better blood supply and lymph drainage to the ischaemic fistulous area, c provides sur-face for epithelialization and, d helps to maintain conti-nence. Hence we recommend Martius procedure as a surgical modality for the treatment of urethrovaginal fis-tula.

  16. MR evaluation of CSF fistulae

    International Nuclear Information System (INIS)

    Gupta, V.; Goyal, M.; Mishra, N.; Gaikwad, S.; Sharma, A.

    1997-01-01

    Purpose: To evaluate the role of MR imaging in the localisation of cerebrospinal fluid (CSF) fistulae. Material and Methods: A total of 36 consecutive unselected patients with either clincally proven CSF leakage (n=26) or suspected CSF fistula (n=10) were prospectively evaluated by MR. All MR examinations included fast spin-echo T2-weighted images in the 3 orthogonal planes. Thin-section CT was performed following equivocal or negative MR examination. MR and CT findings were correlated with surgical results in 33 patients. Results: CSF fistula was visualised as a dural-bone defect with hyperintense fluid signal continuous with that in the basal cisterns on T2-weighted images. MR was positive in 26 cases, in 24 of which the fistula was confirmed surgically. In 2 patients the CSF leakage was directly demonstrated on MR. MR sensitivity of 80% compared favourably with the reported 46-81% of CT cisternography (CTC). No significant difference in MR sensitivity in detecting CSF fistula was found between active and inactive leaks. (orig.)

  17. Large Urethro-Vesico-Vaginal Fistula due to a Vaginal Foreign Body in a 22-Year-Old Woman: Case Report and Literature Review.

    Science.gov (United States)

    D'Elia, Carolina; Curti, Pierpaolo; Cerruto, Maria Angela; Monaco, Carmelo; Artibani, Walter

    2015-01-01

    In the non-industrialized countries of Africa and Asia obstetric fistulas are more frequently caused by prolonged labour, whereas in countries with developed healthcare systems they are generally the result of complications of gynaecological surgery or, rarely, benign pathologies like inflammation or foreign bodies. A 22-year-old woman was brought to the gynaecology clinic because of foul-smelling vaginal discharge. On pelvic examination a ring-like foreign body was impacted between the anterior and posterior vaginal wall. MRI scan confirmed the presence of a cylindrical foreign body in the vagina and the patient revealed that she had 'involuntarily' inserted a plastic bubble bath cap into the vagina. At surgery removal of the cap was difficult and at the end of the manoeuver evidence of a huge urethro-vesico-vaginal fistula occurred. The patient was discharged with bilateral ureteral stents and suprapubic catheter. After 3 months we performed an end-to-end anastomotic urethroplasty to repair the urethral avulsion and restored the bladder/trigonal and vaginal/cervical defects with 3 layers of sutures; 3 months later the patient had no complaints. Complex genital fistulas represent an extremely debilitating morbidity. In our case, a vaginal approach was successful, but the choice between an abdominal or vaginal approach depends on the surgeon's experience and training. © 2015 S. Karger AG, Basel.

  18. Extracorporeal membrane oxygenator as a bridge to successful surgical repair of bronchopleural fistula following bilateral sequential lung transplantation: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    Machaal Ali

    2007-06-01

    Full Text Available Abstract Background Lung transplantation (LTx is widely accepted as a therapeutic option for end-stage respiratory failure in cystic fibrosis. However, airway complications remain a major cause of morbidity and mortality in these patients, serious airway complications like bronchopleural fistula (BPF are rare, and their management is very difficult. Case presentation A 47-year-old man with end-stage respiratory failure due to cystic fibrosis underwent bilateral sequential lung transplantation. Severe post-operative bleeding occurred due to dense intrapleural adhesions of the native lungs. He was re-explored and packed leading to satisfactory haemostasis. He developed a bronchopleural fistula on the 14th post-operative day. The fistula was successfully repaired using pericardial and intercostal vascular flaps with veno-venous extracorporeal membrane oxygenator (VV-ECMO support. Subsequently his recovery was uneventful. Conclusion The combination of pedicled intercostal and pericardial flaps provide adequate vascular tissue for sealing a large BPF following LTx. Veno-venous ECMO allows a feasible bridge to recovery.

  19. [Surgical treatment of the perianal and rectovaginal fistulas by means of Surgisis AFP anal fistula plug].

    Science.gov (United States)

    Yaramov, N; Sokolov, M; Angelov, K; Petrov, B; Pavlov, V

    2010-01-01

    Symptoms of painful and uncomfortably occurred in patients with anal and rectovaginal fistulas witch worsened their quality of life. The introduce of Biodesign Fistula Plug is called "dramatic jump in surgery of the fistulas". We can avoid from the traditionally and technicaly difficult treatment of perianal and rectovaginal fistulas through this advice. Therefore like this surgeons can avert frequently complications of the anal sphyncteric apparatus like incontinence or stenosis. We have only two cases like attempt for now but with excellent result followed up about 31 and 33 months.

  20. Spinal extradural arteriovenous fistula with intradural drainage: three surgical cases with long-term follow-up.

    Science.gov (United States)

    Vázquez, Enrique J; Gefaell, Joaquín; Fernandez, Leticia; López, Eva; Areitio, Eduardo; Elexpuru, Jose A

    2017-06-01

    Spinal extradural arteriovenous fistulas (SEDAVF) with intradural drainage are uncommon vascular lesions that cause venous congestive myelopathy. We present three SEDAVF with intradural drainage treated with surgical disconnection of the intradural drainage via a single level laminectomy, followed by transarterial embolization (TAE) with Onyx if spontaneous thrombosis of the extradural fistula did not occur spontaneously. All patients improved their neurological condition and no congestive myelopathy recurrence was noted after mean follow-up of 84 months. We believe that SEDAVF with intradural drainage constitute a specific entity that should be included in the classifications of spinal arteriovenous malformations.

  1. Embolotherapy of an Arterioportal Fistula

    International Nuclear Information System (INIS)

    Chen, Qi; Tack, Carl; Morcos, Morcos; Ruggiero, Mary Ann; Schlossberg, Peter; Fogel, Joshua; Weng Lijun; Farkas, Jeffrey

    2007-01-01

    We present a complex case of a splanchnic arterioportal vein fistula in a patient who presented with weight loss, abdominal pain, diarrhea, and pancreatitis. We report successful use of the Guglielmi Detachable Coil (GDC) and N-butyl cyanoacrylate glue for the therapeutic embolization of the fistula between the superior mesenteric artery, the common hepatic artery, and the portal vein. On the day following the procedure, the patient reported total remission of the abdominal pain and diarrhea. These results were maintained at 3 months follow-up

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  3. Milk Fistula: Diagnosis, Prevention, and Treatment.

    Science.gov (United States)

    Larson, Kelsey E; Valente, Stephanie A

    2016-01-01

    Milk fistula is an uncommon condition which occurs when there is an abnormal connection that forms between the skin surface and the duct in the breast of a lactating woman, resulting in spontaneous and often constant drainage of milk from this path of least resistance. A milk fistula is usually a complication that results from a needle biopsy or surgical intervention in a lactating patient. Here, the authors present an unusual case of a spontaneous milk fistula which developed from an abscess in the breast of a lactating woman. The patient initially presented to the office with a large open wound on her breast, formed from skin breakdown, within which milk was pooling. She was treated with local wound care and cessation of breastfeeding, with appropriate healing of the wound and closure of the fistula with 6 weeks. Diagnosis, prevention, and treatment of milk fistula were reviewed. © 2015 Wiley Periodicals, Inc.

  4. [Simultaneous diagnosis of pseudomeningocele, tethered cord syndrome and cerebrospinal fluid fistula: Report of a case].

    Science.gov (United States)

    Quillo-Olvera, Javier; Zambrano-Velarde, Luis E; Velázquez-Santana, Héctor; Gutiérrez-Partida, Carlos F; Velázquez-García, Francisco; Alcántara-Gómez, Leopoldo A

    2016-01-01

    The clinical case is presented on a patient with an extensive sacral dysraphism, a history of myelomeningocele surgical repair in her childhood, as well as tethered cord syndrome. The patient was also diagnosed with pseudomeningocele and a cerebrospinal fluid cutaneous fístula. A surgical approach was used, with encouraging results being obtained in the clinical outcome of the patient. A review of the literature was performed to support the surgical decision in this case. Copyright © 2015 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  5. 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.

  6. Vesicouterine fistula and blind vagina

    International Nuclear Information System (INIS)

    Hafeez, M.; Hameed, S.; Asif, S.

    2003-01-01

    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)

  7. A case of rectovagino-vesical fistula due to radiation therapy for uterine cancer treated with covered expandable metallic stent

    Energy Technology Data Exchange (ETDEWEB)

    Ohtsukasa, Shunroh; Okabe, Satoshi; Tanami, Hideaki [Tokyo Medical and Dental Univ. (Japan). School of Medicine] (and others)

    2002-04-01

    A 65-year-old woman had received a panhysterectomy and radiation therapy for a uterine cancer in 1974 and underwent a drainage operation for a peritonitis due to rupture of the bladder associated with radiation cystitis in 1983. A rectovesical fistula was revealed and partial resection of the bladder and rectum was performed in 1996. In 1998, rectovesical fistula recurred and symptom of fecaluria and contact-type dermatitis at perineal region subsequently worsened. In February, 2000, colonoscopy and gastrograffin-enema revealed a giant recto-vagino-vesical fistula. Although we recommended ileostomy, the patient refused our offer. She gave informed consent to our proposal about the insertion of a covered expandable metallic stent (EMS) into the rectum to treat for fecaluria. After insertion of a covered EMS, fecaluria and contact-type dermatitis at perineal region subsequently improved. Three months later, fecaluria appeared again. Finally, seven months later, severe inflammation occurred at perineal and pubic region because of migration of the covered EMS into the bladder, then we removed the covered EMS and performed ileostomy. It is difficult to use the covered EMS treatment for benign rectovesical or rectovaginal fistula for a long term. (author)

  8. Endovascular treatment of a bleeding secondary aorto-enteric fistula. A case report with 1-year follow-up.

    Science.gov (United States)

    Brountzos, Elias N; Vasdekis, Spyros; Kostopanagiotou, Georgia; Danias, Nikolaos; Alexopoulou, Efthymia; Petropoulou, Konstantina; Gouliamos, Athanasios; Perros, Georgios

    2007-01-01

    We report a patient with life-threatening gastrointestinal bleeding caused by a secondary aorto-enteric fistula. Because the patient had several comorbid conditions, we succesfully stopped the bleeding by endovascular placement of a bifurcated aortic stent-graft. The patient developed periaortic infection 4 months later, but he was managed with antibiotics. The patient is well 1 year after the procedure.

  9. Pancreatitis, panniculitis and polyarthritis (PPP-) syndrome caused by post-pancreatitis pseudocyst with mesenteric fistula. Diagnosis and successful surgical treatment. Case report and review of literature.

    Science.gov (United States)

    Dieker, Wulf; Derer, Johannes; Henzler, Thomas; Schneider, Alexander; Rückert, Felix; Wilhelm, Torsten J; Krüger, Bernd

    2017-01-01

    Pancreatitis, panniculitis and polyarthritis syndrome is a very rare extra-pancreatic complication of pancreatic diseases. While in most cases this syndrome is caused by acute or chronic pancreatitis, we report a case of a 62-year-old man presenting with extensive intraosseous fat necrosis, polyarthritis and panniculitis caused by a post-pancreatitis pseudocyst with a fistula to the superior mesenteric vein and extremely high blood levels of lipase. This became symptomatic 2.5 years after an episode of acute pancreatitis and as in most cases abdominal symptoms were absent. Treatment by surgical resection of the pancreatic head with the pseudocyst and mesenteric fistula led to complete remission of all symptoms. A review of the literature revealed that all publications are limited to case reports. Most authors hypothesize that an unspecific damage can cause a secretion of pancreatic enzymes to the bloodstream leading to a systemic lipolysis and fat tissue necrosis, especially of subcutaneous tissue, bone marrow, inducing panniculitis, polyarthritis and osteonecrosis. Even if caused by an acute pancreatitis abdominal symptoms are often mild or absent in most cases leading to misdiagnosis and poor prognosis. While symptomatic treatment with NSAR and cortisone showed poor to moderate response, causal treatment can be successful depending on the underlying pancreatic disease. Copyright © 2017. Published by Elsevier Ltd.

  10. Fístula esofagopleurocutánea de tercio medio: A propósito de un caso ESOPHAGOPLEUROCUTANEOUS FISTULA OF THE MEAN THIRD: APROPOS OF A CASE

    Directory of Open Access Journals (Sweden)

    Orestes N Mederos Curbelo

    2004-06-01

    Full Text Available La presencia de una fístula esofagopleurocutánea es un problema complejo. Se presenta un caso de difícil solución por los antecedentes oncológicos y la presencia de una fístula esofagopleurocutánea. Paciente del sexo masculino, con antecedentes de neumonectomía derecha por cancer de pulmón 10 años antes, con fístula torácica de un año de evolución y pérdida de 16,36 kg (36 lb de peso, tratado satisfactoriamente con una técnica de exclusión del proceso fistuloso mediante esofagogastroplastia tubular por vía retroesternal con anastomosis cervical (técnica de Postleitwait. Al cerrar el esófago se dejó la fístula por exclusión en la región cervical distal a la anastomosis. La fístula cerró completamente a las dos semanas y el paciente egresó, también a las dos semanas, con el tránsito digestivo restablecido. El paciente tenía el hemitórax congelado por neumonectomía, lo cual hizo imposible la intervención directa y la exclusión resultó el único método posible. La esofagogastroplastia tubular retroesternal solucionó un problema complejo.The presence of an esophagopleurocutaneous fistula is a complex problem. A case of difficult solution due to the oncological history and the existance of an esophagopleurocutaneous fistula is reported. A male patient with history of right pneumonectomy due to lung cancer 10 years before, with thoracic fistula of a year of evolution and loss of 16.36 kg (36 pounds of weight, that was satisfactorily treated with an exclusion technique of the fistulous process by retrosternal tubular esophagogastroplasty with cervical anastomosis (Postleitwait's technique is presented. On clousering the esophagus, the fistula was left by exclusion in the cervical region distal to anastomosis. The fistula closed completely at 2 weeks and the patient was discharged with the digestive tract restored. The patient's hemithorax was frozen by pneumonectomy, which impeded the direct surgery. The exclusion

  11. Double pylorus through antrobulbar fistula formation

    International Nuclear Information System (INIS)

    Hermanns, P.M.; Iben, G.; Ostermann, E.; Vogel, H.; Hamburg Univ.

    1980-01-01

    Three patients are presented with double pylori due to antrobulbary fistulas after penetration of ulcers through the prepyloric mucosa or the pyloric ring. Two cases were diagnosed radiographically; in one of them the diagnosis was confirmed by gastroscopy and verified by subsequent operation. The third case was revealed at autopsy. The etiology and pathogenesis of fistulas within the gastrointestinal tract are discussed with regard to the current literature. (orig.) [de

  12. Iliac arterial-enteric fistulas occurring after pelvic irradiation

    International Nuclear Information System (INIS)

    Vetto, J.T.; Culp, S.C.; Smythe, T.B.; Chang, A.E.; Sindelar, W.F.; Sugarbaker, P.H.; Heit, H.A.; Giordano, J.M.; Kozloff, L.

    1987-01-01

    Fistulas from the iliac artery to the bowel constitute a condition that is often lethal. Excluding fistulas related to vascular grafts, a review of previously reported cases shows that they are most often due to atherosclerotic iliac aneurysms. Three unusual cases of this condition that occurred after high-dose pelvic irradiation for treatment of cancer are presented; in no case was recurrent tumor evident. These cases suggest that high-dose pelvic irradiation can predispose to the formation of iliac arterial-enteric fistulas, particularly if sepsis or inflammation develops. The definitive surgical management of these fistulas entails bowel resection, arterial ligation, and extra-anatomic bypass

  13. Noninvasive Demonstration of Dual Coronary Artery Fistulas to Main Pulmonary Artery with 64-Slice Multidetector-Computed Tomography: A Case Report

    Directory of Open Access Journals (Sweden)

    Yoshiki Noda

    2010-01-01

    Full Text Available Coronary artery fistulas, including coronary pulmonary fistulas, are usually discovered accidently among the adult population when undergoing invasive coronary angiographies. We report here a 58-year-old woman with dual fistulas originating from the left anterior descending coronary artery and right coronary sinus to the main pulmonary artery, demonstrating noninvasively with multidetector-computed tomography (MDCT and transthoracic echocardiography (TTE.

  14. Acute Cholangitis following Biliary Obstruction after Duodenal OTSC Placement in a Case of Large Chronic Duodenocutaneous Fistula

    Directory of Open Access Journals (Sweden)

    Yaseen Alastal

    2015-01-01

    Full Text Available Over-the-Scope Clip system, also called “Bear Claw,” is a novel endoscopic modality used for closure of gastrointestinal defect with high efficacy and safety. We present a patient with history of eosinophilic gastroenteritis and multiple abdominal surgeries including Billroth II gastrectomy complicated by a large chronic duodenocutaneous fistula from a Billroth II afferent limb to the abdominal wall. Bear Claw clip was used for closure of this fistula. The patient developed acute cholangitis one day after placement of the Bear Claw clip. Acute cholangitis due to papillary obstruction is a potential complication of Bear Claw placement at the dome of the duodenal stump (afferent limb in patient with Billroth II surgery due to its close proximity to the major papilla.

  15. Esophago-pleural fistula with multiple esophageal ulcers in human immunodeficiency virus infected patients: A case report

    International Nuclear Information System (INIS)

    Kwon, Soo Hee; Lee, Young Kyung; Choi, Jae Phil; Son, Jin Sung

    2014-01-01

    Esophagitis is a common complication in patients with human immunodeficiency virus (HIV) infection. Esophagitis in HIV infected patient is caused by candidiasis, cytomegalovirus, herpes simplex virus, or idiopathic esophagitis with no detectable etiology. Esophagitis in HIV infected patient is occasionally combined with esophageal ulcers. We report chest CT findings and clinical manifestation of esophago-pleural fistula with pneumothorax in a HIV infected patient, who was treated for aspiration pneumonia and esophageal ulcers.

  16. Esophago-pleural fistula with multiple esophageal ulcers in human immunodeficiency virus infected patients: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Soo Hee; Lee, Young Kyung; Choi, Jae Phil; Son, Jin Sung [Seoul Medical Center, Seoul(Korea, Republic of)

    2014-03-15

    Esophagitis is a common complication in patients with human immunodeficiency virus (HIV) infection. Esophagitis in HIV infected patient is caused by candidiasis, cytomegalovirus, herpes simplex virus, or idiopathic esophagitis with no detectable etiology. Esophagitis in HIV infected patient is occasionally combined with esophageal ulcers. We report chest CT findings and clinical manifestation of esophago-pleural fistula with pneumothorax in a HIV infected patient, who was treated for aspiration pneumonia and esophageal ulcers.

  17. 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.)

  18. 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.

  19. Causes and management of postoperative enterocutaneous fistulas

    International Nuclear Information System (INIS)

    Memon, A.S.; Siddiqui, F.G

    2004-01-01

    Objective: To identify the causes of postoperative enterocutaneous fistulas and to evaluate the results of conservative and operative treatment including the effectiveness of octreotide in the management of these fistulas. Subjects and Methods: Forty patients with postoperative fistula were studied. Demographic variables, causes and management outcome was observed and recorded. Results: There were 25 males and 15 females with 50% of the patients being in age group of 21-30 years. Emergency surgery for typhoid perforation(45%) and intestinal tuberculosis (30%) were the commonest causes. Ileum and jejunum were the commonest sites of fistulation found in 85% cases. Twenty-one patients were started on conservative treatment with spontaneous closure occurring in 15 (71.4%) patients. Nineteen patients were operated within three days of admission due to generalized peritonitis (73.7%) and local intra-abdominal collections (26.3%). Wound infection was the commonest complication in the operative group. The mortality rate in this series was 7.5%. All the deaths occurred following surgery. Conclusion: Postoperative enterocutaneous fistula has a high morbidity and a significant mortality. Sepsis in the peritoneal cavity is the major cause of mortality. Conservative treatment has a good outcome for these fistulas. The use of octreotide is highly recommended as it definitely converts high output fistulas to low output fistulas. (author)

  20. Spinal cord giant arteriovenous fistulae

    International Nuclear Information System (INIS)

    Aymard, A.; Reizine, D.; Marciano, S.; Cervigon, E.G.; Gelbert, F.; Merland, J.J.

    1988-01-01

    Giant extramedullary arteriovenous fistulas fed by spinal arteries are a rare type of spinal cord arteriovenous malformation. Among 11 patient (mean age, 20 years) with spinal hemorrhage in childhood, progressive paraplegia, and myelographic and angiographic diagnosis, magnetic resonance imaging demonstrated the precised extramedulary location and complications (thrombosis 1). Angiography showed dilated spinal arteries feeding giant, high flow fistulas with much venous drainage. Endovascular treatment was performed in 11 cases, with balloons in seven, particulate embolization in three, and polymerizing agents in one. Complete closures of the shunt with clinical improvement was achieved in seven cases and partial closure with partial clinical recovery in two; there was one case each of paraplegia due to involuntary venous blockage by the balloon, and fatal bulbomedullary stroke in particulate embolization of cervical location. Careful endovascular techniques represent a valuable treatment in this severe pathology

  1. Bronchobiliary Fistula Evaluated with Magnetic Resonance Imaging

    International Nuclear Information System (INIS)

    Ragozzino, A.; Rosa, R. De; Galdiero, R.; Maio, A.; Manes, G.

    2005-01-01

    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

  2. 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

    Directory of Open Access Journals (Sweden)

    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.

  3. Severe loin pain following renal biopsy in a high-risk patient: A case report of a rare combination of pseudoaneurysm and arterio-venous fistula

    Directory of Open Access Journals (Sweden)

    Desai Madhav

    2011-01-01

    Full Text Available We report a 50-year-old male patient with diabetes mellitus and hypertension who presented with low-grade fever, anuria and renal failure. He had no prior history of nephropathy and retinopathy. Since anuria persisted, a renal biopsy was performed using automated gun, under ultrasound guidance. Two hours after the renal biopsy was performed, the patient developed severe left loin pain that required analgesics and sedatives. Ultrasound of the abdomen performed immediately, two hours and four hours after the biopsy, did not reveal any hematoma. The hemoglobin was stable when the patient developed loin pain, but after eight hours decreased to 9.1 g/dL, and computed tomography scan of the abdomen revealed a big peri-nephric hematoma around the left kidney. He was managed with blood transfusions and a selective angiogram was done. It revealed a pseudoaneurysm and arterio-venous fistula from the segmental artery of lower pole of the left kidney; both were closed by using microcoils and liquid embolic agent N-butyl-cyanoacrylate (NBCA. The only risk factor the patient had at the time of renal biopsy was severe renal failure. Our case suggests that severe loin pain immediately after renal biopsy in a patient with renal failure warrants careful follow-up of hemoglobin and imaging, even if initial imaging is normal. Further fall of hemoglobin necessitates early evaluation with angiogram, which helps in diagnosing the treatable, although rare, complications like pseudoaneurysm and arterio-venous fistula.

  4. Nodo-colonic fistula caused by intra-abdominal tuberculous lymphadenitis during treatment with anti-tuberculous medication: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Kyung Sun; Bae, Kyung Eun; Jeong, Myeong Ja; Lee, Ji Hae; Kang, Mi Jin; Kim, Jae Hyung; Kim, Soo Hyun [Dept. of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2016-08-15

    Recently, the overall incidence of tuberculosis has decreased, but the incidence of an extrapulmonary manifestation in patients with tuberculosis has increased in the Republic of Korea. Although intestinal tuberculosis is not infrequent, a fistula caused by tuberculosis is a rare condition. A 23-year-old man presented with fever, diarrhea and right lower quadrant pain. A computed tomography (CT) scan revealed a lobulated, peripherally enhancing, low density mass in the mesentery. The patient underwent laparoscopic biopsy for necrotic lymph node, and intra-abdominal tuberculous lymphadenitis was diagnosed. Four months after initiating treatment with anti-tuberculous medication, the patient developed fever together with lower abdominal pain. A follow-up CT scan revealed a fistulous tract that had developed between the initially noted lymphadenopathy and the proximal ascending colon. Laparoscopic right hemicolectomy was performed as a curative treatment. This case suggests that a nodo-colonic fistula may occur as a paradoxical response in patients with intra-abdominal tuberculous lymphadenitis during treatment with anti-tuberculous medication.

  5. An algorithm for the physical examination of early fistula failure.

    Science.gov (United States)

    Beathard, Gerald A

    2005-01-01

    Evaluation of a newly created fistula 4-6 weeks after surgery should be considered mandatory. If the fistula is going to become adequate for dialysis, it will be apparent at this time. This evaluation can be accomplished by physical examination. However, it must be performed by someone who is knowledgeable. Using a systematic approach facilitates the evaluation and ensures that a problem is not overlooked. Once it is determined that the fistula is dysfunctional, the case should be immediately referred for management to an interventionalist who is experienced in dealing with early fistula failure. The majority of these cases can be salvaged.

  6. Digestive system fistula: a problem still relevant today.

    Science.gov (United States)

    Głuszek, Stanisław; Korczak, Maria; Kot, Marta; Matykiewicz, Jarosław; Kozieł, Dorota

    2011-01-01

    Digestive system fistula originates most frequently as a complication after surgical procedures, less often occurs in the course of inflammatory diseases, but it can also result from neoplasm and injuries. THE AIM OF THE STUDY was to analyze the causes and retrospectively assess the perioperative procedures as well as the results of digestive system fistula treatment. MATERIAL AND METHODS. Own experience in digestive system fistula treatment was presented. The subject group consisted of 32 patients treated at the General Surgery, Oncology and Endocrinology Clinical Department between 01.05.2005 and 30.04.2010 due to different digestive tract diseases. The causes of the occurrence of digestive system fistula, methods and results of treatment were analyzed. RESULTS. The analysis covered 32 patients with digestive system fistula, among them 15 men and 17 women. Average age for men was 57 years (20-78), and for women 61 years (24-88). In 11 patients idiopathic fistula causally connected with primary inflammatory disease (7 cases) and with neoplasm (4 cases) was diagnosed, in 19 patients fistula was the result of complications after surgery, in 2 - after abdominal cavity injury. Recovery from fistula was achieved in 23 patients (72%) with the use of individually planned conservative therapy (TPN, EN, antibiotics, drainage, and others) and surgery, depending on the needs of individual patient. 5 patients (16%) died, whereas in 4 left (12%) recovery wasn't achieved (fistula in palliative patients, with advanced stages of neoplasm - bronchoesophageal fistula, the recurrence of uterine carcinoma). CONCLUSIONS. Recently the results of digestive system fistula treatment showed an improvement which manifests itself in mortality decrease and shortening of fistula healing time. Yet, digestive system fistula as a serious complication still poses a very difficult surgical problem.

  7. Uteroenteric Fistula Resulting From Fibroid Expulsion After Uterine Fibroid Embolization: Case Report and Review of the Literature

    Energy Technology Data Exchange (ETDEWEB)

    Gutierrez, Luis B., E-mail: lbgutier@stanford.edu [Stanford University, School of Medicine (United States); Bansal, Anshuman K., E-mail: abansal@mednet.ucla.edu [University of California at Los Angeles, Department of Radiology (United States); Hovsepian, David M., E-mail: hovsepian@stanford.edu [Stanford University, School of Medicine (United States)

    2012-10-15

    A 44-year-old woman underwent uncomplicated uterine fibroid embolization (UFE) for menstrual and bulk-related symptoms in an enlarged, myomatous uterus. After surgery, she spontaneously sloughed a large mass of fibroids that arrested in the cervical canal during passage. Four days after gynecological extraction, she developed copious vaginal discharge that contained enteric contents. Contrast-enhanced computed tomography (CT) demonstrated a fistula between the small bowel and the uterus. She subsequently underwent hysterectomy, left oophorectomy, and small-bowel resection. Her postoperative recovery was uneventful.

  8. Uteroenteric Fistula Resulting From Fibroid Expulsion After Uterine Fibroid Embolization: Case Report and Review of the Literature

    International Nuclear Information System (INIS)

    Gutierrez, Luis B.; Bansal, Anshuman K.; Hovsepian, David M.

    2012-01-01

    A 44-year-old woman underwent uncomplicated uterine fibroid embolization (UFE) for menstrual and bulk-related symptoms in an enlarged, myomatous uterus. After surgery, she spontaneously sloughed a large mass of fibroids that arrested in the cervical canal during passage. Four days after gynecological extraction, she developed copious vaginal discharge that contained enteric contents. Contrast-enhanced computed tomography (CT) demonstrated a fistula between the small bowel and the uterus. She subsequently underwent hysterectomy, left oophorectomy, and small-bowel resection. Her postoperative recovery was uneventful.

  9. MR findings in traumatic cerebrospinal fluid fistulae

    International Nuclear Information System (INIS)

    Fortuny, M.E.; Molina Ferrer, L.; Ferreyra, M.; D'Agustini, M.

    2000-01-01

    Purpose: CSF fistulae represent the 4%-8% of complications after a serious encephalocranial trauma in the infant population. The experience in 3 patients using MRI with Spin-Eco T2 and Cine-GRE sequences is presented. Material and method: Three male patients 6, 11 and 13 years old were studied, who presented encephalocranial trauma and the common complication was Diplococcus Pneumoniae meningitis. They were studied in a 0.5 T equipment with FSE T2 multiplanar sequences with 3 mm slice thickness and Cine-GRE also 3 mm in four phases of 16 images each. Results: Multiple fistulas were found in the temporomastoidic region in two patients. In one case MRI showed only one fistula though the cribiform plate of the ethmoid bone. Conclusions: MRI is a highly reliable method for CSF fistula detection in patients with encephalocranial trauma. FSE-T2-weighted images and Cine-GRE are sensitive sequences. (author)

  10. Retained Products Of Conception In A Utero Cutaneous Fistula: A ...

    African Journals Online (AJOL)

    This is a case report of a patient with utero-cutaneous fistula following Caesarean Section and criminal abortion. Her case was further complicated by the discovery of products of conception within the fistula. At laparotomy, adhesiolysis with the freeing of the uterus and fistulectomy were performed. She had an uneventful ...

  11. 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.

  12. Lymphogranuloma Venereum Presenting as a Rectovaginal Fistula

    Directory of Open Access Journals (Sweden)

    C. M. Lynch

    1999-01-01

    Full Text Available Lymphogranuloma venereum (LGV is a rare form of the sexually transmitted disease caused by Chlamydia trachomatis. In the United States, there are fewer than 350 cases per year. In a review of the world’s literature, there has not been a case reported in the last thirty years of a case ofLGV presenting as a rectovaginal fistula. We present a case of an otherwise healthy American woman who presented with a rectovaginal fistula. Although uncommon, LGV does occur in developed countries and may have devastating tissue destruction if not recognized and treated before the tertiary stage. Infect. Dis. Obstet. Gynecol. 7:199–201, 1999.

  13. A rare complication of Meckel's diverticulum: A fistula between Meckel's diverticulum and the appendix

    Directory of Open Access Journals (Sweden)

    Ping-Fu Yang

    2012-10-01

    Full Text Available Meckel diverticulum is the most common congenital anomaly of the small intestine, occurring in about 2%–4% of the population. Meckel diverticulum results from incomplete closure of the omphalomesenteric duct. The presentation of symptomatic Meckel diverticulum includes gastrointestinal hemorrhage, intestinal obstruction, volvulus, intussusception, diverticulitis, and neoplasms. The development of fistula is an extremely rare complication. Previous literature has even shown an enterocolonic fistula, a vesicodiverticular fistula, ileorectal fistula, and fistula-in-ano. To the best of our knowledge, we present the first case of the fistula complicated between Meckel diverticulum and the appendix in a review of the English literature.

  14. Traumatic rectourethral fistula repair: A potential application of porcine small intestinal submucosa

    Directory of Open Access Journals (Sweden)

    Shanmugasundaram Rajaian

    2013-01-01

    Full Text Available Rectourethral fistula is an uncommon but devastating condition. Traumatic rectourethral fistula is still uncommon and repair of traumatic rectourethral fistula involves a complex procedure. Most of the urologists would prefer to repair the fistula through perineal route especially when urethral reconstruction is also required. The repaired ends of the fistula are separated with various interposition flaps and grafts in order to prevent recurrence. Gracilis interposition muscle flap is commonly used. We describe the first case of traumatic rectourethral fistula repair in a 45-year-old man using interposition of a porcine small intestinal submucosal (Biodesign™ (Surgisis ® graft.

  15. Closure of oroantral fistula with rotational palatal flap technique

    Directory of Open Access Journals (Sweden)

    David B. Kamadjaja

    2007-03-01

    Full Text Available Oroantral fistula is one of the common complications following dentoalveolar surgeries in the maxilla. Closure of oroantral fistula should be done as early as possible to eliminate the risk of infection of the antrum. Palatal flap is one of the commonly used methods in the closure of oroantral fistula. A case is reported of a male patient who had two oroantral communication after having his two dental implants removed. Buccal flap was used to close the defects, but one of them remained open and resulted in oroantral fistula. Second correction was performed to close the defect using buccal fat pad, but the fistula still persisted. Finally, palatal rotational flap was used to close up the fistula. The result was good, as the defect was successfully closed and the donor site healed uneventfully.

  16. Spontaneous cholecystocutaneous fistula in a dog.

    Science.gov (United States)

    Marquardt, Shelly A; Rochat, Mark C; Johnson-Neitman, Jennifer L

    2012-01-01

    The purpose of this case report was to describe the surgical correction of a cholecystocutaneous fistula in a dog. A 6 yr old Vizsla presented with a 2 mo history of a chronic draining wound on the right ventral thorax. Diagnostics revealed numerous fistulous tracts opening at a single site on the right ventrolateral chest wall, extending caudodorsally through the chest wall and diaphragm to the region of the right medial liver lobe. Exploratory laparotomy revealed the apex of the gallbladder adhered to the diaphragm with a tract of fibrous tissue extending along the diaphragm laterally to the right thoracic wall. Cholecystectomy was performed. The fistulous tract was incised to expose the lumen of the fistula, and the fistula was omentalized. Twenty-eight months after surgery, the dog had had no recurrence of the fistulous tract. Exploratory laparotomy allowed excellent visualization of the intra-abdominal path of the fistula and facilitated the ease of resection of the source. Cholecystectomy resulted in rapid and complete resolution of the fistula without the need for excision of the fistula. Although rare, gallbladder disease should be a differential for chronic fistulous tracts.

  17. Tracheocutaneous Fistula Closure with Turnover Flap and Polydioxanone Plate

    Directory of Open Access Journals (Sweden)

    Justin R. Bryant, DO, MBA

    2017-10-01

    Full Text Available Summary:. An alternative surgical treatment is proposed for closure of tracheocutaneous fistulas. The authors present a new technique for reconstruction of persistent tracheocutaneous fistula resultant from temporary tracheostomy. The single-stage closure under local anesthesia involves a fistulous tract turnover flap with a perforated 0.15 mm polydioxanone plate between the flap and the subcutaneous closure. This article presents 3 cases of persistent tracheocutaneous fistula treated by this method. At follow-up examination after follow-up, no recurrent fistula formation had occurred, and no respiratory deformity was present.

  18. Multimodality Imaging of Left Circumflex Artery to Coronary Sinus Fistula

    Science.gov (United States)

    Sze, Tan Ling; Abdul Aziz, Yang Faridah; Abu Bakar, Norzailin; Mohd Sani, Fadhli; Oemar, Hamid

    2015-01-01

    Coronary artery fistula (CAF) is a rare anomaly of the coronary artery. Patients with this condition are usually asymptomatic. However, cardiac failure may occur later in life due to progressive enlargement of the fistula. Diagnosis is traditionally made by echocardiogram and conventional angiogram. However with the advantage of new technologies such as computed tomography (CT) coronary angiography, the course and communications of these fistulae can be delineated non-invasively and with greater accuracy. We report a case of a left circumflex artery fistula to the coronary sinus which was suspected on echocardiogram and the diagnosis was clinched on ECG-gated CT. PMID:25793089

  19. Spontaneous Umbilical CSF Fistula Due to Migration of the Peritoneal End of VP Shunt: A Case Report and Review of Pathogenesis.

    Science.gov (United States)

    Vankipuram, Siddharth; Jaiswal, Somil; Jaiswal, Manish; Bajaj, Ankur; Chandra, Anil; Ojha, B K

    2017-01-01

    Abdominal complications after ventriculoperitoneal (VP) shunt surgery for hydrocephalus have been known to occur. The more common complications include peritoneal pseudocyst, obstruction of the lower end, and shunt infection. Perforations of the intra-abdominal hollow viscera leading to spontaneous extrusions of the peritoneal catheter via the natural orifices have also been reported. A rarer phenomenon still is the migration of the lower end of the VP shunt through the anterior abdominal wall, leading to the formation of a spontaneous umbilical fistula at a site unrelated to the surgical site. Eight cases have been described in the literature so far with various causes elucidated. We report this condition in a child 4.5 years after his shunt surgery and postulate different mechanisms for both early and late presentations of this condition.

  20. Fístula oroantral e retalho mucoso geniano: revisão de 25 casos Oroantral fistula and genian mucosal flap: a review of 25 cases

    Directory of Open Access Journals (Sweden)

    Roberto Campos Meirelles

    2008-02-01

    Full Text Available A fístula oroantral é a comunicação patológica entre cavidade oral e seio maxilar, quase sempre decorrentes de traumatismos durante procedimentos dentários. OBJETIVO: Apresentar experiência de 25 casos. CASUÍSTICA E MÉTODOS: Realizado estudo retrospectivo de pacientes com FOA no período de 1996 a 2000. O diagnóstico incluiu exame otorrinolaringológico, endoscopia nasal ou da fístula, tomografia computadorizada das cavidades paranasais, pesquisa bacteriológica, fúngica e análise patológica. RESULTADOS: Encontrados 25 casos, sendo 10 de segundo molar, 8 de primeiro molar, 6 de segundo pré-molar e 1 de canino. Todos foram operados pela técnica de Caldwell-Luc, reavivamento das bordas da fístula, meatotomia média e rotação de retalho mucoso geniano. DISCUSSÃO: Nas fístulas de alto débito (n=14, colocou-se enxerto ósseo da própria parede anterior do seio. Todos, exceto um, tiveram resultado cirúrgico bom. A cultura bacteriológica (n=19 demonstrou estreptococos pneumoniae (13, haemophilus influenzae (6, moraxella catarrhalis (2, estafilococos aureus (2. Encontrado aspergilus niger em um caso que apresentava imagem radiológica de bola fúngica. CONCLUSÕES: Após 30 dias, os resultados foram bons em todos, exceto um dos casos. Este foi reoperado com colocação de enxerto ósseo, inicialmente não utilizado, tendo sucesso. Após 6 meses, todos os 23 pacientes localizados não apresentavam problemas.The oroantral fistula is a pathological connection between the maxillary sinus and with the oral cavity. The condition mostly follows dental extraction. AIM: To present the experience of 25 cases. MATERIAL AND METHODS: Retrospective cases between 1996-2000. The ORL examination included nasal or sinusal endoscopy, a CT scan and histopathological analysis. RESULTS: Twenty-five cases were found: ten 2nd molar cases, eight 1st molar cases, six 2nd premolar cases, and one canine case. All patients underwent a Caldwell-Luc operation

  1. Magnetic resonance imaging findings in an unusual case of atlanto axial dislocation and vertebral artery-vein fistulas in a patient of neurofibromatosis-1

    International Nuclear Information System (INIS)

    Maheshwari, S.; Kale, H.A.; Desai, S.B.; Kohli, A.

    2002-01-01

    Neurofibromatosis is a dysplasia of mesodermal and neuroectodermal tissues with potential for diffuse systemic involvement. Vertebral arteriovenous fistulas - abnormal communications of the artery and vein- are uncommon in neurofibromatosis. We describe MRI findings of a patient with an unusual association of bilateral vertebral arteriovenous fistulas with an atlantoaxial dislocation in the setting of neurofibromatosis. Copyright (2002) Blackwell Science Pty Ltd

  2. Vertebral defect, anal atresia, cardiac defect, tracheoesophageal fistula/esophageal atresia, renal defect, and limb defect association with Mayer-Rokitansky-Küster-Hauser syndrome in co-occurrence: two case reports and a review of the literature.

    Science.gov (United States)

    Bjørsum-Meyer, Thomas; Herlin, Morten; Qvist, Niels; Petersen, Michael B

    2016-12-21

    The vertebral defect, anal atresia, cardiac defect, tracheoesophageal fistula/esophageal atresia, renal defect, and limb defect association and Mayer-Rokitansky-Küster-Hauser syndrome are rare conditions. We aimed to present two cases with the vertebral defect, anal atresia, cardiac defect, tracheoesophageal fistula/esophageal atresia, renal defect, and limb defect association and Mayer-Rokitansky-Küster-Hauser co-occurrence from our local surgical center and through a systematic literature search detect published cases. Furthermore, we aimed to collect existing knowledge in the embryopathogenesis and genetics in order to discuss a possible link between the vertebral defect, anal atresia, cardiac defect, tracheoesophageal fistula/esophageal atresia, renal defect, and limb defect association and Mayer-Rokitansky-Küster-Hauser syndrome. Our first case was a white girl delivered by caesarean section at 37 weeks of gestation; our second case was a white girl born at a gestational age of 40 weeks. A co-occurrence of vertebral defect, anal atresia, cardiac defect, tracheoesophageal fistula/esophageal atresia, renal defect, and limb defect association and Mayer-Rokitansky-Küster-Hauser syndrome was diagnosed in both cases. We performed a systematic literature search in PubMed ((VACTERL) OR (VATER)) AND ((MRKH) OR (Mayer-Rokitansky-Küster-Hauser) OR (mullerian agenesis) OR (mullerian aplasia) OR (MURCS)) without limitations. A similar search was performed in Embase and the Cochrane library. We added two cases from our local center. All cases (n = 9) presented with anal atresia and renal defect. Vertebral defects were present in eight patients. Rectovestibular fistula was confirmed in seven patients. Along with the uterovaginal agenesis, fallopian tube aplasia appeared in five of nine cases and in two cases ovarian involvement also existed. The co-occurrence of the vertebral defect, anal atresia, cardiac defect, tracheoesophageal fistula/esophageal atresia, renal

  3. Association Between Prior Peripherally Inserted Central Catheters and Lack of Functioning Arteriovenous Fistulas: A Case-Control Study in Hemodialysis Patients

    Science.gov (United States)

    Ters, Mireille El; Schears, Gregory J.; Taler, Sandra J.; Williams, Amy W.; Albright, Robert C.; Jenson, Bernice M.; Mahon, Amy L.; Stockland, Andrew H.; Misra, Sanjay; Nyberg, Scott L.; Rule, Andrew D.; Hogan, Marie C.

    2013-01-01

    Background Although an arteriovenous fistula (AVF) is the hemodialysis access of choice, its prevalence continues to be lower than recommended in the United States. We assessed the association between past peripherally inserted central catheters (PICCs) and lack of functioning AVFs. Study Design Case-control study. Participants & Setting Prevalent hemodialysis population in 7 Mayo Clinic outpatient hemodialysis units. Cases were without functioning AVFs and controls were with functioning AVFs on January 31, 2011. Predictors History of PICCs. Outcomes Lack of functioning AVFs. Results On January 31, 2011, a total of 425 patients were receiving maintenance hemodialysis, of whom 282 were included in this study. Of these, 120 (42.5%; cases) were dialyzing through a tunneled dialysis catheter or synthetic arteriovenous graft and 162 (57.5%; controls) had a functioning AVF. PICC use was evaluated in both groups and identified in 30% of hemodialysis patients, with 54% of these placed after dialysis therapy initiation. Cases were more likely to be women (52.5% vs 33.3% in the control group; P = 0.001), with smaller mean vein (4.9 vs 5.8 mm; P PICC was identified in 53 (44.2%) cases, but only 32 (19.7%) controls (P PICC use and lack of a functioning AVF (OR, 3.2; 95% CI, 1.9–5.5; P PICCs are commonly placed in patients with end-stage renal disease and are a strong independent risk factor for lack of functioning AVFs. PMID:22704142

  4. 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.

  5. Facial fistula. Long-term sequelae of a complicated exodontia.

    Science.gov (United States)

    Alasseri, Nasser A; Assari, Ahmad S

    2015-04-01

    Facial cutaneous fistula is a complication of odontogenic infection that is often misdiagnosed with dermatological infection, and hence, mistreated. We report a case of facial fistula that developed 8 years following a dental extraction, presenting its clinical appearance, radiographical findings, and treatment approach.

  6. Choledochoduodenal fistula (CDF): a compication of chronic peptic ...

    African Journals Online (AJOL)

    Bilio-enteric fistulas have been reported though not common. They are usually incidental findings during certain investigative procedures. It is mostly associated with gallstones or penetrating abdominal injury. A case of choledochoduodenal fistula (CDF) complicating chronic duodenal ulcer disease picked up on upper ...

  7. Esophagobronchial fistula - A rare complication of aluminum phosphide poisoning

    Directory of Open Access Journals (Sweden)

    Bhargava Sumeet

    2011-01-01

    Full Text Available Aluminum phosphide is a systemic lethal poison. Fistulous communication between esophagus and airway tract (esophagorespiratory fistula has rarely been reported in the survivors of aluminum phosphide poisoning. We report a case of benign esophagobronchial fistula secondary to aluminum phosphide poisoning, which to best of our knowledge has not been reported in the medical literature.

  8. Esophagobronchial fistula - A rare complication of aluminum phosphide poisoning.

    Science.gov (United States)

    Bhargava, Sumeet; Rastogi, Rajul; Agarwal, Ajay; Jindal, Gaurav

    2011-01-01

    Aluminum phosphide is a systemic lethal poison. Fistulous communication between esophagus and airway tract (esophagorespiratory fistula) has rarely been reported in the survivors of aluminum phosphide poisoning. We report a case of benign esophagobronchial fistula secondary to aluminum phosphide poisoning, which to best of our knowledge has not been reported in the medical literature.

  9. Esophagobronchial fistula - A rare complication of aluminum phosphide poisoning

    OpenAIRE

    Bhargava, Sumeet; Rastogi, Rajul; Agarwal, Ajay; Jindal, Gaurav

    2011-01-01

    Aluminum phosphide is a systemic lethal poison. Fistulous communication between esophagus and airway tract (esophagorespiratory fistula) has rarely been reported in the survivors of aluminum phosphide poisoning. We report a case of benign esophagobronchial fistula secondary to aluminum phosphide poisoning, which to best of our knowledge has not been reported in the medical literature.

  10. 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.

  11. 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...

  12. Rectovaginal fistula following sexual intercourse. | Ijaiya | Annals of ...

    African Journals Online (AJOL)

    Female genital fistula is an important feature of the developing countries gynecology. Most of the rectovaginal fistulae encountered in the tropics are due to obstetrics causes and genital malignancies. In developed countries, radiation injury and Crohn's disease are also common etiological factors. The index case is ...

  13. Percutaneous Treatment of a Jejunovaginal Fistula Using a Combination of the Amplatzer Vascular Plug II and N-Butyl-2-Cyanoacrylate: A Case Report

    International Nuclear Information System (INIS)

    Lee, Hyun Kyung; Kwak, Hyo Sung; Han, Young Min; Kim, Young Kon

    2011-01-01

    Treatment for an enterovaginal fistula should consider the location of an intestinal fistula. Most rectovaginal fistulas develop in the lower third of the vagina and can be treated surgically. Jejunovaginal fistulas can spontaneously close during conservative management. We report the first use of the Amplatzer vascular plug II (AVP II; AGA Medical Corp, Golden Valley, MN, USA) and the use of an N-butyl-2-cyanoacrylate (NBCA; Histoacryl, Braun, Melsungen, Germany)- iodized oil (Lipiodol Ultra-Fluid, Guerbet, Aulnay-sous-Bois, France) mixture for treatment of a patient with a jejunovaginal fistula which failed to close after conservative management. The patient did not have any vaginal discharge one day later after deployment of the AVP II.

  14. Percutaneous Treatment of a Jejunovaginal Fistula Using a Combination of the Amplatzer Vascular Plug II and N-Butyl-2-Cyanoacrylate: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Kyung; Kwak, Hyo Sung; Han, Young Min [Dept. of Radiology, Chonbuk National University School of Medicine and Hospital, Chonju (Korea, Republic of); Kim, Young Kon [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2011-04-15

    Treatment for an enterovaginal fistula should consider the location of an intestinal fistula. Most rectovaginal fistulas develop in the lower third of the vagina and can be treated surgically. Jejunovaginal fistulas can spontaneously close during conservative management. We report the first use of the Amplatzer vascular plug II (AVP II; AGA Medical Corp, Golden Valley, MN, USA) and the use of an N-butyl-2-cyanoacrylate (NBCA; Histoacryl, Braun, Melsungen, Germany)- iodized oil (Lipiodol Ultra-Fluid, Guerbet, Aulnay-sous-Bois, France) mixture for treatment of a patient with a jejunovaginal fistula which failed to close after conservative management. The patient did not have any vaginal discharge one day later after deployment of the AVP II.

  15. 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...

  16. CLINICAL STUDY OF FISTULA IN ANO

    Directory of Open Access Journals (Sweden)

    Sushma Ramteke

    2017-02-01

    Full Text Available BACKGROUND Fistula in ano is one of the common problem faced in today’s world. Fistula in ano is track lined by granulation tissue that connect deeply in the anal canal or rectum and superficially on the skin around the anus. It usually results from cryptoglandular infection causing abscess, which burst spontaneously or was drained inadequately. The study is conducted to find most common aetiological factor and to evaluate various surgical technique and their outcome. The aim of the study is to- 1. Study the incidence of various aetiologies of fistula in ano. 2. Study the clinical presentation of fistula in ano. 3. Evaluate different modalities of surgical approach and their outcome. MATERIALS AND METHODS This prospective study was conducted at Late Lakhiram Agrawal Memorial Government Medical College, Raigarh, during the study period of July 2015 to July 2016. All the 50 cases were included in this study who were above 15 year of age diagnosed with fistula in ano on the basis of clinical examination who underwent surgical procedure. RESULTS In present study of 50 cases, 60% of cases were in the age group of 31-50 years. Male:female ratio was 9:1. 80% of cases belong to low socioeconomic status. The most common mode of presentation was discharging sinus in 96% of cases. 70% of patient had past history of burst abscess or surgical drainage of abscess. 90% of cases have single external opening. 80% of cases had posterior external opening. Most of the fistula are of low anal type, which was 92% and rest of the patient had an internal opening situated above the anorectal ring. The most common surgical approach done was fistulectomy. Only fistulectomy was done in 80% of patients. Fistulectomy with sphincterectomy was done in two patients. These two patients had associated anal fissure. Fistulectomy with seton placement was done in two patients of high level of fistula type. Fistulotomy was done in four patients (8%, these were of low fistula type

  17. Congenital bronchobiliary fistula diagnosis by cholescintigraphy

    International Nuclear Information System (INIS)

    Aguilar, C.; Cano, R.; Camasca, A.; Del Pino, T.; Gonzales, J.; Rivera, J.; Untiveros, A.

    2005-01-01

    A case of a six-year-old female patient diagnosed with congenital bronchobiliary fistula is presented. Only 20 cases have been reported in the literature of this disease in this institution. The patient showed sings and symptoms of a respiratory illness from birth that complicated progressively. She was submitted to multiple imaging like chest x-rays, CT, ultrasound and Tc-99m HIDA cholescintigraphy. This procedure confirmed the presence of a bronchobiliary fistula that was corrected by surgery, with subsequent improvement of clinical symptoms. (authors)

  18. [A case of Crohn's disease developing bladder rupture 4 months after laparoscopic sigmoidectomy with partial cystectomy for vesicosigmoidal fistula].

    Science.gov (United States)

    Masumori, Naoya; Tanaka, Toshiaki; Takeuchi, Motoi; Ichihara, Koji; Inoue, Ryuta; Shinkai, Nobuo; Maehana, Takeshi; Mizuno, Takahiro; Tabata, Hidetoshi; Hiyama, Yoshiki; Tsukamoto, Taiji

    2012-05-01

    A 32-year-old well-nourished man having a vesicosigmoidal fistula due to Crohn's disease received laparoscopic sigmoidectomy with partial cystectomy. The bladder wall was closed with an all-layer running suture and additional interrupted sutures using 2-0 Vicryl. Four months after surgery, the suture site on the bladder showed perforation to the abdominal cavity. Since the same event occurred again 6 months after surgery, open partial cystectomy was performed to repair the perforated site 8 months after the initial surgery. The perforated site showed a thinning bladder wall composed of normal urothelium, scar tissue and thin detrusor muscle. Non-caseating granuloma was not found in the specimen, even though it was slightly observed in the margin of the detrusor muscle resected in the initial surgery. Although it was possible that the persisting activity of Crohn's disease, subclinical impaired nutrition due to Crohn's disease or insufficient suturing of the bladder wall were involved in the bladder rupture, the definitive cause remains unknown.

  19. Endovascular Management of Acute Bleeding Arterioenteric Fistulas

    International Nuclear Information System (INIS)

    Leonhardt, Henrik; Mellander, Stefan; Snygg, Johan; Loenn, Lars

    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 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

  20. 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.

  1. Anovestibular fistula with normal anal opening: Is it always congenital?

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    Jain Prashant

    2008-01-01

    Full Text Available Aim: To review 12 cases of anovestibular fistula with normal anal opening. Methods: Retrospective analysis of 12 children with anovestibular fistula and normal anal opening were treated between the years 2000 and 2007. Of these, 11 patients were diagnosed as having acquired anovestibular fistula with normal anal opening and were managed by conservative management. Results: Most of them presented with diarrhea and labial redness. One patient was considered to have fistula of congenital origin and was managed surgically. Eleven patients presented between the ages of 1.5-11 months and were considered as cases of acquired anovestibular fistula and only two of them required surgical management in the form of colostomy and fistula excision. Others were successfully managed by conservative treatment; the fistulous output and labial redness decreased gradually within a period of 5-19 (average 11.5 days. Conclusions: Not all presentations of anovestibular fistula with normal anal opening can be considered as congenital. Presence of inflammation, paramedian fistula, and a favourable response to conservative management/colostomy suggest acquired etiology. Trial of conservative management should be given in the acquired variety.

  2. Tracheocutaneous Fistula Closure: Comparison of Rhomboid Flap Repair with Z Plasty Repair in a Case Series of 40 Patients.

    Science.gov (United States)

    Hernot, Sharad; Wadhera, Raman; Kaintura, Madhuri; Bhukar, Sandeep; Pillai, Dheeraj Shashikumar; Sehrawat, Usha; George, Jitu Sam

    2016-12-01

    Tracheocutaneous fistula (TCF) is one of the recognized sequelae of a long-term tracheostomy resulting from mucocutaneous overgrowth which prevents closure of the artificial lumen at the site of tracheostomy. Primary closure of TCF has disappointing results and may lead to complications like pneumothorax, pneumomediastinum, cervicofacial subcutaneous emphysema, and depressed scar. To compare TCF repair using fistulectomy followed by rhomboid flap versus fistulectomy followed by Z plasty repair. In this prospective study, 40 patients of either sex with persistent TCF were included. All patients were randomly divided into two groups. Group I had 20 patients who underwent TCF repair using a technique in which fistulectomy was done followed by its closure in layers, and finally closing the defect using a rhomboid flap. The remaining 20 were included in group II who underwent TCF repair using a technique in which fistulectomy was done followed by layered closing, and final closure of the defect was done using Z plasty. The follow-up period was 3 months. Out of 40 patients, all but 8 experienced a successful outcome without any complications, and complete aesthetic satisfaction, with improvement in phonation, and no soiling of clothes with mucus or sputum. The 8 unsuccessful patients belonged to group II (Z plasty group). Both techniques have been described in the literature and are proven to give good results. Our study emphasizes the fact that in our experience, the rhomboid flap was a better alternative for TCF repair than Z plasty. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

  3. Blood pressure shifts resulting from a concealed arteriovenous fistula associated with an iliac aneurysm: a case report.

    Science.gov (United States)

    Doi, Shintaro; Motoyama, Yoshiaki; Ito, Hiromi

    2016-01-01

    A solitary iliac aneurysm (SIA) is more uncommon than an abdominal aortic aneurysm. The aneurysm is located in the deep pelvis and is diagnosed when it reaches a large size with symptoms of compression around adjacent structures and organs or when it ruptures. A definite diagnosis of an arteriovenous fistula (AVF) associated with a SIA is difficult preoperatively because there might not be enough symptoms and time for diagnosis. Here, we present a patient with asymptomatic rupture of SIA into the common iliac vein with characteristic blood pressure shifts. A 41-year-old man with a huge SIA underwent aortobifemoral graft replacement. Preoperatively, his blood pressure showed characteristic shifts for one or two heartbeats out of five beats, indicating that an AVF was present and that the shunt was about to having a high flow. During surgery, an AVF associated with the SIA was found to be concealed owing to compression from the huge iliac artery aneurysm, and the shunt showed a high flow, resulting in shock during the surgery. No complications were noted after aortobifemoral graft replacement. Postoperatively, we noted an enhanced paravertebral vein on computed tomography (CT), which indicated the presence of an AVF. Definite diagnosis of an AVF offers advantages in surgical and anesthetic management. We emphasize that a large SIA can push the iliac vein and occlude an AVF laceration, concealing the enhancement of the veins in the arterial phase on CT. Blood pressure shifts might predict the existence of a concealed AVF that has a large shunt. Even if the vena cava and the iliac veins are not enhanced on CT, anesthesiologists should carefully determine whether their distal branches are enhanced.

  4. Lacrimal Gland Fistula following Severe Head Trauma

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    Cemil Demir

    2015-01-01

    Full Text Available We aim to present a unique case with discharging lacrimal gland fistula secondary to severe head trauma by an animal. A 9-year-old girl presented with serous fluid discharge from a cutaneous fistula in the left orbital region. The patient had history of surgery for traumatic frontal bone fracture and skin laceration in the superior orbital rim three weeks earlier. She underwent a complete ophthalmological examination and there was no anterior segment or fundus pathology. The orifice of the fistula was detected in mediolateral part of the left superior orbital rim and fluid secretion was increasing with irritation of the left eye. Neurosurgical complications were excluded and radiological assessment was nonremarkable. The patient’s legal representatives were informed and lacrimal gland fistulectomy was planned. However, the fistula was self-closed one week after initial ophthalmological examination, and the patient had no symptoms. In conclusion, traumatic injuries of superior orbital region should be carefully evaluated and wounds should be well closed to prevent consecutive lacrimal gland fistula.

  5. 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.

  6. Obstetric fistulas: a clinical review.

    Science.gov (United States)

    Creanga, A A; Genadry, R R

    2007-11-01

    A high proportion of genitourinary fistulas have an obstetric origin. Obstetric fistulas are caused by prolonged obstructed labor coupled with a lack of medical attention. While successful management with prolonged bladder drainage has occasionally been reported, mature fistulas require formal operative repair, and it is crucial that the first repair is done properly. The literature reports 3 approaches to fistula repair: vaginal, abdominal, and combined vaginal and abdominal. Many authors report high success rates for the surgical closure of obstetric fistulas at the time of hospital discharge, without further evaluation of the repair's effect on urinary continence or subsequent quality of life. Data on obstetric fistulas are scarce, and thus many questions regarding fistula management remain unanswered. A standardized terminology and classification, as well as a data reporting system on the surgical management of obstetric fistulas and its outcomes, are critical steps that need to be taken immediately.

  7. Clinical Experiences of Bronchopleural Fistula-related Fatal Hemoptysis after 
the Resection of Lung Cancer: A Report of 7 Cases

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    Zhenming ZHANG

    2012-01-01

    Full Text Available Background and objective Massive hemoptysis was a rare but severe postoperative complication of lung cancer. The aim of the present study is to investigate the mechanisms, risk factors, early symptoms, prevention, and treatment options for fatal hemoptysis. Methods From April 2007 to May 2011, 1,737 patients with lung cancer were surgically treated in the West China Hospital of Sichuan University. Twenty patients died during the perioperative period, seven of whom died of massive hemoptysis. These seven cases were analyzed, and their clinical data, as well as related literatures, were reviewed. Results Massive hemoptysis is the second cause of death after lung cancer surgery. Six patients died directly of massive hemoptysis. One patient underwent secondary surgery because of massive hemoptysis, but eventually died because of lung infection and respiratory failure. Early symptoms of hemorrhage were observed in four cases, and the overall incidence rate of massive hemoptysis was 0.4% (7/1,737. Conclusion Bronchovascular fistula (BVF caused by bronchopleural fistula (BPF is the mechanism for massive hemoptysis. Diabetes is a high risk factor. Early diagnosis and surgical treatment of BPF or BVF can prevent the occurrence of death as a result of massive hemoptysis.

  8. Intraoperative air leak test was useful for the detection of a small biliary fistula: A rare case of non-parasitic hepatic cysts with biliary communication.

    Science.gov (United States)

    Shimizu, Atsushi; Hata, Shojiro; Kobayashi, Kaoru; Teruya, Masanori; Kaminishi, Michio

    2015-01-01

    Symptomatic non-parasitic hepatic cysts with biliary communication are rare and no standard treatment has been established yet. Careful attention should be paid to avoidance of postoperative bile leakage during surgical treatment. We report the case of a 74-year-old man who visited our department complaining of right upper abdominal pain and elevated serum levels of the liver enzymes. Computed tomography revealed hepatic cysts including a large one measuring 16cm in diameter in Segments IV and VIII. Percutaneous drainage of the cyst revealed bile-staining of the cyst fluid. Endoscopic retrograde cholangiography demonstrated the presence of a cyst-biliary communication. We performed open deroofing of the cyst. During the operation, the biliary fistula was invisible, however, air injection into the bile duct through the stump of the cystic duct caused release of air bubbles from the cyst cavity, which allowed us to detect the small biliary orifice and repair it successfully by suture. We utilized the intraoperative air leak test, which has previously been reported to be effective for preventing postoperative bile leakage in patients undergoing hepatectomy to detect of a small cyst-biliary communication in a case undergoing non-parasitic hepatic cyst surgery. An intraoperative air leak test may be a useful test during surgical treatment of non-parasitic hepatic cysts with biliary communication. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Recurrent anal fistulae: limited surgery supported by stem cells.

    Science.gov (United States)

    Garcia-Olmo, Damian; Guadalajara, Hector; Rubio-Perez, Ines; Herreros, Maria Dolores; de-la-Quintana, Paloma; Garcia-Arranz, Mariano

    2015-03-21

    To study the results of stem-cell therapy under a Compassionate-use Program for patients with recurrent anal fistulae. Under controlled circumstances, and approved by European and Spanish laws, a Compassionate-use Program allows the use of stem-cell therapy for patients with very complex anal fistulae. Candidates had previously undergone multiple surgical interventions that had failed to resolve the fistulae, and presented symptomatic recurrence. The intervention consisted of limited surgery (with closure of the internal opening), followed by local implant of stem cells in the fistula-tract wall. Autologous expanded adipose-derived stem cells were the main cell type selected for implant. The first evaluation was performed on the 8(th) postoperative week; outcome was classified as response or partial response. Evaluation one year after the intervention confirmed if complete healing of the fistula was achieved. Ten patients (8 male) with highly recurrent and complex fistulae were treated (mean age: 49 years, range: 28-76 years). Seven cases were non-Crohn's fistulae, and three were Crohn's-associated fistulae. Previous surgical attempts ranged from 3 to 12. Two patients presented with preoperative incontinence (Wexner scores of 12 and 13 points). After the intervention, six patients showed clinical response on the 8(th) postoperative week, with a complete cessation of suppuration from the fistula. Three patients presented a partial response, with an evident decrease in suppuration. A year later, six patients (60%) remained healed, with complete reepithelization of the external opening. Postoperative Wexner Scores were 0 in six cases. The two patients with previous incontinence improved their scores from 12 to 8 points and from 13 to 5 points. No adverse reactions or complications related to stem-cell therapy were reported during the study period. Stem cells are safe and useful for treating anal fistulae. Healing can be achieved in severe cases, sparing fecal

  10. Eyelid liquoric fistula secondary to orbital meningocele

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    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.

  11. Spontaneous Enterocutaneous Fistula Resulting from Richter's Hernia.

    Science.gov (United States)

    Hajong, Ranendra; Khongwar, Donkupar; Komut, Ojing; Naku, Narang; Baru, Kappa

    2017-08-01

    Richter's hernia is due to the entrapment of a part of circumference of the bowel wall. As the bowel continuity is maintained, the patients usually do not have intestinal obstruction. Some patients with Richter's hernia may present with enterocutaneous fistula either spontaneous or due to surgical intervention mistaking the obstructed hernia to be inguinal abscess. This is more so in developing countries due to lack of awareness among the masses or due to the delay in seeking medical attention. Presenting here is a case of a 53-year-old male patient with enterocutaneous fistula which occurred spontaneously and sought medical attention only after about three years of repeated discharge of yellowish fluid from the left inguinal region. Magnetic resonance fistulogram confirmed the diagnosis of enterocutaneous fistula. Laparotomy with resection and primary anastomosis of the fistulous bowel was done. Patient recovered uneventfully without any complications or recurrence.

  12. Repair of a vesicouterine fistula following cesarean section.

    Science.gov (United States)

    Milani, Rodolfo; Cola, Alice; Frigerio, Matteo; Manodoro, Stefano

    2018-02-01

    Vesicouterine fistula is a rare complication of cesarean section. The aim of this video is to present a case report and to provide a tutorial on the surgical technique of delayed transvaginal repair of a high vesicouterine fistula that developed after cesarean section with manual removal of a morbidly adherent placenta. A 43-year-old woman was referred to our unit for continuous urinary leakage 3 months after undergoing a cesarean section with manual removal of a morbidly adherent placenta. A vesicouterine fistula starting from the posterior bladder wall was identified. The surgical repair consisted of a transvaginal layered repair as shown in the video. No surgical complications were observed postoperatively. Two months after surgery the fistula had not recurred and the patient reported no urinary leakage. Transvaginal layered primary repair of vesicouterine fistula was shown to be a safe and effective procedure for restoring continence. The vaginal route can be particularly attractive for urogynecological surgeons.

  13. A STUDY ON MANAGEMENT OPTIONS ON ENTEROCUTANEOUS FISTULA

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    Periaswamy

    2016-05-01

    Full Text Available BACKGROUND & OBJECTIVES Enterocutaneous Fistulas (ECF present as a deadly complication following abdominal surgery in the postoperative period. Over the past four decades, the mortality from enterocutaneous fistula has diminished from 40-60% to approximately 15-20%. This improvement in prognosis is due to recent advances in treatment modalities. In the present era, sepsis accounts for more than 80% of deaths. METHODS 41 cases of gastrointestinal fistulas were included; 34 patients were male and 7 patients were female and aged 40-60 years. RESULTS 95% of the fistulas seen in the postoperative setting and maximum in the age group of 40-60. The incidence is high in males. CONCLUSION Concluded from the study that postoperative causes account for the majority of gastrointestinal fistulas and associated factors like sepsis, malnutrition, malignancy, low serum albumin level are the factors that prevent the spontaneous closure.

  14. VACTERL (vertebral anomalies, anal atresia or imperforate anus, cardiac anomalies, tracheoesophageal fistula, renal and limb defect) spectrum presenting with portal hypertension: a case report.

    Science.gov (United States)

    Bhurtel, Dilli Raj; Losa, Ignatius

    2010-05-05

    We report for the first time a unique case of VACTERL (vertebral anomalies, anal atresia or imperforate anus, cardiac anomalies, tracheoesophageal fistula, renal and limb defect) spectrum associated with portal hypertension. The occurrence of both VACTERL spectrum and extrahepatic portal hypertension in a patient has not been reported in the literature. We examined whether or not there was any association between extrahepatic portal hypertension and VACTERL spectrum. A two-and-half-year-old Caucasian girl with VACTERL spectrum presented with hematemesis and abdominal distension. She had caput medusae, ascites, splenomegaly, gastric and esophageal varices. Her liver function tests were within normal limits. Magnetic resonance imaging of the liver with contrast showed a thready portal vein with collateral vessels involving both right and left portal veins without intrahepatic duct dilation. A thready portal vein, with features of extrahepatic portal hypertension, is a rare non- VACTERL-type defect in patients with VACTERL spectrum. Understandably, clinicians should give low priority to looking for portal hypertension in VACTERL spectrum patients presenting with gastrointestinal bleeding. However before routinely looking for a thready portal vein and/or extrahepatic portal hypertension in asymptomatic VACTERL spectrum patients, we need further evidence to support this rare association.

  15. Reliability of Oronasal Fistula Classification.

    Science.gov (United States)

    Sitzman, Thomas J; Allori, Alexander C; Matic, Damir B; Beals, Stephen P; Fisher, David M; Samson, Thomas D; Marcus, Jeffrey R; Tse, Raymond W

    2018-01-01

    Objective Oronasal fistula is an important complication of cleft palate repair that is frequently used to evaluate surgical quality, yet reliability of fistula classification has never been examined. The objective of this study was to determine the reliability of oronasal fistula classification both within individual surgeons and between multiple surgeons. Design Using intraoral photographs of children with repaired cleft palate, surgeons rated the location of palatal fistulae using the Pittsburgh Fistula Classification System. Intrarater and interrater reliability scores were calculated for each region of the palate. Participants Eight cleft surgeons rated photographs obtained from 29 children. Results Within individual surgeons reliability for each region of the Pittsburgh classification ranged from moderate to almost perfect (κ = .60-.96). By contrast, reliability between surgeons was lower, ranging from fair to substantial (κ = .23-.70). Between-surgeon reliability was lowest for the junction of the soft and hard palates (κ = .23). Within-surgeon and between-surgeon reliability were almost perfect for the more general classification of fistula in the secondary palate (κ = .95 and κ = .83, respectively). Conclusions This is the first reliability study of fistula classification. We show that the Pittsburgh Fistula Classification System is reliable when used by an individual surgeon, but less reliable when used among multiple surgeons. Comparisons of fistula occurrence among surgeons may be subject to less bias if they use the more general classification of "presence or absence of fistula of the secondary palate" rather than the Pittsburgh Fistula Classification System.

  16. A Case of Intractable Left Forearm Congenital Arteriovenous Fistula Ending with Amputation: Importance of New Medical Information Obtained via the Internet.

    Science.gov (United States)

    Liu, Jiajia; Shimada, Yasuyuki

    2014-01-01

    The aim of the present study was to consider the importance of medical information obtained via the Internet for difficult cases in hospitals, especially in those located in rural areas. We report here a case of congenital arteriovenous fistula (AVF) in the upper extremities. A 30-year-old lady was transported to our hospital by ambulance due to massive bleeding in her left hand. She was seen by our current cardiovascular surgery team for the first time, although she had been diagnosed with congenital AVF of the left arm 9 years previously. Because it was asymptomatic, she was followed up by observation. During 5 years of observation, symptoms such as cyanosis, pain, and refractory ulcers gradually developed. When she was 26 years old, she was referred to a university hospital in Akita, but surgery had already been judged to be impossible. When she was 30 years old, traumatic bleeding in her left hand and hemorrhagic shock led her to be taken to our hospital by ambulance. Using the Internet, we found an institution that had treated a large number of cases of AVF. After controlling the bleeding, we referred her to that institution. However, she could not be treated without an above-elbow amputation. Congenital AVF in the upper extremities is a rare vascular anomaly and has been generally accepted to be an extremely difficult disease to treat. Treatment should be started as early as possible before the presence of any symptoms. When a specialist is not available near the hospital, precise information must be found using the Internet and the patient should be referred without any delay.

  17. A simple novel technique [PUIT] for closure of urethrocutaneous fistula after hypospadias repair: Preliminary results

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    Awad M

    2005-01-01

    Full Text Available Urethrocutaneous fistula is a common complication of urethroplasty for severe hypospadias, even when a microsurgical technique is applied, the closure of the fistula is a challenging problem. We present a simple surgical procedure, posterior urethral incision technique [PUIT] to close the fistula in our department. Between February 2001 and December 2004 we prospectively evaluated 32 patients, 26 patients with initial hypospadias fistulas and 6 with recurrent fistulas who underwent closure of urethrocutaneous fistula after hypospadias repair. The mean age of patients was 5 years, the operation consisted of trimming the fistula edge after mobilization of the skin all-around then a midline posterior urethral incision was done 2 mm above and 2 mm below the fistula opening then re-approximation of the urethral edges using 6/0 vicryl sutures with loop magnification. The timing of fistula repair was between 6 and 13 months after it was formed, all of these were effectively closed except three cases with stricture and fistula. Of these, two were completely relieved after repeated urethral dilatation, three times a week for 2 weeks. The third failed case will need another sitting after 6 months. The posterior midline urethral incision gives a good opportunity for repair without tension with a good cosmetic outcome. This may be done under local anesthesia in adults. The procedure is considered simple rapid and easy to be done for variable fistulas types whatever of its site and the age.

  18. Successful closure of persistent oro-cutaneous fistulas by injection of autologous adipose-derived stem cells: a case report [Erfolgreiche Behandlung persistierender oro-kutaner Fisteln durch Injektion mit autologen Fettstammzellen: ein Fallbericht

    Directory of Open Access Journals (Sweden)

    Föll, D. A.

    2013-07-01

    Full Text Available [english] Introduction: Oro-cutaneous fistulas are a possible complication of oro-facial surgery. If recurrent they are difficult to treat and greatly affect the patient's functional and aesthetic integrity besides carrying the risk of infection. Usage of concentrated adipose-derived stem cells for chronic wounds is a new and experimental treatment strategy, so far only applied in a few selected studies. We report the case of two oro-cutaneous fistulas in one patient treated with adipose-derived stem cells leading to closure of the fistulas.Case description: The patient was a 57-year old female immunosuppressed liver and kidney recipient who presented with a large mandibular and soft tissue defect after resection and irradiation of a squamous-cell carcinoma of the tongue base. After radical debridement, hardware removal and soft tissue reconstruction using a second free flap two oro-cutaneous fistulas reoccurred. Conventional surgical methods failed to consolidate the fistulas due to the severe radiation of the oral mucosa. Therefore autologous adipose-derived stem cells were extracted from lipoaspirate and applied in the surrounding fistula tissue in one session using the Cytori Celution system. The fistulas closed spontaneously during the postoperative course within 4 weeks and remain closed after 6 months.Conclusion: To our knowledge this is the first report of successful application of adipose-derived stem cells to two oro-cutaneous fistulas. Innovative stem cell therapy in combination with well established surgical methods can be a useful treatment strategy in certain cases.[german] Einleitung: Oro-kutane Fisteln sind eine mögliche Komplikation eines oro-fazialen Eingriffs. Bei Therapieresistenz können solche Fisteln zu hohem Leidensdruck führen und stellen eine ständige Infektionsgefahr dar. Die Applikation von konzentrierten Stammzellen aus Fettgewebe zur Behandlung chronischer Wunden ist eine neue und experimentelle Therapiestrategie

  19. Genito-urinary fistula: a major morbidity in developing countries

    International Nuclear Information System (INIS)

    Sachdev, P.S.; Hassan, N.; Abbasi, R.M.; Das, C.M.

    2009-01-01

    Uro-genital fistulas, majority of which are vesico-vaginal fistulas (VVF), are a great challenge for women in developing countries. It is commonly caused by prolong obstructed labour and is one of the worst complications of child birth and poor obstetric care. The objective of this descriptive study was to review the cases of genitourinary fistulae so as to understand the magnitude of the problem and its aetiology and to share our experience of surgical repair with other specialists in this field. The study was conducted at Gynaecological Unit-II, Liaquat University Hospital Hyderabad, Pakistan from June 1996 to December 2007. The case records of all patients admitted and managed during study period were reviewed. The information regarding characteristics, risk factors and surgical management was collected. The data was analysed by SPSS and mean, range, standard deviation and percentage were calculated. During the study period, 278 patients with genitourinary fistulae were admitted and managed. The mean age of patients with urinary fistulae was 31.5+-7.5 years, parity was 4.2+-2.8, and duration of labour was 38.4+-6.5 hours. The duration of fistulae ranged from 1 day to 25 years. Obstructed labour 246 (88.4%) was the most common cause of urinary fistulae, followed by gynaecological surgeries mainly hysterectomies 26 (9.35%). The most common type of urinary fistula was vesico-vaginal fistula (VVF) 250 (89.9%). A total of 268 underwent surgery. Almost all 261 (97.3%) urinary fistulae were repaired transvaginally except patients with ureterovaginal and vesico-uterine fistulae. The most common surgical procedure used was layered closure. Martius graft was used in 3 (1.1%) patients, who required creation of new urethra. The success rate following first, second and third attempt was 85%, 91% and 96% respectively. Urogenital fistulae are rarity in developed world, but are frequently encountered problem in developing countries like Pakistan, often resulting from prolonged

  20. Left atrio-esophageal fistula of a possibly iatrogenic aetiology.

    Science.gov (United States)

    Arkuszewski, Piotr; Barzdo, Maciej; Ostrowski, Stanisław; Szram, Stefan; Berent, Jarosław

    2015-07-01

    The study presents an exceptionally rare case of an esophago-left atrial fistula, which was diagnosed during a forensic post-mortem examination. Due to complex nature of the disease and many attempts to cure the patient, the authors did not manage to identify the aetiology of the fistula. It was only implied that the fistula might have been a distant complication of intraoperative endocardial ablation or it might have appeared as a consequence of perforation of the esophageal wall or left atrial wall of the enlarged heart with the end of an intubation tube or nasogastric tube. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Cholecystoduodenal fistula, an infrequent complication of cholelithiasis: Our experience in its surgical management

    OpenAIRE

    F. Aguilar-Espinosa; R. Maza-Sánchez; F. Vargas-Solís; G.A. Guerrero-Martínez; J.L. Medina-Reyes; P.I. Flores-Quiroz

    2017-01-01

    Introduction: Bilioenteric fistulas are the abnormal communication between the bile duct system and the gastrointestinal tract that occurs spontaneously and is a rare complication of an untreated gallstone in the majority of cases. These fistulas can cause diverse clinical consequences and in some cases be life-threatening to the patient. Aim: To identify the incidence of bilioenteric fistula in patients with gallstones, its clinical presentation, diagnosis through imaging study, surgical man...

  2. Combination of hypertonic saline and fibrin glue: Another selection to treat chronic enterocutaneous fistula

    OpenAIRE

    Po-Chang Hsu; Sheng-Der Hsu

    2017-01-01

    Gastrointestinal tract fistula is a frequent complication of surgery or disease. In general, cases involving failure to manage fistulae after 5–6 weeks of nonoperative treatment possibly require surgery. Here, we report a case involving a chronic enterocutaneous fistula (ECF) for 24 months that was treated using hypertonic saline injection within the duodenal mucosa and use of fibrin glue as an adhesive to ensure rapid closure. This technique is a simple and effective method for treating an E...

  3. Cutaneous Basal Cell Carcinoma Arising in Odontogenic Cutaneous Fistula.

    Science.gov (United States)

    Kim, Nam Gyun; Kim, Jun Oh; Park, Young Ji; Kim, Jun Sik; Lee, Yoon Jung; Lee, Kyung Suk

    2017-06-01

    An odontogenic cutaneous fistula is a pathological communication between the outer skin surface of the face and the oral cavity. Facial cutaneous fistula is a complication of odontogenic infection that is often misdiagnosed with skin infection. We report a rare case, which was diagnosed as basal cell carcinoma based on the biopsy of skin lesions in the patient who had been diagnosed with odontogenic cutaneous fistula. A 64-year-old male patient presented with a cutaneous odontogenic fistula. The patient had undergone surgical extraction of fistula tract and loose tooth before dermatology or plastic surgery consultation. With the biopsy and computed tomography, it was confirmed that fistula and basal cell carcinoma. However, the connection between the fistula and skin cancer was not clear. Positron emission tomography-computed tomography scan was performed and was not detected as other local or distant metastasis. After that, wide excision of the skin lesion was performed. Although skin cancer is not commonly observed, it is necessary to rule out this disease entity by performing biopsy of skin lesions.

  4. Surgical Management of Enterocutaneous Fistula

    International Nuclear Information System (INIS)

    Lee, Suk Hwan

    2012-01-01

    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.

  5. Surgical Management of Enterocutaneous Fistula

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Suk Hwan [Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of)

    2012-02-15

    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.

  6. Aorto-right atrial fistula after Bentall repair.

    Science.gov (United States)

    Howard, Charles E; Velasco, Carlos E; Roullard, Christina P; Rafael, Aldo

    2017-07-01

    We describe a man with the Marfan syndrome and a prior ascending aortic aneurysm resection who presented with knee pain and concern of endocarditis. Transesophageal echocardiogram showed no vegetations, and computed tomography angiogram of the heart showed a possible pseudoaneurysm. Cardiac catheterization and aortogram revealed the diagnosis of an aorto-right atrial fistula, which was then operatively repaired. This case highlights the role that cardiac catheterization with aortogram can play in the detection of aorto-atrial fistula.

  7. Coloarticular fistula: A rare complication of revision total hip arthroplasty

    OpenAIRE

    Long, Suzanne S.; Tawa, Nicholas E.; Ayres, Douglas K.; Abdeen, Ayesha; Wu, Jim S.

    2011-01-01

    Fistula formation between bowel and total hip arthroplasty or revision arthroplasty hardware is rare. We present a case of a 78-year-old woman with protrusio of left hip arthroplasty and acetabular reconstruction hardware that caused direct perforation of the sigmoid colon and fistula formation between the sigmoid colon and the left hip joint. The patient underwent several joint debridements, sigmoid colectomy, and removal of all orthopedic hardware; she ultimately died after two prolonged ho...

  8. H type tracheoesophageal fistula detected by radionuclide salivagram

    Energy Technology Data Exchange (ETDEWEB)

    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.

  9. Pleuropancreatic fistula: endoscopic retrograde cholangiopancreatography and computed tomography

    International Nuclear Information System (INIS)

    McCarthy, S.; Pellegrini, C.A.; Moss, A.A.; Way, L.W.

    1984-01-01

    The complementary use of endoscopic retrograde cholangiopancreatography and computed tomography in the diagnosis and management of pleuropancreatic fistulas is described in relation to four cases in which computed tomography revealedthe thoracic extension of a pancreatic fistula not demonstrable by endoscopic retrograde cholangiopancreatography, although the latter indicated an abnormal pancreatic duct. The complementary use of both techniques may be necessary to define the pathologic anatomy so that the appropriate therapy, particularly the surgical approach, can be decided

  10. First-in-Human Case Study: Pregnancy in Women With Crohn’s Perianal Fistula Treated With Adipose-Derived Stem Cells: A Safety Study

    Science.gov (United States)

    García-Arranz, Mariano; Guadalajara, Hector; de la Quintana, Paloma; Herreros, Maria Dolores; García-Olmo, Damián

    2015-01-01

    The aim of this study was to determine whether treatment with adipose-derived stem cells (ASCs) had any influence on fertility, course of pregnancy, newborn weight, or physical condition of newborns. We performed a retrospective study of patients with a desire to become pregnant after having received intralesional injection of autologous ASCs for the treatment of perianal or rectovaginal fistula associated with Crohn’s disease. We collected data on the resulting pregnancies, deliveries, and newborns of these patients. ASCs were expanded in vitro and characterized according to the international guidelines for cell surface markers (clusters of differentiation) and differentiated to adipocytes, chondrocytes, and osteocytes prior to implantation (except first implant in 2002). We analyzed five young women with Crohn’s disease treated with ASCs: one for rectovaginal and perianal fistula, two for rectovaginal fistula only, and two for perianal fistula only. All patients received 2 doses of 20 million and 40 million cells at an interval of 3–4 months. Another patient received 2 doses of 6.6 million and 20 million ASCs with 9 months between each dose. Fertility and pregnancy outcomes were not affected by cell therapy treatment. No signs of treatment-related malformations were observed in the neonates by their respective pediatricians. In the patients studied, cell therapy with ASCs did not affect the course of pregnancy or newborn development. Significance Local treatment with mesenchymal stem cells derived from adipose tissue seems not to affect the ability to conceive, the course of pregnancy, pregnancy outcomes, or newborns’ health in female patients. This is the first publication about pregnancy outcome in women with perianal fistula and Crohn’s disease treated with stem cell therapy, and could be of interest for doctors working in cell therapy. This is a very important question for patients, and there was no answer for them until now. PMID:25925838

  11. Gastrosplenic fistula in Hodgkin's lymphoma treated successfully by laparoscopic surgery and chemotherapy

    International Nuclear Information System (INIS)

    Al-Asghar, Hamad I.; Khan, Mohammad Q.; Ghamdi, Abdullah M.; Bamehirz, Fahad Y.; Maghfoor, I.

    2007-01-01

    A gastrosplenic fistula is a rare complication of a gastric or splenic lesion. We report a case of Hodgkin's lymphoma (nodular sclerosis) involving the spleen that was complicated by spontaneous gastrosplenic fistula. The fistula was closed laparoscopically and the patient underwent partial gastrectomy and gastric wall repair followed by successful chemotherapy. This is also the first reported case in published literature where the closure of gastrosplenic fistula and partial gastrectomy was carried out laparoscopically. We recommend that extensive open surgical procedures including total gastroectomy, splenectomy and pancreatectomy may be avoided in the management of gastrosplenic fistula and the patient could be managed by less radical, simple laparoscopic fistulectomy, with partial gastric resection. If the fistula is caused by a malignant process, the surgical repair should be followed by definitive treatment with chemotherapy and radiotherapy. (author)

  12. Spontaneous bronchoesophageal fistula in an adult – A possible delayed sequela of pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Surendra Patel

    2015-01-01

    Full Text Available Spontaneous bronchoesophageal fistula in the adult is a rare clinical entity. Most bronchoesophageal fistulae are due to malignancy, prolonged endotracheal intubation or trauma. Granulomatous infections like tuberculosis, HIV and mediastinitis are rare causes of acquired bronchoesophageal fistula. We report a case of a 50 year old man, treated for pulmonary tuberculosis 15 years ago, who developed a spontaneous bronchoesophageal fistula between the mid-esophagus and right main stem bronchus, having no history of malignancy or trauma. Surgical closure of the fistula was done and post operative recovery was uneventful. In this case, the bronchoesophageal fistula probably developed as a delayed sequela of pulmonary tuberculosis as the patient had no active signs of pulmonary tuberculosis clinically or histopathologically.

  13. Diagnosis and endoscopic treatment of esophago-bronchial fistula due to gastric heterotopy.

    Science.gov (United States)

    Katsanos, Konstantinos H; Christodoulou, Dimitrios K; Kamina, Sevasti; Maria, Kosmidou; Lambri, Evangelia; Theodorou, Stavroula; Tsampoulas, Konstantinos; Vasiliki, Mitsi; Tsianos, Epameinondas V

    2010-04-16

    Heterotopic gastric mucosa patches are congenital gastrointestinal abnormalities and have been reported to occur anywhere along the gastrointestinal tract from mouth to anus. Complications of heterotopic gastric mucosa include dysphagia, upper gastrointestinal bleeding, upper esophageal ring stricture, adenocarcinoma and fistula formation. In this case report we describe the diagnosis and treatment of the first case of esophago-bronchial fistula due to heterotopic gastric mucosa in mid esophagus. A 40-year old former professional soccer player was referred to our department for treatment of an esophago-bronchial fistula. Microscopic examination of the biopsies taken from the esophageal fistula revealed the presence of gastric heterotopic mucosa. We decided to do a non-surgical therapeutic endoscopic procedure. A sclerotherapy catheter was inserted through which 1 mL of ready to use synthetic surgical glue was applied in the fistula and it closed the fistula opening with excellent results.

  14. Nephrobronchial fistula secondary to xantogranulomatous pyelonephritis

    Directory of Open Access Journals (Sweden)

    Jose R. De Souza

    2003-06-01

    Full Text Available INTRODUCTION: Nephrobronchial fistula is a rare complication of xanthogranulomatous pyelonephritis, a disease that can fistulize to lungs, skin, colon and other organs. CASE REPORT: A 37-year old patient presented a chronic history of lumbar pain and thoracic symptoms such as cough, dyspnea and oral elimination of pus. Patient went to several services and was submitted to 2 thorax surgeries before definitive treatment (nephrectomy was indicated. After nephrectomy, the patient presented an immediate improvement with weight gain (8 kg / 1 month and all his symptoms disappeared. CONCLUSION: This clinical case illustrates the natural history of nephrobronchial fistula, the importance of clinical history for diagnosis and the relevance of early treatment of renal lithiasis.

  15. Anomalous Right Subclavian Artery-Esophageal Fistulae

    Directory of Open Access Journals (Sweden)

    Courtney Brooke Shires

    2018-01-01

    Full Text Available An aberrant right subclavian artery (ARSA is the most common aortic arch anomaly, but only 19 previous cases of ARSA-esophageal fistula have been reported. Six patients have survived their bleeding episode. We describe the case of a 44-year-old woman who developed massive hemoptysis. Laryngoscopy, bronchoscopy, head and neck angiogram, and median sternotomy did not reveal what was presumed initially to be a tracheoinnominate fistula. Contrasted CT showed an anomalous subclavian artery posterior to the esophagus. Given the technical challenge of approaches for this pathology, the patient was unfit for open surgical repair. Therefore, endovascular covered stent grafts were deployed spanning the segment of the subclavian artery in continuity with the esophagus, via a right brachial artery approach. Unfortunately, the patient died after successful placement of the grafts.

  16. Intracranial dural arteriovenous fistula with spinal medullary venous drainage

    International Nuclear Information System (INIS)

    Wiesmann, M.; Padovan, C.S.; Pfister, H.W.; Yousry, T.A.

    2000-01-01

    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.)

  17. 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.

  18. Ureterovaginal fistula: A complication of a vaginal foreign body.

    Science.gov (United States)

    Lo, Tsia-Shu; Jaili, Sukanda Bin; Ibrahim, Rami; Kao, Chuan Chi; Uy-Patrimonio, Ma Clarissa

    2018-02-01

    To know the diagnostic tools and proper management of ureterovaginal fistula following neglected vaginal foreign body in order to achieve optimal outcome. A case of ureterovaginal fistula associated with a neglected vaginal foreign body. The patient was complaining of a foul-smelling vaginal discharge and lower abdominal pain. On vaginal examination, a hard and large foreign body was found. Examination under anesthesia was performed, and an aerosol cap was removed from her vagina. The patient developed urinary incontinence after removal of the foreign body. Subsequent work-up demonstrated the presence of a right ureterovaginal fistula. The patient underwent an abdominal ureteroneocystostomy. At one year follow up, the patient had fully recovered. Ureterovaginal fistula following neglected vaginal foreign body is a serious condition. Early diagnosis, treatment of infection and proper surgical management can improve the outcome and decrease complications. Copyright © 2018. Published by Elsevier B.V.

  19. Urinary tract infection among fistula patients admitted at Hamlin fistula hospital, Addis Ababa, Ethiopia.

    Science.gov (United States)

    Dereje, Matifan; Woldeamanuel, Yimtubezinesh; Asrat, Daneil; Ayenachew, Fekade

    2017-02-16

    Urinary Tract Infection (UTI) causes a serious health problem and affects millions of people worldwide. Patients with obstetric fistula usually suffer from incontinence of urine and stool, which can predispose them to frequent infections of the urinary tract. Therefore the aim of this study was to determine the etiologic agents, drug resistance pattern of the isolates and associated risk factor for urinary tract infection among fistula patients in Addis Ababa fistula hospital, Ethiopia. Across sectional study was conducted from February to May 2015 at Hamlin Fistula Hospital, Addis Ababa, Ethiopia. Socio-demographic characteristics and other UTI related risk factors were collected from study participants using structured questionnaires. The mid-stream urine was collected and cultured on Cysteine lactose electrolyte deficient agar and blood agar. Antimicrobial susceptibility was done by using disc diffusion method and interpreted according to Clinical and Laboratory Standards Institute (CLSI). Data was entered and analyzed by using SPSS version 20. Out of 210 fistula patients investigated 169(80.5%) of the patient were younger than 25 years. Significant bacteriuria was observed in 122/210(58.1%) and 68(55.7%) of the isolates were from symptomatic cases. E.coli 65(53.7%) were the most common bacterial pathogen isolated followed by Proteus spp. 31(25.4%). Statistical Significant difference was observed with history of previous UTI (P = 0.031) and history of catheterization (P = 0.001). Gram negative bacteria isolates showed high level of resistance (>50%) to gentamicin and ciprofloxacin, while all gram positive bacteria isolated were showed low level of resistance (20-40%) to most of antibiotic tested. The overall prevalence of urinary tract infection among fistula patient is 58.1%. This study showed that the predominant pathogen of UTI were E.coli followed by Proteus spp. It also showed that amoxicillin-clavulanic acid was a drug of choice for urinary tract

  20. 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.

  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. Graciloplasty for recurrent recto-neovaginal fistula in a male-to-female transsexual.

    Science.gov (United States)

    Altomare, D F; Scalera, I; Bettocchi, C; Di Lena, M

    2013-02-01

    Rectovaginal fistula is usually a challenging condition for surgeons, but a fistula between the rectum and the neovagina in male-to-female transsexual is even more difficult to treat as it is a rare complication occurring in a patient with modified anatomy of the perineum, with heavy psychological implications for the patient. Here, we report a case of recurrent recto-neovaginal fistula in a male-to-female transsexual successfully treated by perineal graciloplasty.

  3. Assessment of the efficacy of the rectovaginal button fistula plug for the treatment of ileal pouch-vaginal and rectovaginal fistulas.

    Science.gov (United States)

    Gonsalves, Simon; Sagar, Peter; Lengyel, John; Morrison, Charles; Dunham, Richard

    2009-11-01

    The treatment of rectovaginal and ileal pouch-vaginal fistulas remains a challenging problem for the colorectal surgeon. The aim of this study was to assess the short-term efficacy of the new Surgisis Biodesign rectovaginal button fistula plug in patients with such fistulas. Between May 2008 and September 2008, patients with confirmed rectovaginal and ileal pouch-vaginal fistulas with backgrounds of inflammatory bowel disease were treated with the button fistula plug. The fistulas were assessed by magnetic resonance imaging and/or examination under anesthesia before the procedure. Twelve patients with a median age of 36 (range, 29-42) years underwent a total of 20 plug insertions. Five patients had confirmed rectovaginal fistulas and seven patients had ileal pouch-vaginal fistulas. At a median follow-up of 15 (interquartile range, 10-21) weeks, 7 of 12 patients (58%) had been treated successfully. Seven of the 20 plugs that were inserted (35%) were successful. This equates to the successful treatment of three of five (60%) of the rectovaginal fistulas, and four of seven (57%) of the ileal pouch-vaginal fistulas. Of the six patients who initially failed, a repeat procedure was performed of which one was successful. Two patients underwent a third repeat procedure, which was again unsuccessful in both cases. The success rate of these eight repeat plug insertions was therefore 12.5%. All plug failures were the result of dislodgement of the plug. There was no morbidity in our series. The new button fistula plug successfully treated 7 of 12 (58%) rectovaginal and ileal pouch-vaginal fistulas.

  4. Acquired tracheo-oesophageal fistula.

    Directory of Open Access Journals (Sweden)

    Shah C

    1994-04-01

    Full Text Available Acquired tracheo-oesophageal fistula is rare. The most common causes are tuberculosis and malignancy. Here we report a patient who had come with dysphagia and aspiration pneumonia with paratracheal lymphnodes on X-ray chest and was diagnosed to have a tracheo-bronchial fistula on barium studies. Transtumoral intubation by pull-through method was carried out.

  5. Cholecystic fistula with atypical symptoms

    DEFF Research Database (Denmark)

    Bang, U.C.; Hasbak, P.; From, G.

    2008-01-01

    We report a patient with spontaneous cholecystocolonis fistula secondary to cholelithiasis. A 93 year-old woman was admitted because of weight loss, diarrhoea and upper abdominal pain. Ultrasound examination revealed air in the biliary tract and cholescientigraphy revealed a fistula between the g...

  6. Case report: Manual lymphatic drainage and kinesio taping in the secondary malignant breast cancer-related lymphedema in an arm with arteriovenous (A-V) fistula for hemodialysis.

    Science.gov (United States)

    Chou, Ya-Hui; Li, Shu-Hua; Liao, Su-Fen; Tang, Hao-Wei

    2013-08-01

    Lymphedema is a dreaded complication of breast cancer treatment. The standard care for lymphedema is complex decongestive physiotherapy, which includes manual lymphatic drainage (MLD), short stretch bandaging, exercise, and skin care. The Kinesio Taping could help to improve lymphatic uptake. We reported a patient with unilateral secondary malignant breast cancer-related lymphedema and arteriovenous (A-V) fistula for hemodialysis happened in the same arm, and used kinesio taping, MLD, and exercise to treat this patient because no pressure could be applied to the A-V fistula. The 12-session therapy created an excellent effect. We do not think the kinesio taping could replace short stretch bandaging, but it could be another choice for contraindicating pressure therapy patients, and we should pay attention to wounds induced by kinesio tape.

  7. APPENDICOVESICAL FISTULA: A RARE COMPLICATION OF APPENDICITIS

    Directory of Open Access Journals (Sweden)

    F. Golfam

    2008-05-01

    Full Text Available Appendicovesical fistula is an uncommon type of enterovesical fistula and a rare complication of unrecognized appendicitis. Appendicovesical fistula often presents with recurrent or persistent urinary tract infection, especially in men. The commonest causes are appendicitis, cecal diverticulitis, and cystadenocarcinoma or carcinoid tumors of appendix. Approximately 114 cases have been reported previously in the literature, the vast majority in young male patients. Our special case joins the other cases which have already been described in the international literature. This case is a middle-aged man and is the first who has large and multiple fecaliths. We reviewed other cases and contributed an additional one with hope that increased awareness of this entity may facilitate the correct diagnosis and avoid inappropriate management.

  8. A traumatic dural arteriovenous fistula between the inferolateral trunk of the internal carotid artery and the ophthalmic vein: A case of transvenous coil embolization via the facial vein

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jun Young; Hong, Chang Ki; Suh, Sang Hyun [Dept. of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Dong Ik [Dept. of of Radiology, CHA Bundang Medical Center, CHA University, Seongnam (Korea, Republic of)

    2017-05-15

    A 31-year-old man was admitted with exophthalmos. He suffered from progressive exophthalmos, bruit and conjunctival chemosis 7 days after head trauma caused by falling down. Cerebral angiography showed a dural arteriovenous fistula (DAVF) draining into the ophthalmic vein caused by tear in the inferolateral trunk, which is a rare presentation of traumatic DAVF. Selective transvenous coil embolization was performed via the facial vein without neurologic complications.

  9. 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......Intraoperative identification and later development of arteriovenous fistulas were investigated prospectively in 70 in situ saphenous vein bypass procedures. Surveillance was performed by completion arteriography and intra- and postoperative continuous wave Doppler examination. The intraoperative...... of the fistula. Pursuing a policy of selectively ligating fistulas that only fill the deep venous system on completion arteriography led to an additional nine arteriovenous fistulas. Developed over an average follow-up of six months, four patients presented symptoms of edema and swelling and were relieved upon...

  10. 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.

  11. Dural fistulas of the cavernous sinus

    International Nuclear Information System (INIS)

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

    1984-01-01

    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. (orig.)

  12. Frequency of oronasal fistulae in complete cleft palate repair

    International Nuclear Information System (INIS)

    Aslam, M.

    2015-01-01

    To determine the frequency of oro-nasal fistula in patients undergoing complete cleft palate repair by two flappalatoplasty. Study Design: Case series. Place and Duration of Study: Department of Plastic Surgery, Services Hospital, Lahore, from January to December 2013. Methodology: Patients admitted to the study place for repair of cleft palate after informed consent obtained were included. Cleft palate was repaired by two-flap palatoplasty, using Bardach technique. Patients were discharged on the second postoperative day and followed-up at third week postoperatively. During follow-up visits, fistulae formation and their sites were recorded on pre-designed proforma. Results: Among the total 90 patients, 40 patients (44.4%) were male and 50 patients (55.6%) were female. The mean age was 6.4 +- 5.7 years ranging from 9 months to 20 years. At third week follow-up, 5 patients (5.6%) had fistulae formation. Four patients (80%) had anterior fistulae and one patient (20%) had posterior fistula. Conclusion: With two-flap palatoplasty Bardach procedure for repair of cleft palate, the complication of fistula formation was uncommon at 5.6%, provided the repair was tension free and multi-layered. (author)

  13. Bronchobiliary Fistula Localized by Cholescintigraphy with Single-Photon Emission Computed Tomography

    International Nuclear Information System (INIS)

    Artunduaga, Maddy; Patel, Niraj R.; Wendt, Julie A.; Guy, Elizabeth S.; Nachiappan, Arun C.

    2015-01-01

    Biliptysis is an important clinical feature to recognize as it is associated with bronchobiliary fistula, a rare entity. Bronchobiliary fistulas have been diagnosed with planar cholescintigraphy. However, cholescintigraphy with single-photon emission computed tomography (SPECT) can better spatially localize a bronchobiliary fistula as compared to planar cholescintigraphy alone, and is useful for preoperative planning if surgical treatment is required. Here, we present the case of a 23-year-old male who developed a bronchobiliary fistula in the setting of posttraumatic and postsurgical infection, which was diagnosed and localized by cholescintigraphy with SPECT

  14. 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....... 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...

  15. Post-laparotomy haemoptysis due to broncho-abdominal fistula ...

    African Journals Online (AJOL)

    migrating through the diaphragm into the chest and presenting as a right-sided lung abscess.6 Broncho-abdominal fistula (BAF) is similarly rare with a search yielding two reports involving single cases and one other report involving three cases.7–9. All aforementioned BAF cases refer to the right hemi-diaphragm.

  16. Management of pharynx fistula after upper digestive tract instrumentation

    Directory of Open Access Journals (Sweden)

    Bogdan Popescu

    2017-05-01

    Full Text Available Pharynx fistula is a pathological state that can pose serious problems for both physician and patient and can lead up to the death of the patient in complicated cases. The authors describe a series of guidelines for the management of the pharynx fistula regarding the complications of the instrumentation of the upper digestive tract. Most of the cases that are addressed to our clinic can be treated with a conservative approach and a nutrition therapy plan tailored to each case. In selected cases surgery is the method of choice for therapy. The management of the pharynx fistula can be well managed in a multidisciplinary approach using resources from the E.N.T. and H.N.S. department and more important from the ICU department.

  17. Duodenal-bronchial fistula: an unusual cause of shortness of breath and a productive cough

    Directory of Open Access Journals (Sweden)

    Cynthia Wong, BMBS

    2016-09-01

    Full Text Available Duodenal-bronchial fistulas are very uncommon, even among the already rare subgroup of abdominal-bronchial fistulas. We describe a case of a woman with Crohn's disease who presented with shortness of breath and a productive cough who was found to have a duodeanl bronchial fistula on computed tomography scan. We demonstrate with this case how these rare cases can lead to chronic lung aspirations and require multidisciplinary involvement.

  18. Pulmonary arterio-venous micro fistulae - Diagnostic

    International Nuclear Information System (INIS)

    Ebram, J.C.

    1989-01-01

    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)

  19. Risk factors for leukopenia in patients with gastrointestinal fistula.

    Science.gov (United States)

    Zhou, Zheng; Ren, Jian-An; Liu, Hai-Yan; Gu, Guo-Sheng; Li, Jie-Shou

    2010-12-01

    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. 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. 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. 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.

  20. Transitional Flow in an Arteriovenous Fistula: Effect of Wall Distensibility

    Science.gov (United States)

    McGah, Patrick; Leotta, Daniel; Beach, Kirk; Aliseda, Alberto

    2012-11-01

    Arteriovenous fistulae are created surgically to provide adequate access for dialysis in patients with end-stage renal disease. Transitional flow and the subsequent pressure and shear stress fluctuations are thought to be causative in the fistula failure. Since 50% of fistulae require surgical intervention before year one, understanding the altered hemodynamic stresses is an important step toward improving clinical outcomes. We perform numerical simulations of a patient-specific model of a functioning fistula reconstructed from 3D ultrasound scans. Rigid wall simulations and fluid-structure interaction simulations using an in-house finite element solver for the wall deformations were performed and compared. In both the rigid and distensible wall cases, transitional flow is computed in fistula as evidenced by aperiodic high frequency velocity and pressure fluctuations. The spectrum of the fluctuations is much more narrow-banded in the distensible case, however, suggesting a partial stabilizing effect by the vessel elasticity. As a result, the distensible wall simulations predict shear stresses that are systematically 10-30% lower than the rigid cases. We propose a possible mechanism for stabilization involving the phase lag in the fluid work needed to deform the vessel wall. Support from an NIDDK R21 - DK08-1823.

  1. Duodeno-pleural fistula: a rare complication of peptic ulcer perforation

    African Journals Online (AJOL)

    Duodenopleural fistula is a very uncommon complication of peptic ulcer perforation and usually follows empyema after a subdiaphragmatic abscess rupture. We present a rare case of duodenopleural fistula following subdiaphragmatic abscess, which resulted in thoracic empyema after gastric perforation. Keywords: ...

  2. Selective digital venous hypertension: A rare complication of hemodialysis arteriovenous fistula

    Energy Technology Data Exchange (ETDEWEB)

    Swayne, L.C.; Manstein, C.; Somers, R.; Cope, C.

    1983-04-01

    We report and document angiographically a case of selective venous hypertension, masquerading as an infection, which involved the three middle digits of the right hand in a patient with an access arteriovenous (AV) fistula. This complication arose following hemodialysis and was resolved after resection of the right radial artery at the site of AV fistula and re-anastomosis.

  3. Difficult management of posterior urethra gunshot wound combined with urethro-rectal fistula

    Directory of Open Access Journals (Sweden)

    Walid Kerkeni

    2015-06-01

    Full Text Available Posterior urethra gunshot wounds are poorly described in the literature. They are often associated with pelvic vital lesions making difficult early repair of urethral injuries. They can be complicated by urethro-rectal fistula, which makes their management more complicated. We report a new case of posterior urethra disruption due to a gunshot wound and complicated by urethro-rectal fistula.

  4. Difficult management of posterior urethra gunshot wound combined with urethro-rectal fistula

    OpenAIRE

    Walid Kerkeni; Ahmed Saadi; Mohamed Hédi Rebai; Abderrazak Bouzouita; Mohamed Cherif; Amine Derouiche; Tahar Khalfallah; Mohamed Riadh Ben Slama; Mohamed Chebil

    2015-01-01

    Posterior urethra gunshot wounds are poorly described in the literature. They are often associated with pelvic vital lesions making difficult early repair of urethral injuries. They can be complicated by urethro-rectal fistula, which makes their management more complicated. We report a new case of posterior urethra disruption due to a gunshot wound and complicated by urethro-rectal fistula.

  5. The trend of presentation of vesico-vaginal fistula (VVF) and recto ...

    African Journals Online (AJOL)

    This is a case report of an unmarried 16 year old unbooked (P1+0) female patient with a diagnosis of vesico-vaginal fistula and recto-vaginal fistula following four day obstructed labour is presented. Following an intravenous urography (IVU), evidence of contrast in the bladder, vagina and rectum due to fistulous connection ...

  6. Successful management of atrio-esophageal fistula after cardiac radiofrequency catheter ablation.

    Science.gov (United States)

    Shim, Hun Bo; Kim, Chilsung; Kim, Hong-Kwan; Sung, Kiick

    2013-04-01

    An increase in cardiac radiofrequency catheter ablation for treating refractory atrial fibrillation has resulted in an increased prevalence of complications. Among numerous complications of radiofrequency catheter ablation, atrio-esophageal fistula, although rare, is known to have fatal results. We report a case of successful management of an atrio-esophageal fistula as a complication of cardiac radiofrequency catheter ablation.

  7. Endovascular Stenting for Primary Aortobronchial Fistula in Association with Massive Hemoptysis

    OpenAIRE

    Kokotsakis, John; Misthos, Panagiotis; Athanasiou, Thanos; Romana, Constantina; Skouteli, Elian; Lioulias, Achilles; Kaskarelis, Ioannis

    2007-01-01

    Aortobronchial fistula is a potentially lethal complication secondary to the repair of a descending thoracic aneurysm or the placement of a prosthetic graft. Few cases have been reported. Very rarely, primary aortobronchial fistula occurs in a patient who has no history of cardiac surgical intervention.

  8. Acute on Chronic Pancreatitis Causing a Highway to the Colon with Subsequent Road Closure: Pancreatic Colonic Fistula Presenting as a Large Bowel Obstruction Treated with Pancreatic Duct Stenting

    OpenAIRE

    Cochrane, Justin; Schlepp, Greg

    2015-01-01

    Context. Colonic complications associated with acute pancreatitis have a low incidence but carry an increased risk of mortality with delayed diagnosis and treatment. Pancreatic colonic fistula is most commonly associated with walled off pancreatic necrosis or abscess formation and rarely forms spontaneously. Classic clinical manifestations for pancreatic colonic fistula include diarrhea, hematochezia, and fever. Uncommonly pancreatic colonic fistula presents as large bowel obstruction. Case. ...

  9. Obstetric Fistula in Burundi: a comprehensive approach to managing women with this neglected disease

    Science.gov (United States)

    2013-01-01

    Background In Burundi, the annual incidence of obstetric fistula is estimated to be 0.2-0.5% of all deliveries, with 1000–2000 new cases per year. Despite this relatively high incidence, national capacity for identifying and managing obstetric fistula is very limited. Thus, in July 2010, Medecins Sans Frontieres (MSF) set up a specialised Obstetric Fistula Centre in Gitega (Gitega Fistula Centre, GFC), the only permanent referral centre for obstetric fistula in Burundi. A comprehensive model of care is offered including psychosocial support, conservative and surgical management, post-operative care and follow-up. We describe this model of care, patient outcomes and the operational challenges. Methods Descriptive study using routine programme data. Results Between July 2010 and December 2011, 470 women with obstetric fistula presented for the first time at GFC, of whom 458 (98%) received treatment. Early urinary catheterization (conservative management) was successful in four out of 35 (11%) women. Of 454 (99%) women requiring surgical management, 394 (87%) were discharged with a closed fistula, of whom 301 (76%) were continent of urine and/or faeces, while 93 (24%) remained incontinent of urine and/or faeces. In 59 (13%) cases, the fistula was complex and could not be closed. Outcome status was unknown for one woman. Median duration of stay at GFC was 39 days (Interquartile range IQR, 31–51 days). The main operational challenges included: i) early case finding and recruitment for conservative management, ii) national capacity building in obstetric fistula surgical repair, and iii) assessing the psychosocial impact of this model. Conclusion In a rural African setting, it is feasible to implement a comprehensive package of fistula care using a dedicated fistula facility, and satisfactory surgical repair outcomes can be achieved. Several operational challenges are discussed. PMID:23965150

  10. Cholecystic fistula with atypical symptoms

    DEFF Research Database (Denmark)

    Bang, U.C.; Hasbak, P.; From, G.

    2008-01-01

    We report a patient with spontaneous cholecystocolonis fistula secondary to cholelithiasis. A 93 year-old woman was admitted because of weight loss, diarrhoea and upper abdominal pain. Ultrasound examination revealed air in the biliary tract and cholescientigraphy revealed a fistula between the g...... the gallbladder and right colon. Using endoscopic retrograde cholangiopancreatography a calculus was extracted from the bile duct and the symptoms disappeared Udgivelsesdato: 2008/1/14...

  11. Emergency treatment by intravascular embolization in traumatic carotid cavernous fistula

    International Nuclear Information System (INIS)

    Tang Jun; Sun Zengtao; Liu Zuoqin; Liu Yanjun; Li Fengxin

    2006-01-01

    Objective: To discuss the method of intervenfional intravascular treatment in traumatic carotid cavernous fistula (TCCF) and the significance of clinical application in emergency. Methods: In 297 eases of TCCF, 36 cases were treated by interventional intravascular embolization by detachable balloon, embolization orificium or occlusion in one side of carotid artery. In the 36 cases, serious epistaxis occurred in 22 eases, cortical vein inflow in 9 cases, intracranial hemorrhage in 3 cases, aggravation of eyesight in 3 cases, and limb dysfunction in 2 cases. Results: Fistula was successfully embolized and internal carotid artery remained patent in 19 cases. Complete embolization of orificium or internal carotid artery was achieved in 17 eases. The serious epistaxias in 22 cases and intracranial hemorrhage in 3 cases stopped. Eyesight recovered in 2 eases and improved in 1 case. Limb dysfunction improved evidently in 2 cases. Conclusion: Intravascular embolization treatment is the first therapeutic choice for TCCF, especially in emergency. It is necessary, safe and effective. (authors)

  12. Multifactorial dyspahgia complicated by esophago-bronchial fistula

    Directory of Open Access Journals (Sweden)

    Sebastian Julie

    2007-01-01

    Full Text Available Dysphagia in an elderly patient necessitates urgent clinical evaluation to exclude the possibility of an underlying esophageal malignancy. Atherosclerotic aortic aneurysms are common in old age, but dysphagia aortica resulting from compression of the esophagus by an aortic aneurysm is a rare cause for dysphagia. Development of a malignant esophago-airway fistula can occur from a variety of tumors, the most common of which is esophageal cancer. A case of longstanding dysphagia resulting from dysphagia aortica later developing an esophageal malignancy complicated by esophago-bronchial fistula is outlined in this unique case report.

  13. A nasogastric tube inserted into the gastrocutaneous fistula.

    Science.gov (United States)

    Kim, Yang Soo; Kim, Joon Sung; Yu, In Hee; Jeong, Ji Young; Jung, Sung Hee; Jo, Yil Ryun; Chung, Myung Eun

    2011-12-01

    We reported a case in which a nasogastric tube was inserted into the gastrocutaneous fistula, diagnosed by abdominal computed tomography. A 78-year-old man with a history of recurrent cerebral hemorrhage had a percutaneous endoscopic gastrostomy tube due to dysphagia for 2 years. However, soft tissue infection at the gastrostomy site caused the removal of the tube. Immediately, antibiotic agents were infused. For appropriate hydration and medication, a nasogastric tube was inserted. However, there was no significant improvement of the soft tissue infection. Moreover, the amount of bloody exudate increased. Abdominal computed tomography revealed the nasogastric tube placed under the patient's skin via gastrocutaneous fistula. The nasogastric tube was removed, and an antibiotic agents were maintained. After 3 weeks, the signs of infection fully improved, and percutaneous endoscopic gastrostomy was performed again. This case shows necessities of an appropriate interval between removal of the gastrostomy tube and insertion of a nasogastric tube, and suspicion of existence of gastrocutaneous fistula.

  14. A bad experience with endovascular treatment of an aortobronchial fistula.

    Science.gov (United States)

    Eldien, Altarabsheh Salah; Deo, Salil; Nichols, Francis C; Greason, Kevin L

    2012-02-01

    A 35-year-old woman presented with an aortobronchial fistula after polyester graft replacement of coarctation of the descending thoracic aortic. Treatment of the fistula included antibiotic therapy and stent graft placement. Life-threatening sepsis developed in the postoperative period. Subsequent treatment required excision of the infected graft complex with extra-anatomic reconstruction of the thoracic aorta. The patient had a very stormy postoperative course and required heroic measures, including mechanical circulatory support, to achieve survival. The present case demonstrates failure of endovascular therapy of an aortobronchial fistula. The case should serve as a cautious reminder that the underlying cause for infection remains even after apparent successful endovascular therapy. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  15. [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. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  16. Embolization of carotid-cavernous fistula using a silicone balloon and a tracker-catheter system

    International Nuclear Information System (INIS)

    Kim, Sun Yong; Cho, Kil Ho; Park, Bok Hwan

    1992-01-01

    With the recent introduction and development of the detachable balloon system, it has become the treatment of choice in the management of carotid cavernous fistulas(CCFs). But, since most delivery systems for embolization of CCF mainly depend on flow guidance for balloon delivery, in case of small fistula, pseudo aneurysm and arterialized venous collaterals, failure of balloon embolization can occur. To overcome these limitation, the authors designed and used a new versatile, steerable, and flow-guided detachable balloon system by using a Tracker catheter system with silicone or latex balloons. Using this maneuver, we could get successful fistula occlusion in 7 out of 8 patients (silicone balloon). But in one case, we had to occlude the internal carotid artery at the fistula site, proximal and distal cervical portions of the internal carotid artery. This balloon delivery system proved to provide high selectivity for fistula and relatively ease of handing

  17. [Omentum Transplantation in Thorax to Cover Bronchial Stump as Treatment of 
Bronchopleural Fistula After Pulmonary Resection: Report of 6 Cases' Experience].

    Science.gov (United States)

    Yang, Xiaozun; Yang, Xiaojun; Xie, Tianpeng; Hu, Bin; Li, Qiang

    2018-03-20

    Bronchial pleural fistula (BPF) is a common complication after thoracic surgery for lung resection. Clinical treatment is complex and the effect is poor. The treatment of BPF after lung resection has plagued thoracic surgeons. We reviewed retrospectively the clinical and follow-up data of 6 patients in our hospital who underwent the omentum transplantation in thorax to cover bronchial stump as treatment of BPF after pulmonary resection to analyze why BPF occurs and describe this treatment method. We intend to discuss and evaluate the feasibility, safety and small sample success rate ofthis treatment method. During August 2016 to February 2018, six patients in our hospital underwent remedial open thoracotomy and omentum transplantation in pleura space to cover bronchial stump as treatment of bronchopleural fistula after pulmonary resection. Four patients had undergone a prior pneumonectomy and two patients had undergone a prior lobectomy (the residual lungs were resected with the main bronchus cut by endoscopic stapler during the reoperation). The bronchial stumps were sutured by 4-0 string with needle and covered by omentums, which were transplanted in pleura space from the cardiophrenic angle. Postoperatively, the pleura space was irrigated and drained. Summarize the clinical effect and technique learning points. The patients were all males, aged 61 to 73 years (median age: 66). BPF occurred from postoperative day 10 to 45 (median postoperative day 25). The reoperation was finished in 80 mins-150 mins (median 110 mins). Total blood loss was 200 mL-1,000 mL (median 450 mL). These patients were discharged on postoperative day 12-17 (median 14 days), and there was no more complications associated with bronchopleural fistula. All six patients' bronchial stumps were well closed (100%) and have recovered well during the follow-up period, which lasted 1 month-18 months. Remedial operation should be performed as soon as possible when BPF after pulmonary resection

  18. Primary vaginal calculus secondary to urethrovaginal fistula with imperforate hymen in a 6-year-old girl.

    Science.gov (United States)

    Oguzkurt, Pelin; Ince, Emine; Ezer, Semire Serin; Temiz, Abdülkerim; Demir, Senay; Hicsonmez, Akgun

    2009-07-01

    Primary vaginal stones are extremely rare in children and may be mistaken for bladder calculi on plain radiography. We present a case of a large vaginal calculus in a 6-year-old girl who had an imperforate hymen and urethrovaginal fistula. Hymenotomy and urethrovaginal fistula repair were performed, and the vaginal stone was extracted. It was postulated that the vaginal calculus originated from stasis of urine through the urethrovaginal fistula in the obstructed vagina. This is a unique case of a vaginal calculus with a congenital urethrovaginal fistula associated with an imperforate hymen.

  19. A rare approach to entero-atmospheric fistula.

    Science.gov (United States)

    Meshikhes, Abdul-Wahed Nasir; Al-Hariri, Abdulrazzak; Al-Zahir, Ali Ahmed; Al-Nahawi, Mamdouh

    2013-01-01

    Female, 60 FINAL DIAGNOSIS: Recurrent incisional hernia Symptoms: - - Clinical Procedure: Limited ileo-cecal resection Specialty: Surgery. Diagnostic/therapeutic accidents. Iatrogenic entero-atmospheric fistula is devastating and its management is extremely difficult because it is often associated with fluid and electrolyte disturbances, nutritional problems, and life-threatening sepsis. A 60-year-old woman underwent laparoscopic repair of a recurrent incisional hernia that was complicated by iatrogenic cecal injury necessitating a limited ileocecal resection and onlay prosthetic mesh repair of the hernia. Postoperatively, sloughing of the overlying skin led to mesh exposure. An attempted rotational flap coverage was complicated by small bowel injury, which was recognized and repaired. However, an entero-atmospheric fistula developed after the removal of contaminated mesh. The fistula was initially treated by vacuum-assisted closure dressing and later was converted to a 'stoma'. Six months later, the small bowel segment bearing the fistula was excised and bowel continuity was restored. In selected cases, the conversion of entero-atmospheric fistula to a 'stoma' allows the patient to be discharged home early and maintain good nutritional status while awaiting the definitive surgical intervention.

  20. Treatment of ureterovaginal fistula using a Memokath stent

    DEFF Research Database (Denmark)

    Mohammad, Wael; Fode, Mikkel Mejlgaard; Azawi, Nessn Htum

    2014-01-01

    Ureterovaginal fistula (UVF) is a challenging problem for patients and doctors, especially in patients who have been treated by radiation for malignancy. UVF may occur in conjunction with surgeries involving the uterus. A success rate of 70-100% has been reported for fistula repair with the best...... results in non-radiated patients. Meanwhile, conservative treatment using ureteral stents in selected patients has resulted in reported success rates of 71%. We present the case of a 24-year-old woman with UVF due to surgery and radiotherapy for cervix cancer. The patient has been successfully treated...

  1. Presentation and Management of Pseudoaneurysmogastric Fistula: A Life Threatening Emergency.

    Science.gov (United States)

    Dash, Nihar Ranjan; Kilambi, Ragini; Singh, Anand Narayan; Pal, Sujoy; Asfan, Mohammed Adil

    2017-10-01

    Pseudoaneurysmogastric fistula is a rare consequence of pseudoaneurysms occurring in the vicinity of stomach. They are the result of pseudoaneurysms eroding into the stomach, and represent a life threatening emergency. Urgent surgical intervention is often necessary to salvage the patient. Data regarding the presentation and management of this condition is sparse. Herein, we present our experience with four cases of pseudoaneurysmogastric fistula, their clinical context, presentation, management and outcomes. We attempt to outline an algorithm for the diagnosis and management of this unusual complication.

  2. 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 coronary-pulmonary fistula were diagnosed using multiple cardiovascular imaging modalities to provide a sufficient anatomical picture. The patient was considered at high risk of sudden death from aneurysm rupture and received surgical treatment. Subsequent histopathological examination revealed a true...

  3. Spontaneous Enterocutaneous Fistula Resulting from Richter’s Hernia

    Science.gov (United States)

    Khongwar, Donkupar; Komut, Ojing; Naku, Narang; Baru, Kappa

    2017-01-01

    Richter’s hernia is due to the entrapment of a part of circumference of the bowel wall. As the bowel continuity is maintained, the patients usually do not have intestinal obstruction. Some patients with Richter’s hernia may present with enterocutaneous fistula either spontaneous or due to surgical intervention mistaking the obstructed hernia to be inguinal abscess. This is more so in developing countries due to lack of awareness among the masses or due to the delay in seeking medical attention. Presenting here is a case of a 53-year-old male patient with enterocutaneous fistula which occurred spontaneously and sought medical attention only after about three years of repeated discharge of yellowish fluid from the left inguinal region. Magnetic resonance fistulogram confirmed the diagnosis of enterocutaneous fistula. Laparotomy with resection and primary anastomosis of the fistulous bowel was done. Patient recovered uneventfully without any complications or recurrence. PMID:28969198

  4. Surgical repair of an aneurysm-like fistula connecting the left main coronary artery with the right atrium.

    Science.gov (United States)

    Tong, Guang; Sun, Zhongchan; Zhang, Weida

    2016-08-01

    Coronary fistula is defined as an anomalous connection between a coronary artery and any of the four chambers of the heart or any of its great vessels. A coronary fistula connecting the left main coronary artery to the right atrium is the most uncommon. In the present study, we report the surgical management of a very uncommon case of an aneurysm-like fistula connecting the left main coronary artery to the right atrium in a 2-year-old boy.

  5. Left Circumflex Coronary Artery Fistula Connected to the Right Bronchial Artery Associated with Bronchiectasis: Multidetector CT and Coronary Angiography Findings

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Kyung Jin; Choo, Ki Seok [Dept. of Radiology, Medical Research Institute, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan (Korea, Republic of)

    2013-04-15

    Coronary to bronchial artery fistula is a rare vascular anomaly secondary to enlargement of pre-existing vascular anastomosis between the coronary and bronchial arteries. This occurs when there is a constant disturbance of the pressure equilibrium involving either coronary or broncho-pulmonary disorder. Localized bronchiectasis is the most common related condition in patients with a coronary to bronchial artery fistula. Herein, we report on a case of a large left circumflex coronary artery to right bronchial artery fistula associated with bronchiectasis.

  6. [The experience of our clinic in the treatment of vesicovaginal fistulas].

    Science.gov (United States)

    Tode, V; Deleanu, D; Voinea, F

    2001-01-01

    In this work paper we have presented the experience of our clinic in the treatment of vasicovaginal fistulas (17 cases), secondary surgical procedures. The frequency of vesicovaginal fistulas is very high after gynecological surgery (14 after total hysterectomy for uterine cancer, uterine fibroma or uterine necrosis secondary to septic abortion). In all cases authors used Diettel-Forgue-Legueu procedure, with good results in 88.30% of cases.

  7. Aortobronchial fistula after esophagectomy for esophageal cancer—A very rare complication

    Directory of Open Access Journals (Sweden)

    Hsien-Pin Li

    2011-06-01

    Full Text Available Most aorto-respiratory fistulas are related to aortic pathology or procedures, but fistula formation after esophageal resection has never been reported in the literature. We are now reporting a case of hemoptysis that occurred after esophagectomy for locally advanced esophageal cancer. Aortobronchial fistula was detected by computed tomography scan. The patient was finally saved by emergency surgery—Dacron graft interposition of the descending thoracic aorta. There was no malignant cell in the postoperative specimen of the fistula. The erosion of the ligaclips (Johnson & Johnson might be responsible for the aortobronchial fistula formation. For esophageal surgery, avoidance of trauma to aortic wall and careful using of ligaclips are important to circumvent this complication.

  8. Treatment of non-IBD anal fistula

    DEFF Research Database (Denmark)

    Lundby, Lilli; Hagen, Kikke; Christensen, Peter

    2015-01-01

    be supplemented with an endoluminal ultrasound scan and/or an MRI scan. St. Mark's fistula chart should be used for the description. Simple fistulas are amenable to fistulotomy, whereas treatment of complex fistulas requires special expertise and management of all available treatment modalities to tailor...

  9. Post-tracheostomy tracheo-oesophageal fistula – an unusual ...

    African Journals Online (AJOL)

    Tracheostomy, one of the oldest known surgical procedures in the history of medicine, is regularly performed in modern intensive care units. Acquired ulcerative tracheo-oesophageal fistula (TOF) is an uncommon but potentially fatal complication of tracheostomy. We report a case of ulcerative TOF with an unusual yet ...

  10. Combined oesophageal atresia with upper pouch fistula and ...

    African Journals Online (AJOL)

    Upper pouch tracheoesophageal fistula occurs is less than 1% of all oesophageal atresia variants. Meconium peritonitis is a rare neonatal condition with an incidence of 1:30 000 live births. In this case report, we describe the presentation, clinical findings and management of a patient diagnosed with an oesophageal ...

  11. Sigmoid-urachal-cutaneous fistula in an adult male.

    Science.gov (United States)

    Coons, Benjamin J; Clark, Peter E; Maynes, Lincoln J; Terhune, Kyla P; Stokes, Myron C; Beech, Derrick J

    2009-02-01

    An infected urachal cyst is an uncommon finding in adults. We report the first case of a sigmoid-urachal-cutaneous fistula that resulted from rupture of an infected urachal cyst in an adult male. Definitive management consisted of resection of the urachus with a bladder cuff, along with removal of the affected bowel segments and bowel anastomosis.

  12. Chronic foot ulcer complicating a traumatic arteriovenous fistula ...

    African Journals Online (AJOL)

    Background: Chronic foot ulcers could be a complication of traumatic arteriovenous (A-V) fistulation. We report a rare case of chronic foot ulcer and deformity resulting from arteriovenous fistula of the anterior tibial artery. Method: The clinical presentation and the outcome of treatment in a patient treated at the University of ...

  13. Vesicovaginal fistula following an induced abortion with a huge ...

    African Journals Online (AJOL)

    A case of a 26 year old P +1 woman who developed vesico-vaginal fistula (VVF) following an induced 1 abortion is presented. She presented with five year history of continous leakage of urine following a voluntary termination of pregnancy at about 11 weeks of gestation using metallic instruments in a chemist shop by a ...

  14. The split notochord syndrome with dorsal enteric fistula.

    Science.gov (United States)

    Hoffman, C H; Dietrich, R B; Pais, M J; Demos, D S; Pribram, H F

    1993-01-01

    Split notochord syndrome with dorsal enteric fistula is an extremely rare congenital anomaly that may be associated with meningomyelocele or meningocele, and genitourinary anomalies. This case presented with an additional finding of bladder exstrophy, raising the possibility of a relationship between this syndrome and the OEIS complex.

  15. uncomplicated midvaginal vesico-vaginal fistula repair in ibadan

    African Journals Online (AJOL)

    INTRODUCTION. Obstetric fistula is a resultant effect of prolonged obstructed labour, an aftermath of a poorly supervised childbirth1-3. It has been reported as a neglected public health issue in the world4. Surgical expertise for managing this challenging medical condition is dwindling even in countries with many cases like.

  16. genito-urinary fistula patients at bugando medical centre

    African Journals Online (AJOL)

    2010-07-07

    Jul 7, 2010 ... Objectives: To identify high risk populations of fistula patients treated from 1998-. 2006. Design: A prospective ... Main outcome measures: Of the 1294 surgical repairs, 84% of the patients were cured,. 12% had stress incontinence and 4% ..... pelvic floor exercises in such cases. The districts of highest risk ...

  17. Oesophageal atresia without tracheo-oesophageal fistula and an ...

    African Journals Online (AJOL)

    We report on a primary laparoscopically assisted anorectal pullthrough (LAARP) performed in a neonate with pure oesophageal atresia and imperforate anus with recto-bulbo-urethral fistula, representing a unique case for the LAARP approach owing to the undistended nature of the bowel and sterile meconium. Further ...

  18. Dural Arteriovenous Fistula of the Optic Nerve Sheath

    NARCIS (Netherlands)

    van den Berg, René; Smagge, Lucas E.; Saeed, Peerooz; Majoie, Charles B.

    2009-01-01

    Dural arterial-venous fistulas (dAVf) are acquired vascular lesions that can give a variety of symptoms, depending on anatomical localization and venous drainage pattern. We present a very unusual case of a dAVf localized at the level of the optic nerve sheath including discussion of the vascular

  19. Vesico vaginal fistula (VVF): a shift in epidemiology in northeastern ...

    African Journals Online (AJOL)

    Background: Vesico vaginal fistula is not only a medical disorder, but a serious social calamity. It reflects the state of health system failing to meet the basic needs of a growing population. Objective: To determine the epidemiological variables and outcome of the VVF patients. Methodology: Eighty cases of VVF managed ...

  20. MRI of congenital urethroperineal fistula

    International Nuclear Information System (INIS)

    Ghadimi-Mahani, Maryam; Dillman, Jonathan R.; Pai, Deepa; DiPietro, Michael; Park, John

    2010-01-01

    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.)

  1. 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.)

  2. 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.

  3. Successful Endoscopic Management of Bouveret’s Syndrome in a Patient with Cholecystoduodenocolic Fistulae

    Directory of Open Access Journals (Sweden)

    S. Tanwar

    2008-11-01

    Full Text Available Bouveret’s syndrome, first described in 1896 by Léon Bouveret, is rare, limited to approximately 200 published case reports to date [Ariche et al.: Scand J Gastroenterol 2000;35:781–783]. It is a subgroup of gallstone ileus in which a cholecystoduodenal fistula allows the passage of a gallstone that obstructs the duodenum, causing gastric outlet obstruction. This case is unique as it describes Bouveret’s syndrome in a patient with combined cholecystoduodenocolic fistulae. Gastric outlet obstruction was successfully managed endoscopically with lithotripsy. Both fistulae were subsequently managed conservatively without any complications.

  4. Combination of hypertonic saline and fibrin glue: Another selection to treat chronic enterocutaneous fistula

    Directory of Open Access Journals (Sweden)

    Po-Chang Hsu

    2017-01-01

    Full Text Available Gastrointestinal tract fistula is a frequent complication of surgery or disease. In general, cases involving failure to manage fistulae after 5–6 weeks of nonoperative treatment possibly require surgery. Here, we report a case involving a chronic enterocutaneous fistula (ECF for 24 months that was treated using hypertonic saline injection within the duodenal mucosa and use of fibrin glue as an adhesive to ensure rapid closure. This technique is a simple and effective method for treating an ECF. The procedure is easy to perform, carries minimal surgical risk, and features the advantages of reduced hospitalization or home nursing care and expenses compared with traditional therapy.

  5. A complicated true sliding hernia presenting as a spontaneous enteroscrotal fistula in an adult

    Directory of Open Access Journals (Sweden)

    Rajamanickam Saravana

    2010-01-01

    Full Text Available A 26-year-old man presented with an irreducible right inguino-scrotal swelling and fecal discharge from the scrotum. Exploratory laparotomy and inguinal exploration revealed that the caecum, appendix, and terminal ileum had herniated into the scrotum and had perforated through the skin forming a fecal fistula. The herniated gangrenous bowel was resected and a stoma fashioned. Spontaneous entero-scrotal fistulae are very rare and eight pediatric cases have been mentioned in literature till date. We report the first case of true sliding hernia presenting as spontaneous entero-scrotal fistula in an adult.

  6. Endovascular stenting for primary aortobronchial fistula in association with massive hemoptysis.

    Science.gov (United States)

    Kokotsakis, John; Misthos, Panagiotis; Athanasiou, Thanos; Romana, Constantina; Skouteli, Elian; Lioulias, Achilles; Kaskarelis, Ioannis

    2007-01-01

    Aortobronchial fistula is a potentially lethal complication secondary to the repair of a descending thoracic aneurysm or the placement of a prosthetic graft. Few cases have been reported. Very rarely, primary aortobronchial fistula occurs in a patient who has no history of cardiac surgical intervention. Herein, we present the cases of 2 patients whose massive, life-threatening bleeding from primary aortobronchial fistulae was successfully treated with endovascular stenting. Endovascular stenting is an emerging treatment method that can be used in this emergency setting with promising results and without early graft-related sequelae.

  7. The role of proper treatment of maxillary sinusitis in the healing of persistent oroantral fistula

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    David B. Kamadjaja

    2008-09-01

    Full Text Available Background: Oroantral communication (OAC is one of the possible complications after extraction of the upper teeth. If not identified and treated properly, a large OAC may develop into oroantral fistula (OAF which means that there is a permanent epithelium-lined communication between antrum and oral cavity. Such fistulas may cause ingress of microorganism from oral cavity into the antrum leading to maxillary sinusitis. Oroantral fistula usually persists if the infection in the maxillary antrum is not eliminated. Therefore, treatment of oroantral fistula should include management of maxillary sinusitis in which surgical closure of oroantral fistula should be done only when the sinusitis has been cured. Purpose: This case report emphasizes on the importance of proper management of maxillary sinusitis in the healing of oroantral fistula. Case: A case of an oroantral fistula following removal of upper left third molar is presented. As the maxillary sinusitis was not identified pre-operatively, two surgical procedures to close the fistula had ended up in dehiscence. Case management: The diagnosis of maxillary sinusitis was finally made and the sinusitis subsequently treated with combination of trans-alveolar sinus wash out, insertion of an acrylic splint, and two series of nasal and sinus physiotherapy procedures. The size of the defect decreased gradually during the treatment of the sinusitis and finally closed up without any further surgical intervention. Conclusion: This case report points out that it is important to detect intraoperatively an antral perforation after any surgery of the maxillary teeth and to close any oroantral communication as early as possible and that it is important to treat properly any pre-existing maxillary sinusitis before any surgical method is done to close the fistula.

  8. Laparoscopic repair for vesicouterine fistulae

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    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

  9. Fístula arteriovenosa del labio inferior: Presentación de un caso Arteriovenous fistula of the lower lip: Case report

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    M. Estrada Sarmiento

    2007-10-01

    Full Text Available El objetivo del trabajo es exponer nuestra experiencia en el tratamiento quirúrgico de una fístula arteriovenosa del labio inferior de una paciente de 15 años de edad, producida por un mordisco. La paciente fue diagnosticada en su inicio como un hemangioma traumático, el cual fue tratado con esteroides y exéresis quirúrgica. A los 4 años apareció con una tumoración más voluminosa, se realizó disección de la carótida externa y arteriografía carotídea la cual diagnóstico fístula arteriovenosa, se realizó ligadura de la facial y de los vasos venosos, para aislarla de la circulación. Se inyectaron 4 cc de betametazona en la tumoración, posteriormente se inyectaron 4 inyecciones adicionales con intervalos e 3 semanas, a los tres meses de la ligadura de los vasos sé realizo la exéresis de la fibrosis de la tumoración. En estos momentos la paciente tiene 5 años desde la última intervención, no presentando recidiva. Se destaca la importancia del estudio angiográfico para el diagnóstico y tratamiento de esta entidad patológica, que es poco frecuente.The object of this work is to present our experience in the surgical management of an arteriovenous fistula in the lower lip of a fifteen year-old patient as a result of a bite. The patient was diagnosed initially as having a trauma-induced hemangioma, which was treated with steroid and surgical exeresis. Four years later, a larger tumor appeared. The external carotid artery was dissected and an arteriography of the carotid was carried out that gave the diagnosis of arteriovenous fistula. Ligation was carried out of the facial artery and of the venous vessels for isolation from the circulation. Four injections were given with 4cc of betamethasone into the mass. Later 4 additional injections were given with intervals of 3 weeks. Four months after the ligation of the vessels, the fibrous mass was excised. Five years have now passed since the last intervention and there has been no

  10. A Rare Complication of Composite Dual Mesh: Migration and Enterocutaneous Fistula Formation

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    Ozgur Bostanci

    2015-01-01

    Full Text Available Introduction. Mesh is commonly employed for abdominal hernia repair because it ensures a low recurrence rate. However, enterocutaneous fistula due to mesh migration can occur as a very rare, late complication, for which diagnosis is very difficult. Presentation of Case. Here we report the case of an enterocutaneous fistula due to late mesh migration in a mentally retarded, diabetic, 35-year-old male after umbilical hernia repair with composite dual mesh in 2010. Discussion. Mesh is a foreign substance, because of that some of the complications including hematoma, seroma, foreign body reaction, organ damage, infection, mesh rejection, and fistula formation may occur after implantation of the mesh. In the literature, most cases of mesh-associated enterocutaneous fistula due to migration involved polypropylene meshes. Conclusion. This case serves as a reminder of migration of composite dual meshes.

  11. Brachial artery aneurysms following brachio-cephalic AV fistula ligation.

    Science.gov (United States)

    Khalid, Usman; Parkinson, Frances; Mohiuddin, Kamran; Davies, Paula; Woolgar, Justin

    2014-01-01

    Peripheral artery aneurysms proximal to a long-standing arteriovenous (AV) fistula can be a serious complication. It is important to be aware of this and manage it appropriately. Vascular access nurses input all data regarding patients undergoing dialysis access procedures into a securely held database prospectively. This was retrospectively reviewed to identify cases of brachial artery aneurysms over the last 3 years. In Morriston Hospital, around 200 forearm and arm AV fistulas are performed annually for vascular access in renal dialysis patients. Of these, approximately 15 (7.5%) are ligated. Three patients who had developed brachial artery aneurysms following AV fistula ligation were identified. All 3 patients had developed brachial artery aneurysms following ligation of a long-standing brachio-cephalic AV fistula. Two patients presented with pain and a pulsatile mass in the arm, and one presented with pins and needles and discoloration of fingertips. Two were managed with resection of the aneurysm and reconstruction with a reversed long saphenous vein interposition graft, the third simply required ligation of a feeding arterial branch. True aneurysm formation proximal to an AV fistula that has been ligated is a rare complication. There are several reasons for why these aneurysms develop in such patients, the most plausible one being the increase in blood flow and resistance following ligation of the AV fistula. Of note, all the patients in this study were on immunosuppressive therapy following successful renal transplantation. Vigilance by the vascular access team and nephrologists is paramount to identify those patients who may warrant further evaluation and investigation by the vascular surgeon.

  12. Vesicovaginal Fistula Repair During Pregnancy

    African Journals Online (AJOL)

    urogenital fistula (UGF). In this condition there is an abnormal communication between the ... infection, carcinoma of the cervix, and irradiation necrosis from treatment of cervical carcinoma. In Northern Nigeria where the .... Safe Motherhood. Newsletter. 1999; 27: 1. 4. Lawson JB. Injuries of the urinary tract. In Lawson JB,.

  13. Três casos de hipertensão e Fístula Arteriovenosa Renal: com uma fístula de novo Tres casos de hipertención y Fístula Arteriovenosa Renal: con una fístula de novo Three cases of hypertension and Renal Arteriovenous fistula with a de novo fistula

    Directory of Open Access Journals (Sweden)

    Natalia Correa Vieira Melo

    2009-05-01

    Full Text Available Fístula Arteriovenosa Renal (FAVR é uma causa rara e potencialmente reversível de hipertensão e insuficiência renal e/ou cardíaca. O tratamento da FAVR visa preservar o máximo de parênquima renal e, concomitantemente, erradicar os sintomas e efeitos hemodinâmicos decorrentes da FAVR. No presente estudo, serão relatados três casos de FAVR, incluindo um caso de FAVR idiopática de novo, que se apresentaram com hipertensão e insuficiência renal e/ou cardíaca, e descrever a terapêutica adotada e os resultados obtidos.La Fístula Arteriovenosa Renal (FAVR es una causa rara y potencialmente reversible de hipertensión e insuficiencia renal y/o cardíaca. El tratamiento de la FAVR busca preservar el máximo de parénquima renal y, concomitantemente, erradicar los síntomas y efectos hemodinámicos resultantes de la FAVR. En el presente estudio, se relatarán tres casos de FAVR, incluyendo un caso de FAVR idiopática de novo, que se presentaron con hipertensión e insuficiencia renal y/o cardíaca, y describir la terapéutica adoptada y los resultados obtenidos.The Renal Arteriovenous Fistula (RAVF is a rare and potentially reversible cause of hypertension and kidney and/or heart failure. The treatment of RAVF aims at preserving the most of the renal parenchyma and, concomitantly, eradicating the symptoms and hemodynamic effects caused by the RAVF. The present study reports three cases of RAVF, including one case of a de novo idiopathic RAVF, which presented with hypertension and kidney and/or heart failure and describes the therapeutic measures used to treat these patients as well as the outcomes.

  14. Vesical calculus associated with vesicovaginal fistula

    Directory of Open Access Journals (Sweden)

    Ming-Huei Cheng

    2014-02-01

    Full Text Available Vesicovaginal fistula (VVF is relatively common after radiotherapy, but the formation of a bladder stone after VVF is still rare. The diagnosis is often delayed, and mortality sometimes occurs with delayed diagnosis and treatment, especially in elderly and disabled women. To increase knowledge of this unusual condition—vesical stone associated with VVF—we present a case report, and summarize the published cases to review this topic, focusing on the etiology, symptoms and signs, and recent management strategy. Finally, based on this case report, we emphasize that careful physical examination and the use of less invasive and economic tools, such as plain X-ray are important to investigate this very sick and old lady, because these strategies could help us to make an accurate diagnosis earlier without the need for more aggressive, invasive, and expensive tools.

  15. Analysis and description of disease-specific quality of life in patients with anal fistula.

    Science.gov (United States)

    Ferrer-Márquez, Manuel; Espínola-Cortés, Natalia; Reina-Duarte, Ángel; Granero-Molina, José; Fernández-Sola, Cayetano; Hernández-Padilla, José Manuel

    2018-04-01

    In patients diagnosed with anal fistula, knowing the quality of life specifically related to the disease can help coloproctology specialists to choose the most appropriate therapeutic strategy for each case. The aim of our study is to analyzse and describe the factors related to the specific quality of life in a consecutive series of patients diagnosed with anal fistula. Observational, cross-sectional study carried out from March 2015 to February 2017. All patients were assessed in the colorectal surgery unit of a hospital in southeast of Spain. After performing an initial anamnesis and a physical examination, patients diagnosed with anal fistula completed the Quality of Life in Ppatients with Anal Fistula Questionnaire (QoLAF-Q). This questionnaire specifically measures quality of life in people with anal fistula and its score range is the following: zero impact = 14 points, limited impact = 15 to 28 points, moderate impact = 29 to 42 points, high impact = 43 to 56 points, and very high impact = 57 to 70 points. A total of 80 patients were included. The median score obtained in the questionnaire for the sample studied was 34.00 (range=14-68). Statistically significant differences between patients with "primary anal fistula" (n=65) and "recurrent anal fistula" (n=15) were observed (mean rank=42.96 vs. mean rank=29.83, p=0.048). Furthermore, an inverse proportion (P=.016) between "time with clinical symptoms" and "impact on quality of life" was found (5 years: mean rank = 19.00). There were no statistically significant differences (P=.149) between quality of life amongst patients diagnosed with complex (mean rank = 36.13) and simple fistulae (mean rank = 43.59). Anal fistulae exert moderate-high impact on patients' quality of life. "Shorter time experiencing clinical symptoms" and the "presence of primary fistula" are factors that can be associated with worse quality of life. Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Morphological and dynamic MR evaluation of a giant spontaneous vertebrovertebral fistula during endovascular therapy

    International Nuclear Information System (INIS)

    McGlade, C.; Lufkin, R.; Vinuela, F.; Dion, J.; Lylyck, P.; Bentson, J.; Martin, N.

    1989-01-01

    A case of verbro-vertebral fistula in a patient with neurofibromatosis is presented with emphasis on magnetic resonance (MR) evaluation and integration with endovascular therapy. Vascular involvement is a known complication of neurofibromatosis ranging from intimal proliferation causing arterial narrowing, development of small aneurysms, to spontaneous fistulas probably secondary to mesodermal dysplasia. This case report illustrates the latter and portrays a role for MR in diagnosis and follow-up during therapeutic measures. (author). 14 refs.; 3 figs

  17. Post-cardiac catheterization femoral fistula corrected by ultrasound-guided compression.

    Science.gov (United States)

    Verbeeck, N; Lacroix, J

    2005-01-01

    We present a case of post-cardiac catheterization femoral fistula diagnosed by color and pulsed Doppler sonography and treated by ultrasound-guided compression. We avail ourselves of the case to review the echo Doppler semiology of the different types of arteriovenous fistulas with an emphasis on the functional analysis of the dialysis accesses. We also stress the therapeutic options in front of undesirable shunts.

  18. First experience with the use of a collagen fistula plug to treat enterocutaneous fistulas.

    Science.gov (United States)

    Lyon, James W; Hodde, Jason P; Hucks, David; Changkuon, Daniela I

    2013-10-01

    This report describes the authors' first experiences with the use of the Biodesign Enterocutaneous Fistula Plug (EFP). Six patients presented with intraperitoneal abscess and associated chronic bowel fistulas. The fistulas were treated by delivering an EFP by using radiologic guidance. The EFP placement procedure was successfully performed in all patients. All fistulas were closed within 2 weeks. Fistula recurrence occurred in two patients (33%) at 9 and 12 months after the procedure. One recurrence was associated with an adverse reaction to chemotherapy. The other was associated with the silicone flange migrating out of the bowel lumen. The Biodesign EFP offers a promising new approach for the treatment of enterocutaneous fistulas. © SIR, 2013.

  19. Robotic versus laparoscopic resection for sigmoid diverticulitis with fistula.

    Science.gov (United States)

    Elliott, Peter A; McLemore, Elisabeth C; Abbass, Mohammad A; Abbas, Maher A

    2015-06-01

    Robotic abdominal surgery is growing despite a paucity of clinical reports to evaluate its impact on patient outcomes. In this retrospective case series, we aim to analyze our early experience with robotic resection in 11 consecutive patients with chronic colonic diverticulitis complicated by fistula to bladder, vagina, or skin and to compare the results of the robotic approach to 20 patients undergoing laparoscopic resection for the same indication. Our main outcome measures include operative time, blood loss, conversion rate, transfusion rate, hospital length of stay, complications, readmission, and fistula healing rate. In our study, we found robotic resection for colonic diverticulitis with fistula was technically feasible and yielded 100% fistula healing rate. The operative time, complication and readmission rates were similar to laparoscopy. A higher conversion rate, diverting stoma need, and longer hospital length of stay were noted in the robotic group; however, these findings could have been attributed to a higher number of cases involving rectal excision in the robotic group. Larger studies are needed to further examine the impact of robotic surgery on the outcome of patients with complicated chronic sigmoid diverticulitis.

  20. Early presentation of postintubation tracheoesophageal fistula: Perioperative anesthetic management

    Directory of Open Access Journals (Sweden)

    Depinder Kaur

    2012-01-01

    Full Text Available Tracheoesophageal fistula (TEF in adults occurs as a result of trauma, malignancy, cuff-induced tracheal necrosis from prolonged mechanical ventilation, traumatic endotracheal intubation, foreign body ingestion, prolonged presence of rigid nasogastric tube, and surgical complication. Anesthetic management for repair of TEF is a challenge. Challenges include difficulties in oxygenation or ventilation resulting from placement of endotracheal tube in or above the fistula; large fistula defect causing loss of tidal volume with subsequent gastric dilatation, atelactasis, and maintenance of one lung ventilation. The most common cause of acquired nonmalignant TEF is postintubation fistula, which develops after prolonged intubation for ventilatory support. Acquired TEF, which occurs after prolonged intubation, usually develops after 12-200 days of mechanical ventilation, with a mean of 42 days. We present a rare case of TEF that developed after 7 days of intubation. It was a difficult case to be diagnosed as patient had a history of polytrauma, followed by emergency intubation and both these conditions can contribute to tracheobronchial injury.

  1. Fístula Arteriovenosa após Nefrectomia Radical: A Propósito de um Caso Clínico Arteriovenous fistula after Radical Nephrectomy:: a case report

    Directory of Open Access Journals (Sweden)

    Nádia Duarte

    2011-09-01

    Full Text Available Existem três tipos diferentes de fístulas arteriovenosas (FAV renais, as congénitas, as idiopáticas e as adquiridas, sendo as últimas as mais frequentes. Dentro destas, as resultantes da nefrectomia são uma raridade. A FAV entre a artéria renal e a veia cava inferior (VCI é uma complicação rara após nefrectomia, estando descritos cerca de 10 casos na literatura. Os autores descrevem um caso de um homem de 51 anos, insuficiente renal crónico (IRC em hemodiálise, enviado à consulta de Urologia por nódulo sólido do rim direito sugestivo de neoplasia, detectado em ressonância magnética (RMN. Foi submetido a nefrectomia radical direita, tendo sido efectuada laqueação conjunta do pedículo renal, sem intercorrências cirúrgicas. Quatro meses depois, inicia clínica de sobrecarga hídrica, de difícil controlo com a hemodiálise e surge um sopro abdominal localizado no flanco direito, contínuo. O estudo por eco-doppler abdominal e angiografia demonstrou a presença de fístula entre a artéria renal e a veia cava inferior. Foi submetido a embolização da FAV com coils, tendo-se registado migração dos mesmos para a artéria pulmonar. A sua recolha foi efectuada imediatamente com basket, sem outras intercorrências. Posteriormente, foi submetido a laparotomia com laqueação simples da artéria renal justa-aórtica, com resolução e estabilização do quadro clínico. A propósito deste caso clínico os autores discutem a abordagem diagnóstica e a hierarquia terapêutica da FAV reno-VCI nomeadamente na cirurgia directa e endovascular.There are three different types of renal arteriovenous fistula (AVF, congenital, idiopathic and acquired, being the latter the most frequent. Within these, those resulting from nephrectomy are rare. The AVF between the renal artery and the inferior vena cava (IVC is a rare complication, with about 10 cases described in literature. The authors describe the case of a 51 year old man, with chronic

  2. Primary treatment of early fistula of parotid duct with botulinum toxin type A injection*

    Science.gov (United States)

    Ferron, Camila; Cernea, Selma Schuartz; de Almeida, Ada Regina Trindade; Cesar, Denise Vieira Galvão

    2017-01-01

    Salivary duct injury can be idiopathic, iatrogenic, or post-trauma and may result in sialocele or fistula. Most injuries regress spontaneously and botulinum toxin A is one of several therapeutic possibilities. We report a case of iatrogenic injury to the parotid duct after Mohs' micographic surgery for a squamous cell carcinoma excision in the left jaw region, treated by injection of botulinum toxin type A. Although the fistula by duct injury can be self-limiting, botulinum toxin injection by promoting the inactivity of the salivary gland allows rapid healing of the fistula. PMID:29364451

  3. Ureteroiliac Artery Fistula in a Young Woman with Short Bowel Syndrome for Radiation Enteritis

    Directory of Open Access Journals (Sweden)

    Lidia Santarpia

    2010-01-01

    Full Text Available Ureteral-iliac artery fistula is a rare and potentially life-threatening complication, typically occurring after radiation therapy in already surgically treated cancer patients. This case report describes the diagnostic challenges and the successful management, with the positioning of an intra-arterial prosthesis, of a fistula between the internal iliac artery and the left ureter presenting as massive hematuria in a young woman with history of total colectomy and pelvic radiotherapy for rectal cancer and subsequent wide ileal resections and bilateral ureteral stent positioning for radiation enteritis. Ureteroiliac artery fistulas require a prompt diagnosis and intervention, to avoid life threatening clinical events.

  4. [Pyelovenous fistula revealed by repeated thromboembolic events after emergency peripartum hysterectomy].

    Science.gov (United States)

    Sauvanaud, C; Boillot, B; Sergent, F; Long, J A; Pernod, G; Rambeaud, J J

    2014-04-01

    We report the case of a 51-year old woman presenting pyelovenous fistula revealed by recurrent and serious thromboembolic events after ureteral ligation during emergency peripartum hysterectomy. Imaging reported a complete left ureteral obstruction, a fistula between the upper calix and the left renal vein and a renal function preserved. Uretero-vesical reimplantation was performed. The patient was well doing after 12 months. The authors wonder if pyelovenous fistula is responsible for prothrombotic state and maintaining renal function. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  5. Aortocavitary fistula as a complication of infective endocarditis and subsequent complete heart block in a patient with severe anemia

    Directory of Open Access Journals (Sweden)

    Jose N. Galeas

    2015-12-01

    Full Text Available Infective endocarditis has different presentations depending on the involvement of valvular and perivalvular structures, and it is associated with high morbidity and mortality. Aortocavitary fistula is a rare complication. We introduce the case of a 48-year-old female with native valve endocarditis, complicated by aortocavitary fistula to the right atrium, and consequently presented with syncope.

  6. Non-healing post-surgical fistulae: treatment with image-guided percutaneous injection of cyanoacrylic glue.

    Science.gov (United States)

    Mauri, Giovanni; Pescatori, Lorenzo C; Mattiuz, Chiara; Poretti, Dario; Pedicini, Vittorio; Melchiorre, Fabio; Rossi, Umberto; Solbiati, Luigi; Sconfienza, Luca Maria

    2017-02-01

    To present the results of our experience with cyanoacrylic glue percutaneous injection to treat post-surgical non-healing enteric fistulae after failure of standard treatments. Eighteen patients (14 males; age range 33-84, mean 69 years) were treated for a non-healing post-surgical enteric fistula after failure of standard treatments. Under computed tomography and/or fluoroscopic guidance, a mixture of cyanoacrylic glue (Glubran 2, GEM, Viareggio, Italy) and ethiodized oil was injected at the site of the fistula. Fistula was considered healed when no material was drained by the percutaneous drainage and a subsequent computed tomography confirmed the disappearance of any fluid collection. In all cases, it was possible to reach the site of the fistula using a percutaneous access. A median of 1 injection (range 1-5) was performed. Fistula healing was achieved in 16/18 (89 %) patients. One patient died for other reasons before fistula healing. Median time for fistula healing was 0 days (mean 8, range 0-58 days). No complications occurred. Reoperation was needed in one patient. Percutaneous injection of cyanoacrylic glue is feasible, safe, and effective to treat non-healing post-surgical enteric fistulae. It may represent a further option to avoid surgical reoperation in frail patients.

  7. Inner Ear Conductive Hearing Loss and Unilateral Pulsatile Tinnitus Associated with a Dural Arteriovenous Fistula: Case Based Review and Analysis of Relationship between Intracranial Vascular Abnormalities and Inner Ear Fluids

    Directory of Open Access Journals (Sweden)

    Ettore Cassandro

    2015-01-01

    Full Text Available While pulsatile tinnitus (PT and dural arteriovenous fistula (DAVF are not rarely associated, the finding of a conductive hearing loss (CHL in this clinical picture is unusual. Starting from a case of CHL and PT, diagnosed to be due to a DAVF, we analyzed relationship between intracranial vascular abnormalities and inner ear fluids. DAVF was treated with endovascular embolization. Following this, there was a dramatic recovery of PT and of CHL, confirming their cause-effect link with DAVF. We critically evaluated the papers reporting this association. This is the first case of CHL associated with PT and DAVF. We describe the most significant experiences and theories reported in literature, with a personal analysis about the possible relationship between vascular intracranial system and labyrinthine fluids. In conclusion, we believe that this association may be a challenge for otolaryngologists. So we suggest to consider the possibility of a DAVF or other AVMs when PT is associated with CHL, without alterations of tympanic membrane and middle ear tests.

  8. Autologous intratympanic blood patch for presumed perilymphatic fistulas.

    Science.gov (United States)

    Foster, P K

    2016-12-01

    To assess an alternative to bed rest and surgery for suspected perilymphatic fistulas using intratympanic blood injections. A review was conducted of patients' history, physical and audiometric data, before and after treatment by intratympanic blood injections performed from 2009 to 2015. Twelve ears were identified, with trauma associated with air travel, water sports or nose blowing. Ten of these cases had hearing loss, six had vestibular symptoms. Four cases had audiological and vestibular symptoms, two had vestibular symptoms only, and six had audiological symptoms only. Time-to-treat varied from 1 day to 30 days. Magnetic resonance imaging scans were obtained for five cases. Ten cases received steroids. Six out of seven cases showed improvement of hearing loss. Five cases showed positive fistula test results, four with documented resolution. Seven cases had full resolution of all symptoms, four had near-full resolution and one had no improvement. Intratympanic blood injections offer an effective alternative to conservative or surgical therapy. Advantages include sooner time-to-treat, lower financial costs and decreased psychosocial burdens. It allows a more flexible and liberal use of a potential definite treatment for perilymphatic fistula.

  9. Gastropericardial Fistula as a Late Complication of Laparoscopic Gastric Banding

    Directory of Open Access Journals (Sweden)

    Adam A Rudd

    2017-01-01

    Full Text Available Laparoscopic adjustable gastric banding (LAGB is a bariatric procedure that is being performed with increasing frequency as an alternative management option for morbid obesity. Several common complications have been reported including gastric band slippage and associated pouch dilatation, intragastric erosion of the band, gastric wall perforation, and abscess formation. We present a case of gastropericardial fistula occurring nine years after an LAGB. There have been no previous documented cases of the complication after this procedure.

  10. Use of a double-channel endoscope for closure of a surgically failed chronic benign tracheoesophageal fistula using over-the-scope-clip

    Directory of Open Access Journals (Sweden)

    Saumil K Shah

    2015-01-01

    Full Text Available This case reports the use of a double-channel therapeutic gastroscope to permanently close a surgically failed chronic, benign tracheoesophageal fistula following endotracheal intubation in an elderly lady, using the over-the-scope-clip. Argon plasma coagulation seems essential in such smooth chronic fistulas to make the edges raw. A double-channel therapeutic gastroscope would be ideal for such cases, especially in larger fistulas.

  11. Malignant sigmoidoduodenal fistula

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    I.M. Shapey

    2014-01-01

    CONCLUSION: Management options must be considered in the context of patient wishes, their co-morbidities, and predicted post-operative outcome. In most cases this is likely to represent a non-operative approach, however surgical resection may benefit selected cases on occasion.

  12. MR cisternography: a new method for the diagnosis of CSF fistulae

    International Nuclear Information System (INIS)

    Eberhardt, K.E.W.; Tomandl, B.F.; Huk, W.J.; Hollenbach, H.P.; Deimling, M.

    1997-01-01

    The aim of this study was to compare a new MRI method for detecting the existence of cerebrospinal fluid (CSF) fistulae, i. e. MR cisternography, with CT cisternography. In a prospective study, 30 patients with post-traumatic CSF fistulae were examined. The MR examinations were performed with a 1.0-T whole-body MR system, using two T2 * -weighted sequences, a 3D PSIF (time-inversed fast imaging with steady-state precession, FISP) and a 3D constructive interference steady-state (CISS) sequence. The results of MRI and CT cisternography were compared with the surgical findings. The sensitivity in detecting CSF fistulae with MR cisternography (PSIF: 89.9 %; CISS: 93.6 %) was higher than with CT cisternography (72.3 %). The sensitivity of CT cisternography at detecting CSF fistulae in patients with a size of dural lesion less than 2 mm or in patients with multiple dural lesions is significantly lower compared with the MR method. Although the localization of CSF fistulae always proved possible with MR cisternography, this could only be accomplished wih CT in 70 % of cases. The MR cisternography technique is a new examination method with a higher sensitivity for the detection of CSF fistulae than CT cisternography. The CISS technique is superior compared with PSIF and should be used in patients with high-flow CSF fistulas. (orig.)

  13. Surgery for post-operative entero-cutaneous fistulas: is bowel resection plus primary anastomosis without stoma a safe option to avoid early recurrence? Report on 20 cases by a single center and systematic review of the literature.

    Science.gov (United States)

    Lauro, A; Cirocchi, R; Cautero, N; Dazzi, A; Pironi, D; Di Matteo, F M; Santoro, A; Faenza, S; Pironi, L; Pinna, A D

    2017-01-01

    A review was performed on entero-cutaneous fistula (ECF) repair and early recurrence, adding our twenty adult patients (65% had multiple fistulas). The search yielded 4.098 articles but only 15 were relevant: 1.217 patients underwent surgery. The interval time between fistula's diagnosis and operative repair was between 3 months and 1 year. A bowel resection with primary anastomosis was performed in 1.048 patients, 192 (18.3%) underwent a covering stoma: 856 patients (81.7%) had a fistula takedown in one procedure. The patients had 14.3% recurrence and 13.1% mortality rate. In our experience 75% were surgically treated after a period equal or above one year from fistula occurrence: surgery was very demolitive (in 40% remnant small bowel was less than 100 cm). We performed a bowel resection with a hand-sewn anastomosis (95%) without temporary stoma. In-hospital mortality was 0% and at discharge all were back to oral intake with 0% early re-fistulisation. Literature supports our experience: ECF takedown could be safely performed after an adequate period of recovery from 3 months to one year from fistula occurrence. In our series primary repair (bowel resection plus reconnection surgery without temporary stoma) avoided an early recurrence without mortality.

  14. Enterovaginal or Vesicovaginal Fistula Control Using a Silicone Cup.

    Science.gov (United States)

    Russell, Katie W; Robinson, Ryan E; Mone, Mary C; Scaife, Courtney L

    2016-12-01

    An enterovaginal or vesicovaginal fistula is a complication resulting in vaginal discharge of succus, urine, or stool that can lead to significant complications. For low-volume fistulae, tampons or pads may be used. With high-volume fistulae, frequent product change can be painful and unpredictable in terms of efficacy. The psychologic distress is profound. Surgery may not be an option, making symptom control the priority. We report the use of a reusable menstrual silicone vaginal cup placed to divert and contain drainage. The menstrual cup provided significant symptom relief. Drainage is immediately diverted from tissue, unlike with tampon or pad use, which involves longer contact periods with caustic fluids. A system was created by adapting the end of the cup by adding silastic tubing and an external leg bag to provide long-term drainage control. Improvement in quality of life is of primary importance when dealing with fistula drainage. This simple and inexpensive device should be considered in those cases in which the drainage can be diverted as a viable option, especially in those who are symptomatic and awaiting surgical repair or in those for whom surgery cannot be performed.

  15. Long-term survival from gastrocolic fistula secondary to adenocarcinoma of the transverse colon

    Directory of Open Access Journals (Sweden)

    Murali Kothandaraman

    2005-02-01

    Full Text Available Abstract Background Gastrocolic fistula is a rare presentation of both benign and malignant diseases of the gastrointestinal tract. Malignant gastrocolic fistula is most commonly associated with adenocarcinoma of the transverse colon in the Western World. Despite radical approaches to treatment, long-term survival is rarely documented. Case presentation We report a case of a 24-year-old woman who presented with the classic triad of symptoms associated with gastrocolic fistula. Radical en-bloc surgery and adjuvant chemotherapy were performed. She is still alive ten years after treatment. Conclusions Gastrocolic fistula is an uncommon presentation of adenocarcinoma of the transverse colon. Radical en-bloc surgery with adjuvant chemotherapy may occasionally produce long-term survival.

  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. Arterioureteral Fistula: Treatment of a Hemorrhagic Shock with Massive Hematuria by Placing a Balloon Catheter

    Directory of Open Access Journals (Sweden)

    Nicolas Merzeau

    2017-01-01

    Full Text Available Arterioureteral fistulas (AUF are serious diseases with increasing incidence. This case report relates the management of AUF in a patient with a history of abdominal oncological surgery, pelvic radiotherapy, and a double J stent in place. The fistula was discovered during a hemorrhagic shock with massive hematuria. The bleeding was controlled by a balloon catheter which led to endovascular treatment consisting of a covered stent.

  18. Endoscopic repair of post-traumatic fistulae of posterior urethra using hyaluronic acid dextranomer.

    Science.gov (United States)

    Appignani, Antonino; Bertozzi, Mirko; Prestipino, Marco

    2010-07-01

    Many surgical approaches to posterior urethral diseases are reported in published data. The authors report a case of a patient with prostatic urethral post-traumatic fistulae, probably developed from an abscess that developed after a surgical intervention to correct a pubic symphysis fracture. The fistulae were repaired with an unusual mininvasive endourologic procedure, using the hyaluronic acid dextranomer, which is commonly used in vesicoureteral reflux treatment. Copyright 2010 Elsevier Inc. All rights reserved.

  19. Extralobar pulmonary sequestration in the right lower thoracic region associated with esophageal fistula.

    Science.gov (United States)

    Feng, Xing; Xiong, Xiao-Ling

    2013-09-01

    Extralobar pulmonary sequestrations (ELS) are most commonly found within the left thoracic cavity. We report the case of a 10-year-old girl with ELS in the right thoracic cavity, associated with esophageal fistula. Chest computed tomography scans revealed a parenchymal mass between the right lower lobe and the diaphragm. At last, successful resection of the mass and repair of the esophageal fistula were performed. The girl recovered uneventfully. Georg Thieme Verlag KG Stuttgart · New York.

  20. Spontaneous Appendicocutaneous Fistula I

    African Journals Online (AJOL)

    M T0k0de* MB, BS and. Dr 0. A. AWOj0bi+ FMCS (Nig). ABSTRACT. Ruptured appendicitis is not a common cause of spontaneous enterocutaneous fistula. A case of ruptured retrocaecal appendicitis presenting as an enterocutaneous fistula in a Nigerian woman is presented. The literature on this disorder is also reviewed.

  1. 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.

  2. 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.

  3. 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.

  4. Congenital arteriovenous fistula of the horseshoe kidney with multiple hemangiomas

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    Lazić Miodrag

    2012-01-01

    Full Text Available Introduction. Congenital renal arteriovenous fistulas (AVF are rare, especially if they are associated with other developmental renal anomalies. Case Outline. A 34-year-old female was hospitalized due to total painless hematuria and bladder tamponade. Excretory urography revealed a horseshoe kidney with normal morphology of pyelocaliceal system and ureters. Aortography and selective renovasography detected a cluster-like vascular formation with multiple arteriovenous fistulas (AVF. Due to a large AVF gauge and poor flow of the efferent vein to the inferior vena cava, a surgical procedure of two renal artery segmentary branches ligation and division was performed. During the operative procedure, the presence of multiple superficial renal hemangiomas was detected. Conclusion. Although selective arterial embolization represents the preferable treatment option, conventional surgery remains favorable alternative in selected cases with large and complex AVF.

  5. [Great vesicovaginal fistula after normal vaginal delivery in a developed country].

    Science.gov (United States)

    López-Carpintero, Nayara; de la Fuente-Valero, Jesús; Salazar-Arquero, Francisco Javier; Hernández-Aguado, Juan José

    2015-12-01

    Obstetric fistulas in developed countries are infrequent and have been associated with instrumental vaginal delivery, manual removal of placenta and surgical complications during caesarean section. We present the diagnosis and treatment of an obstetric fistula of patient without clear risk factors in a developed country. The case presented is of a 37 weeks pregnant with history of previous cesarean section. A male of 2,600 g was born after a not prolonged vaginal delivery. In the immediate postpartum period, appeared evident hematuria and in the exploration a defect was detected in the vaginal anterior face at 3 cm from the urethral meatus. Cystoscopy showed a torn in bladder of 8 cm at the bottom. Reparation of vesicovaginal fistula was carried out with omentoplasty. Postoperative course was uneventful. A vesicovaginal fistula must be considered in any patient with hematuria. Early repair is essential for a favorable outcome.

  6. Transvaginal coloanal anastomosis after rectal resection for the treatment of a rectovaginal fistula induced by radiation.

    Science.gov (United States)

    Brezean, I

    2014-01-01

    Although decreasing in number, radiation induced rectovaginal fistulas are caused by some radiation injuries and chronic ischemic lesions. Most of the experienced authors recommend anterior rectal resection with coloanal anastomosis accessed through the abdominal-perineum area for high fistula. We present a patient with a fistula that developed 23 years after hysterectomy and radiotherapy. In this case we performed an abdominal-transvaginal rectal resection with transverse coloplastypouch, coloanal anastomosis and protection ileostomy three months after a terminal sigmoidostomy. The dissection of the distal rectum by posteriour colpotomy and coloanal transvaginalan astomosis is a technical variant that may prove advantage ous compared to the procedures featured in the literature as solutions by rectal resection for rectovaginal fistula. Celsius.

  7. Management of Iatrogenic Facial Nerve Palsy and Labyrinthine Fistula in Mastoid Surgery

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    Yeoh Thiam Long

    2004-07-01

    Full Text Available A 6-year review of complications of mastoid surgery between June 1995 and June 2001 revealed five cases with serious iatrogenic complications from mastoid surgery, of which four were facial nerve palsy and two were labyrinthine fistula. One of these patients had concomitant facial nerve palsy and labyrinthine fistula. There were two cases of complete facial nerve palsy (House Brackmann grade VI and two cases of incomplete palsy (House Brackmann grades IV and V. The second genu was the site of injury in three of the four cases. Of the four cases with facial nerve palsy, two patients had full recovery (House Brackmann grade I, one recovered only to House Brackmann grade III, and one was lost to follow-up. Both patients with labyrinthine fistula had postoperative vertigo and profound sensorineural hearing loss. The site of iatrogenic fenestration was the lateral semicircular canal in both cases.

  8. Aorto-right atrial fistula after Bentall repair

    OpenAIRE

    Howard, Charles E.; Velasco, Carlos E.; Roullard, Christina P.; Rafael, Aldo

    2017-01-01

    We describe a man with the Marfan syndrome and a prior ascending aortic aneurysm resection who presented with knee pain and concern of endocarditis. Transesophageal echocardiogram showed no vegetations, and computed tomography angiogram of the heart showed a possible pseudoaneurysm. Cardiac catheterization and aortogram revealed the diagnosis of an aorto-right atrial fistula, which was then operatively repaired. This case highlights the role that cardiac catheterization with aortogram can pla...

  9. Adenosquamous carcinoma of vesicovaginal fistula: a rare entity.

    Science.gov (United States)

    Tabali, Rudresh; Ramkumar, Aravind

    2014-01-01

    A 56-year-old lady presented with a vesicovaginal fistula (VVF) along with past history of abdominal hysterectomy. Biopsy of the fistulous tract showed squamous cell carcinoma (SCC). Patient underwent radical cystourethrectomy, total vaginectomy, and bilateral pelvic lymph node dissection along with ileal conduit. The final histopathology report of the resected specimen showed adenosquamous carcinoma in VVF. As this is a rare entity, we are reporting this case.

  10. Adenosquamous Carcinoma of Vesicovaginal Fistula: A Rare Entity

    Directory of Open Access Journals (Sweden)

    Rudresh Tabali

    2014-01-01

    Full Text Available A 56-year-old lady presented with a vesicovaginal fistula (VVF along with past history of abdominal hysterectomy. Biopsy of the fistulous tract showed squamous cell carcinoma (SCC. Patient underwent radical cystourethrectomy, total vaginectomy, and bilateral pelvic lymph node dissection along with ileal conduit. The final histopathology report of the resected specimen showed adenosquamous carcinoma in VVF. As this is a rare entity, we are reporting this case.

  11. Cholecystitis of a duplicated gallbladder complicated by a cholecystoenteric fistula

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Brady K. [University of Rochester Medical Center, Department of Imaging Sciences, Rochester, NY (United States); Chess, Mitchell A. [University of Rochester Medical Center, Department of Imaging Sciences, Rochester, NY (United States); Advanced Imaging, Batavia, NY (United States)

    2009-04-15

    Gallbladder duplications are uncommon anatomic variants that are sometimes mistaken for other entities on imaging. We present a surgically confirmed case of cholecystitis in a ductular-type duplicated gallbladder complicated by the formation of an inflammatory fistula to the adjacent duodenum. Both US and magnetic resonance cholangiopancreatography were performed preoperatively, in addition to intraoperative cholangiography, which confirmed the presence of a duplicated gallbladder. (orig.)

  12. Cholecystoduodenal fistula, an infrequent complication of cholelithiasis: Our experience in its surgical management.

    Science.gov (United States)

    Aguilar-Espinosa, F; Maza-Sánchez, R; Vargas-Solís, F; Guerrero-Martínez, G A; Medina-Reyes, J L; Flores-Quiroz, P I

    Bilioenteric fistulas are the abnormal communication between the bile duct system and the gastrointestinal tract that occurs spontaneously and is a rare complication of an untreated gallstone in the majority of cases. These fistulas can cause diverse clinical consequences and in some cases be life-threatening to the patient. To identify the incidence of bilioenteric fistula in patients with gallstones, its clinical presentation, diagnosis through imaging study, surgical management, postoperative complications, and follow-up. A retrospective study was conducted to search for bilioenteric fistula in patients that underwent cholecystectomy at our hospital center due to cholelithiasis, cholecystitis, or cholangitis, within a 3-year time frame. Four patients, 2 men and 2 women, were identified with cholecystoduodenal fistula. Their mean age was 81.5 years. Two of the patients presented with acute cholangitis and 2 presented with bowel obstruction due to gallstone ileus. All the patients underwent surgical treatment and the diagnostic and therapeutic management of each of them was analyzed. The incidence of cholecystoduodenal fistula was similar to that reported in the medical literature. It is a rare complication of gallstones and its diagnosis is difficult due to its nonspecific symptomatology. It should be contemplated in elderly patients that have a contracted gallbladder with numerous adhesions. Copyright © 2017 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  13. Urethrocutaneous fistula complicating circumcision in children ...

    African Journals Online (AJOL)

    Introduction: Urethrocutaneous fistula is an unusual but preventable complication following circumcision. We describe our experience with the management of this potentially challenging condition. Materials and Methods: We reviewed all patients who had surgical repair of post‑circumcision urethrocutaneous fistula from ...

  14. Hysterosalpingography in itrogenic uterine fistula | Nwankwo | West ...

    African Journals Online (AJOL)

    Fistulae were found in the fornices of the patients and these were the openings through which the contrast refluxed into the vagina preventing demonstration of the uterine cavity and fallopian tubes. These fistulae were cannulated after using the volselum forceps to clip the anterior and posterior lips of the cervix. The uterine ...

  15. Treatment of a biliary-venous fistula following percutaneous biopsy in a pediatric living related liver transplant patient

    International Nuclear Information System (INIS)

    Weintraub, Joshua L.; Mobley, David; Hawari, Ashraf; English, Benjamin

    2006-01-01

    Liver biopsy is a common study performed after hepatic transplantation. Most centers routinely perform a biopsy 1 week after surgery to evaluate for the possibility of acute rejection. Subsequent biopsies are based on clinical symptoms and routine hepatic function laboratory testing. We report the clinical presentation and treatment of a biliary-venous fistula resulting in sepsis and bilhemia (elevated serum bilirubin levels caused by a biliary-venous fistula) in a 21/2-year-old patient 4 months after partial left lateral segment living related liver transplantation. This case is unusual in that the fistula is the reversal of the more common venous-biliary fistula. The fistula developed after a percutaneous liver biopsy was performed. (orig.)

  16. 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.

  17. Physiologic assessment of coronary artery fistula

    International Nuclear Information System (INIS)

    Gupta, N.C.; Beauvais, J.

    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

  18. Fistula Fortnight: innovative partnership brings mass treatment and public awareness towards ending obstetric fistula.

    Science.gov (United States)

    Ramsey, K; Iliyasu, Z; Idoko, L

    2007-11-01

    As part of the global Campaign to End Fistula, the Fistula Fortnight, a 2-week mass obstetric fistula treatment project, was organized in northern Nigeria to contribute to reducing the backlog of untreated fistulas and raise awareness regarding obstetric fistulas and safe motherhood. An array of partners joined forces to provide free surgical treatment, strengthen the capacity of existing facilities to manage obstetric fistulas, and utilize media strategies to raise awareness. The Fistula Fortnight took place from February 21 to March 6, 2005, at 4 established fistula repair centers in the northern Nigeria states of Kano, Katsina, Kebbi, and Sokoto. A total of 569 women received treatment, with an 87.8% rate of successful closures. The highly publicized event also raised awareness on the issue of obstetric fistula and helped put a face to maternal deaths. The Fortnight, which required extensive and thoughtful planning involving many persons cognizant of health system and quality of care issues, was effective in drawing attention to the vast fistula problem and contributed to reducing the backlog of patients.

  19. Women's Intention to Prevent Vesico Vaginal Fistula Recurrence in ...

    African Journals Online (AJOL)

    Objective: The study purpose was to determine the association between intention to prevent Vesico-Vaginal Fistula recurrence and knowledge of the risk factors of Vesico Vaginal Fistula recurrence, attitude towards Vesico Vaginal Fistula prevention and self esteem among women with Vesico-Vaginal Fistula in two repair ...

  20. Women's Intention to prevent Vesico Vaginal Fistula recurrence in ...

    African Journals Online (AJOL)

    Esem

    ABSTRACT. Objective: The study purpose was to determine the association between intention to prevent Vesico-Vaginal. Fistula recurrence and knowledge of the risk factors of. Vesico Vaginal Fistula recurrence, attitude towards. Vesico Vaginal Fistula prevention and self esteem among women with Vesico-Vaginal Fistula ...

  1. Morphologic and functional assessment of hemodialysis arteriovenous fistula with duplex doppler sonography

    Energy Technology Data Exchange (ETDEWEB)

    Cho, On Koo; Kim, Yong Soo; Rhim, Hyun Chul; Koh, Byung Hee; Kim, Bong Soo; Song, Soon Young; Park, Chan Hyun [Hanyang University College of Medicine, Seoul (Korea, Republic of)

    2001-03-15

    The pattern of morphologic and functional status of the hemodialysis AV fistula was studied using doppler ultrasound to define the useful parameter and its normal range for detecting the initial dysfunctional. Sixty patients of chronic renal failure with radial artery-cephalic vein fistula for hemodialysis (50 clinically normal and 10 clinically abnormal functioning AV fistula) were studied by duplex ultrasound. The examination followed the feeding artery to the draining vein and observed the morphology and waveform of the vessels. Peak systolic velocity (PSV), End diastolic velocity (EDV) and Systolic/Diastolic ratio (S/D ratio) were measured in the feeding artery. In the draining vein, peak velocity was measured and the presence of arterial pulsation was observed. Normal range of these measuring parameters and its significance and reliability for detecting dysfunction AV fistula were studied. In normally functioning fistula, waveforms of flow in the feeding artery were monophasic, with PSV 0.5-3.48 m/sec (average 1.75 {+-} 0.79 m/sec), EDV 0.2-1.47 m/sec (average 0.82 {+-} 0.41 m/sec) and S/D ratio 1.44-3.48 (average 2.34 {+-} 0.56). The draining vein showed components of arterial pulsations with peak velocity of 0.21-1.20 m/sec (average 0.54 {+-} 0.23 m/sec). Of the 10 clinically dysfunctional AV fistula, two cases had arteriosclerous vessel wall calcification and showed normal function on doppler sonography. Two cases of focal stenotic lesion of the draining vein showed significantly increased PSV which were more than 4.0 m/sec. Six cases of venous thrombosis showed a high resistance pattern of reversed diastolic flow with a measured S/D ratio of more than 4.0 and the absence of flow was noted within the draining S/D ratio was statically very reliable parameter (P=0.003) for defining normal and abnormal functioning AV fistula, however PSV and EDVV were unreliable (P=0.459). Duplex ultrasound is a useful diagnostic method for interpretating function of the

  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. Early detection of occult bronchopleural fistula after routine standard pneumonectomy.

    Science.gov (United States)

    Misthos, P; Konstantinou, M; Kokotsakis, J; Skottis, I; Lioulias, A

    2006-06-01

    The aim of this study was to define symptoms and signs for early diagnosis of occult bronchopleural fistula (OBPF) after routine pneumonectomy. From 1999 to 2003, 301 pneumonectomies for malignancy were performed. The records of these patients were retrospectively analyzed for several clinicopathologic factors. All patients (group A) that presented postoperatively with one or more suspicious symptoms and signs were recorded. These cases were grouped according to bronchopleural fistula documentation (group A1) or not (group A2). Both groups were subjected to multivariate analysis. In 10 cases (3.3%) bronchopleural communication was confirmed (group A1). The most frequent signs included the lack of contracture or even enlargement of postpneumonectomy space (52.7%), subcutaneous emphysema (33.3%), fever (27.7%), respiratory insufficiency (27.7%), and cough (22.2%). Multivariate analysis disclosed failure of the postpneumonectomy space to contract as an independent prodromal sign for bronchopleural communication (P=0.03, odds ratio 58.3, 95% CI: 1.45-2335.9). Chest radiology proved to be the diagnostic modality of choice for early detection of bronchopleural fistula.

  4. [Sigmoido-buttock fistula by diverticulitis: report of a rare complication].

    Science.gov (United States)

    Evaristo-Méndez, Gerardo; Sánchez-Hernández, Alma Teresa; Melo-Velázquez, Armando; Ventura-Sauceda, Félix Antonio; Sepúlveda-Castro, Rogelio Ricardo

    2013-01-01

    The complicated diverticulitis of the colon is characterized by its association with abscesses, bleeding, stenosis, perforation, obstruction or fistula. We report a case of spontaneous sigmoido-cutaneous fistula from diverticulitis to an unusual place in the gluteal region. A 59-year-old male patient presented an inflammatory wound in left buttock without response to the conservative medical treatment. The fistulography, colonoscopy, barium enema and computed tomography showed a sigmoido-cutaneous fistula to the left buttock from diverticulitis. The biopsy of the lesion ruled out malignancy. We performed an elective sigmoid resection with primary colorectal anastomosis, partial fistulectomy and injection of a fibrin sealant in the residual tract. The colon-cutaneous fistulas from diverticulitis are relatively rare. We report a spontaneous fistula with origin in a single diverticulum in the sigmoid colon and that drained through the piriform fossa of the pelvic floor to the skin of the left buttock. A high index of suspiscion is necessary to not confuse the colo-buttock fistula with local abscesses.

  5. Congenital Palatal Fistula Associated with Submucous Cleft Palate

    Science.gov (United States)

    Eshete, Mekonen; Camison, Liliana; Abate, Fikre; Hailu, Taye; Demissie, Yohannes; Mohammed, Ibrahim; Butali, Azeez; Losken, H. Wolfgang

    2016-01-01

    Background: Although cleft lip and cleft palate are among the most common congenital malformations, the presence of an isolated congenital palatal fistula along with a submucous cleft is very rare. This appears as an oval-shaped, full-thickness fenestration in the palatal midline that does not fully extend anteriorly or posteriorly, accompanied by the findings of a submucous cleft. Because of the uncommon nature of this entity, there is controversy about its etiology, diagnosis, and management. Methods: Two cases of children with congenital palatal fistulae and a submucous cleft palate are presented who were treated in different settings by different surgeons. Cases are discussed along with a thorough review of the available literature. Results: Patient 1 presented at 4 years of age with “a hole in the palate” since birth and abnormal speech. His palatal fistula and submucous cleft were repaired with a modified von Langenbeck technique in Ethiopia. At a 2-year follow-up, the palate remained closed, but hypernasal speech persisted. Patient 2 was a 1-year-old presenting with failure to thrive and nasal regurgitation, who underwent a Furlow palatoplasty in the United States with good immediate results. She was unfortunately lost to follow-up. Conclusions: A congenital fenestration of the palate is rare. Reports reveal suboptimal speech at follow-up, despite various types of repair, especially when combined with a submucous cleft. Available literature suggests that repair should not focus on fistula closure only but instead on providing adequate palate length to provide good velopharyngeal function, as in any cleft palate repair. PMID:27014542

  6. Algorithm for Optimal Urethral Coverage in Hypospadias and Fistula Repair: A Systematic Review.

    Science.gov (United States)

    Fahmy, Omar; Khairul-Asri, Mohd Ghani; Schwentner, Christian; Schubert, Tina; Stenzl, Arnulf; Zahran, Mohamed Hassan; Gakis, Georgios

    2016-08-01

    Although urethral covering during hypospadias repair minimizes the incidence of fistula, wide variation in results among surgeons has been reported. To investigate what type of flap used during Snodgrass or fistula repair reduces the incidence of fistula occurrence. We systematically reviewed published results for urethral covering during Snodgrass and fistula repair procedures. An initial online search detected 1740 reports. After exclusion of ineligible studies at two stages, we included all patients with clear data on the covering technique used (dartos fascia [DF] vs tunica vaginalis flap [TVF]) and the incidence of postoperative fistula. A total of 51 reports were identified involving 4550 patients, including 33 series on DF use, 11 series on TVF use, and seven retrospective comparative studies. For distal hypospadias, double-layer DF had the lowest rate of fistula incidence when compared to single-layer DF (5/855 [0.6%] vs 156/3077 [5.1%]; p=0.004) and TVF (5/244, 2.0%), while the incidence was highest for single-layer DF among proximal hypospadias cases (9/102, 8.8%). Among repeat cases, fistula incidence was significantly lower for TVF (3/47, 6.4%) than for DF (26/140, 18.6%; p=0.020). Among patients with fistula after primary repair, the incidence of recurrence was 12.2% (11/90) after DF and 5.1% (5/97) after TVF (p=0.39). The absence of a minimum follow-up time and the lack of information regarding skin complications and rates of urethral stricture are limitations of this study. A double DF during tubularized incised plate urethroplasty should be considered for all patients with distal hypospadias. In proximal, repeat, and fistula repair cases, TVF should be the first choice. On the basis of these findings, we propose an evidence-based algorithm for surgeons who are still in their learning phase or want to improve their results. We systematically reviewed the impact of urethral covering in reducing fistula formation after hypospadias repair. We propose an

  7. [Neurofibromatosis associated with intra- and extracranial aneurysms and extracranial vertebral arteriovenous fistula].

    Science.gov (United States)

    Kamiyama, K; Endo, S; Horie, Y; Koshu, K; Takaku, A

    1985-08-01

    Neurofibromatosis associated with vascular disorders is generally known as a vascular neurofibromatosis. In the neurosurgical aspect, it has been pointed out that "moyamoya disease" -like stenosis and/or occlusion of the internal carotid artery are seen in some of the patients with neurofibromatosis. This 58-year-old female with multiple café-au-lait spots and neurofibromas all over the body was admitted to our hospital with complaints of left orbital tumor and tinnitus. She had been suffering from the left intraorbital neurofibroma since ten years of age. Radiological examinations revealed left intraorbital neurofibroma extending into the intracranial cavity, multiple aneurysms and arteriovenous fistula. The aneurysms were located at the left vertebral-posterior interior cerebellar artery junction and at the extracranial internal carotid artery. The arterio-venous fistula was demonstrated at the left extracranial vertebral artery. Pathological changes of the blood vessels in the vascular neurofibromatosis are essentially obstructive lesions due to intimal thickening. Only few cases of neurofibromatosis associated with aneurysms and arteriovenous fistula have been reported, and eleven cases of them could be reviewed in the literature. Six are with intracranial aneurysms, two with extracranial aneurysms and three with extracranial vertebral arteriovenous fistula,. It is interesting that in all cases the extracranial vertebral arteriovenous fistula are located on the left side. This is corresponding to the fact that the bone defect around the asterion is predominantly seen on the left side in cases of neurofibromatosis.

  8. Post-traumatic recto-spinal fistula

    International Nuclear Information System (INIS)

    Lantsberg, L.; Greenberg, G.; Laufer, L.; Hertzanu, Y.

    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.)

  9. Y-type congenital urethral duplication with normal dorsal urethra and small ventral fistula to perineal skin – 28th reported case

    Directory of Open Access Journals (Sweden)

    Donald E. Meier

    2016-05-01

    Full Text Available There are numerous types of urethral duplication previously described in the literature including a Type IIA2Y where a large ventral channel branches from the hypoplastic, dorsal, orthotopic urethra. There have been 27 previously reported cases of a similar defect, called “congenital posterior urethrocutaneous fistula” (CUPF with the only difference being that the ventral urethra is hypoplastic and the dorsal, orthotopic one normal. The difference in treatment for these 2 entities is markedly different, and preoperative identification of the appropriate abnormality is essential. Treatment of CUPF requires only safe excision of the ventral segment, but treatment for a Type IIA2Y duplication requires resection of the hypoplastic, orthotopic urethra and transposition of the larger ventral segment into the dorsal orthotopic position. The outcome for treatment of CUPF is much better than for treatment of Type IIA2Y entities. We herein present the 28th case of CUPF in the English literature with discussion of the anatomy, appropriate diagnostic criteria, and safe method of treatment for these entities.

  10. Tracheoesophageal Fistula due to a Damaged Tracheal Stent

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    Masahiro Kimura

    2014-01-01

    Full Text Available We describe the management of a tracheoesophageal fistula due to a damaged tracheal stent, which was first inserted to treat tracheal stenosis. A 29-year-old woman with a history of treated epilepsy had a seizure and suffered from smoke inhalation during a fire. Breathing difficulties appeared and gradually worsened; consultation was obtained two years afterward. After undergoing a thorough examination, the patient was diagnosed with tracheal strangulation. A noncovered, metallic stent was inserted. When the patient was 37 years old, she was admitted to our hospital for the treatment of a tracheoesophageal fistula. We diagnosed it as a tracheoesophageal fistula due to the collapse of the damaged tracheal stent toward the esophageal side, and we decided to perform a mediastinal tracheostomy. Granulation may be formed in the circumference of a stent that has been present for a prolonged period, and removal of the stent may become difficult. This case suggests that insertion of a noncovered, metallic stent is contraindicated for a benign disease.

  11. Selective Management for Gastrointestinal Hemorrhage caused by Choledochoduodenal Fistula

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    Pawan Chansaenroj

    2017-03-01

    Full Text Available Background: To report a patient of choledochoduodenal fistulae (CDF who presented with melena and review a specific treatment for CDF. Methods: This study was designed as a retrospective chart review using patient’s clinical data, imaging, endoscopic report, treatment review, and literature review for treatment options. Results: A 74-year-old female presented with diffuse, non-tender abdominal pain and associated melena for one week. Physical examination showed mildly icteric sclera and mild epigastric tenderness on deep palpation. Initial diagnoses included cholangitis with anemia and acute kidney injury. Computed tomography of the abdomen revealed dilated common bile duct (CBD with a likely 1 cm stone at the distal common bile duct. The patient was given intravenous antibiotic and proper fluid administration. An ERCP was performed noting a fistula from the bile duct to the 2nd part of the duodenum with stone impaction. Sphincterotomy was performed from papilla to fistula. Balloon extraction of 1 cm stone from the CBD was done. Conclusion: The clinical presentation of CDF is generally quite nonspecific. In this case report, we present a presentation of a patient with gastrointestinal hemorrhage as an example of the presentation of CDF associated with a CBD stone. This study also discussed recent data concerning proposed treatment of CDF.

  12. Management of Atrio-Esophageal Fistula Following Left Atrial Ablation.

    Science.gov (United States)

    Yousuf, Tariq; Keshmiri, Hesam; Bulwa, Zachary; Kramer, Jason; Sharjeel Arshad, Hafiz Muhammad; Issa, Rasha; Woznicka, Daniel; Gordon, Paul; Abi-Mansour, Pierre

    2016-02-01

    Currently, no guidelines have been established for the treatment of atrio-esophageal fistula (AEF) secondary to left atrial ablation therapy. After comprehensive literature review, we aim to make suggestions on the management of this complex complication and also present a case series. We performed a review of the existing literature on AEF in the setting of atrial ablation. Using keywords atrial fibrillation, atrial ablation, fistula formation, atrio-esophageal fistula, complications, interventions, and prognosis, a search was made using the medical databases PUBMED and MEDLINE for reports in English from 2000 to April 2015. A statistical analysis was performed to compare the three different intervention arms: medical management, stent placement and surgical intervention. The results of our systematic review confirm the high mortality rate associated with AEF following left atrial ablation and the necessity to diagnose atrio-esophageal injury in a timely manner. The mortality rates of this complication are 96% with medical management alone, 100% with stent placement, and 33 % with surgical intervention. Atrio-esophageal injury and subsequent AEF is an infrequent but potentially fatal complication of atrial ablation. Early, prompt, and definitive surgical intervention is the treatment of choice.

  13. 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.

  14. Diagnosis and treatment of traumatic carotid cavernous fistula combined with sphenoid sinus pseudoaneurysm

    International Nuclear Information System (INIS)

    Chen Huairui; Bai Rulin; Huang Chengguang; Hu Guohan; Luo Chun; Yuan Guoliang; Lu Yicheng

    2008-01-01

    Objective: To explore the diagnosis and treatment of traumatic carotid cavernous fistula combined with sphenoid sinus pseudoaneurysm. Methods: Interventional diagnosed and treated 6 eases of traumatid carotid cavernous fistula combined with sphenoid sinus pseudoaneurysm. Results: 5 patients presented with recurrent massive epistaxis and symptoms of CCF caused by pseudoaneurysms and fistulas were occluded with detachable balloons and internal carotid arteries were reserved in 2 cases; of which, 1 case also had indirect carotid cavernous fistula in contralateral side, embolizated by trans facial vein approach with microcoil. Complete symptoms resolution was achieved in all cases, without procedure related complications. During the follow-up period, all patients returned to their work. Conclusions: Falling from high speed motorcycle without helmet may be one of the main causes of this disease. The site of strike mostly localize at the frontal and lateral aspects of the orbit. MRI scan is very helpful for the diagnosis before receiving angiography. Detachable balloon occlusion for the pseudoaneurysm and fistula is safe and efficient for the treatment. (authors)

  15. Endovascular Exclusion of Aortobronchial Fistula and Distal Anastomotic Aneurysm after Extra-Anatomic Bypass for Aortic Coarctation.

    Science.gov (United States)

    Bozzani, Antonio; Arici, Vittorio; Rodolico, Giuseppe; Brunetto, Massimo Borri; Argenteri, Angelo

    2017-02-01

    The treatment of choice for aortic coarctation in adults remains open surgical repair. Aortobronchial fistula is a rare but potentially fatal late sequela of surgical correction of isthmic aortic coarctation via the interposition of a graft. The endovascular treatment of aortobronchial fistula is still under discussion because of its high risk for infection, especially if the patient has a history of cardiovascular prosthetic implantation. Patients need close monitoring, most notably those with secondary aortobronchial fistula. We discuss the case of a 65-year-old man who presented with the combined conditions, and we briefly review the relevant medical literature.

  16. New Surgical Approach for treatment of complex vesicovaginal fistula. Vesical autoplasty; Avances en la cirugia de la fistula vesicovaginal compleja. Autoplastia vesical

    Energy Technology Data Exchange (ETDEWEB)

    Gil-Vernet Vila, J. M.

    2009-07-01

    Although currently complex ve sico-vaginal fistulae are an uncommon finding, their solution still remains a problem since no effective surgical technique is yet available. We describe a new vesical autoplasty procedure for solving this entity. Once the fistulae has been thoroughly resected and its borders have been unfolded, a graft is obtained from the posterior-superior vesical wall, which is then slid down to the vesical neck thereby covering great extensions where tissue has been lost, even in the presence of low-capacity bladders. This new operation has led to a 100% cure rate of the 42 consecutive cases of vesico-vaginal fistulae operated on and that had undergone repeated surgery using other thecniques. (Author) 8 refs.

  17. Sphincter of Oddi botulinum toxin injection to prevent pancreatic fistula after distal pancreatectomy.

    Science.gov (United States)

    Hackert, Thilo; Klaiber, Ulla; Hinz, Ulf; Kehayova, Tzveta; Probst, Pascal; Knebel, Phillip; Diener, Markus K; Schneider, Lutz; Strobel, Oliver; Michalski, Christoph W; Ulrich, Alexis; Sauer, Peter; Büchler, Markus W

    2017-05-01

    Postoperative pancreatic fistula represents the most important complication after distal pancreatectomy. The aim of this study was to evaluate the use of a preoperative endoscopic injection of botulinum toxin into the sphincter of Oddi to prevent postoperative pancreatic fistula (German Clinical Trials Register number: DRKS00007885). This was an investigator-initiated, prospective clinical phase I/II trial with an exploratory study design. We included patients who underwent preoperative endoscopic sphincter botulinum toxin injection (100 units of Botox). End points were the feasibility, safety, and postoperative outcomes, including postoperative pancreatic fistula within 30 days after distal pancreatectomy. Botulinum toxin patients were compared with a control collective of patients undergoing distal pancreatectomy without botulinum toxin injection by case-control matching in a 1:1 ratio. Between February 2015 and February 2016, 29 patients were included. All patients underwent successful sphincter of Oddi botulinum toxin injection within a median of 6 (range 0-10) days before operation. One patient had an asymptomatic, self-limiting (48 hours) increase in serum amylase and lipase after injection. Distal pancreatectomy was performed in 24/29 patients; 5 patients were not resectable. Of the patients receiving botulinum toxin, 7 (29%) had increased amylase levels in drainage fluid on postoperative day 3 (the International Study Group of Pancreatic Surgery definition of postoperative pancreatic fistula grade A) without symptoms or need for reintervention. Importantly, no clinically relevant fistulas (International Study Group of Pancreatic Surgery grades B/C) were observed in botulinum toxin patients compared to 33% postoperative pancreatic fistula grade B/C in case-control patients (P pancreatectomy. The results of the present trial suggest its efficacy in the prevention of clinically relevant postoperative pancreatic fistula and are validated currently in the

  18. CT in the diagnosis of enterovesical fistulae

    International Nuclear Information System (INIS)

    Goldman, S.M.; Fishman, E.K.; Gatewood, O.M.B.; Jones, B.; Siegelman, S.S.

    1985-01-01

    Enterovesical fistulae are difficult to demonstrate by conventional radiographic methods. Computed tomography (CT), a sensitive, noninvasive method of documenting the presence of such fistulae, is unique in its ability to outline the extravesical component of the primary disease process. Twenty enterovesical fistulae identified by CT were caused by diverticulitis (nine), carcinoma of the rectosigmoid (two), Crohn disease (three), gynecologic tumors (two), bladder cancer (one), cecal carcinoma (one), prostatic neoplasia (one), and appendiceal abscess (one). The CT findings included intravesical air (90%), passage of orally or rectally administered contrast medium into the bladder (20%), focal bladder-wall thickening (90%), thickening of adjacent bowel wall (85%), and an extraluminal mass that often contained air (75%). CT proved to be an important new method in the diagnosis of enterovesical fistulae

  19. CT in the diagnosis of enterovesical fistulae

    Energy Technology Data Exchange (ETDEWEB)

    Goldman, S.M.; Fishman, E.K.; Gatewood, O.M.B.; Jones, B.; Siegelman, S.S.

    1985-06-01

    Enterovesical fistulae are difficult to demonstrate by conventional radiographic methods. Computed tomography (CT), a sensitive, noninvasive method of documenting the presence of such fistulae, is unique in its ability to outline the extravesical component of the primary disease process. Twenty enterovesical fistulae identified by CT were caused by diverticulitis (nine), carcinoma of the rectosigmoid (two), Crohn disease (three), gynecologic tumors (two), bladder cancer (one), cecal carcinoma (one), prostatic neoplasia (one), and appendiceal abscess (one). The CT findings included intravesical air (90%), passage of orally or rectally administered contrast medium into the bladder (20%), focal bladder-wall thickening (90%), thickening of adjacent bowel wall (85%), and an extraluminal mass that often contained air (75%). CT proved to be an important new method in the diagnosis of enterovesical fistulae.

  20. Treatment of radiation-induced vesicovaginal fistulae

    International Nuclear Information System (INIS)

    Parm Ulhoei, B.; rosgaard, A.; Harling, H.

    1994-01-01

    The records of 23 patients with vesicovaginal fistulae (VVF) probably caused by irradiation treatment for cancer of the uterine cervix were analyzed. The median latency between irradiation and fistula formation was 17 years. Ten patients had histologically verified cancer recurrence besides a VVF. In addition, nine patients had a rectovaginal- and one an ileovaginal fistula. Twelve patients were treated primarily with ureteroileocutaneostomy a.m. Bricker. Six had bladder drainage, and four of these had ureteroileocutaneostomy performed at a later stage. Four patients initially underwent percutaneous nephrostomy. One patients had a unilateral ureteroileocutaneostomy performed. Eight patients are alive today (median observation time 2.5 years), and all of these had had ureteroileocutaneostomy performed. Three of these patients (39%) were completely relieved of symptoms while the rest occasionally experienced pain, vaginal discharge and bladder empyema. We conclude that ureteroilocutaneostomy a.m. Bricker is a satisfactory procedure for vesicovaginal fistulae because the socially incapacitating symptoms disappear or are considerably diminished. (au) (9 refs.)

  1. Endosonography and magnetic resonance imaging in the diagnosis of high anal fistulae – a comparison

    Directory of Open Access Journals (Sweden)

    Iwona Sudoł-Szopińska

    2014-06-01

    Full Text Available Anal fistula is a benign inflammatory disease with unclear etiology which develops in approximately 10 in 100 000 adult patients. Surgical treatment of fistulae is associated with a risk of damaging anal sphincters. This usually happens in treating high fistulae, branched fistulae, and anterior ones in females. In preoperative diagnosis of anal fistulae, endosonography and magnetic resonance imaging play a significant role in planning the surgical technique. The majority of fistulae are diagnosed in endosonography, but magnetic resonance is performed when the presence of high fistulae, particularly branched ones, and recurrent is suspected. The aim of this paper was to compare the roles of the two examinations in preoperative assessment of high anal fistulae. Material and methods: The results of endosonographic and magnetic resonance examinations performed in 2011–2012 in 14 patients (4 women and 10 men with high anal fistulae diagnosed intraoperatively were subject to a retrospective analysis. The patients were aged from 23 to 66 (mean 47. The endosonographic examinations were performed with the use of a BK Medical Pro Focus system with endorectal 3D transducers with the frequency of 16 MHz. The magnetic resonance scans were performed using a Siemens Avanto 1.5 T scanner with a surface coil in T1, T1FS, FLAIR, T2 sequences and in T1 following contrast medium administration. The sensitivity and specificity of endosonography and magnetic resonance imaging were analyzed. A surgical treatment served as a method for verification. The agreement of each method with the surgery and the agreement of endosonography and magnetic resonance imaging were compared in terms of the assessment of the fistula type, localization of its internal opening and branches. The agreement level was determined based on the percentage of consistent assessments and Cohen’s coefficient of agreement, κ. The integrity of the anal sphincters was assessed in each case

  2. Post Incisional Hernia Meshplasty Vesicocutaneous Fistula – A Rare Complication

    Directory of Open Access Journals (Sweden)

    M. Raghavendran

    2017-07-01

    Full Text Available Laparoscopic meshplasty is gold standard in hernia surgery. Mesh migration into bowel/bladder has been documented after laparoscopic repair, though migration into bowel is more common than bladder. Only 12 cases of migration into bladder have been described post inguinal meshplasty. We report the 1st case of mesh migration into bladder post Incisional hernia meshplasty, presenting as vesicocutaneous fistula. The objectives of this report are highlighting important points enabling earlier diagnosis, treatment. We would also like to suggest important preventive measures during meshplasty which we believe will go a long way in avoiding this important complication, thus immensely benefiting patients.

  3. MRI IN THE EVALUATION OF PERIANAL FISTULAS

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    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.

  4. Hemodynamic Simulations in Dialysis Access Fistulae

    Science.gov (United States)

    McGah, Patrick; Leotta, Daniel; Beach, Kirk; Riley, James; Aliseda, Alberto

    2010-11-01

    Arteriovenous fistulae are created surgically to provide adequate access for dialysis in patients with End-Stage Renal Disease. It has long been hypothesized that the hemodynamic and mechanical forces (such as wall shear stress, wall stretch, or flow- induced wall vibrations) constitute the primary external influence on the remodeling process. Given that nearly 50% of fistulae fail after one year, understanding fistulae hemodynamics is an important step toward improving patency in the clinic. We perform numerical simulations of the flow in patient-specific models of AV fistulae reconstructed from 3D ultrasound scans with physiologically-realistic boundary conditions also obtained from Doppler ultrasound. Comparison of the flow features in different geometries and configurations e.g. end-to-side vs. side-to-side, with the in vivo longitudinal outcomes will allow us to hypothesize which flow conditions are conducive to fistulae success or failure. The flow inertia and pulsatility in the simulations (mean Re 700, max Re 2000, Wo 4) give rise to complex secondary flows and coherent vortices, further complicating the spatio- temporal variability of the wall pressure and shear stresses. Even in mature fistulae, the anastomotic regions are subjected to non-physiological shear stresses (>10.12pcPa) which may potentially lead to complications.

  5. Fistula-in-Ano Complicated by Fournier fs Gangrene Our Experience ...

    African Journals Online (AJOL)

    Background: Fistula-in-ano when complicated by Fournierfs gangrene is an unusual finding and always carries high morbidity. This study details our experience in managing 10 cases. Methods of Study: Case files of all patients managed in University of Maiduguri Teaching Hospital and Federal Medical Center of Yola and ...

  6. Effect of BioGlue on the incidence of pancreatic fistula following pancreas resection.

    Science.gov (United States)

    Fisher, William E; Chai, Christy; Hodges, Sally E; Wu, Meng-Fen; Hilsenbeck, Susan G; Brunicardi, F Charles

    2008-05-01

    Despite numerous modifications of surgical technique, pancreatic fistula remains a serious problem and occurs in about 10% of patients following pancreas resection. BioGlue is a new sealant that creates a flexible mechanical seal within minutes independent of the body's clotting mechanism. Application of BioGlue sealant will reduce the incidence of pancreatic fistula following pancreas resection. A retrospective cohort study was performed with 64 patients undergoing pancreas resection. BioGlue sealant was applied to the pancreatic anastomosis (Whipple) or resection margin (distal pancreatectomy) in 32 cases. Factors that could affect the rate of postoperative pancreatic fistula were recorded. Pancreatic fistula was defined as greater than 50 ml of drain output with an amylase content greater than three times normal serum value after postoperative day 10. To improve the sensitivity of our study, we also examined pancreatic fistula with a strict definition of any drain output on or after postoperative day 3 with a high amylase content and graded the fistulas in terms of clinical severity. Grade A leaks were defined as subclinical. Grade B leaks required some response such as making the patient nil per os, parenteral nutrition, octreotide, antibiotics, or a prolonged hospital stay. Grade C leaks were defined as serious and life threatening. They were associated with hemorrhage, sepsis, resulted in deterioration of other organ systems, and mandated intensive care. Comparisons between the two groups were made using the chi-square test or Fisher's exact test for categorical variables and by the Wilcoxon rank-sum test for continuous variables. P values of 0.05 or less were deemed statistically significant. There were no differences between the patients who received BioGlue and the control cohort in terms of comorbid conditions, tumor location, texture of the pancreas, size of the pancreatic duct, or surgical technique. By the common definition, pancreatic fistula occurred

  7. Hemoptysis due to pulmonary pseudosequestration secondary to gastro-pulmonary fistula after a revisional bariatric operation

    Directory of Open Access Journals (Sweden)

    Carlos Cerdán Santacruz

    2014-01-01

    Full Text Available We report the case of a patient with a history of a complicated revisional bariatric operation who developed a lung pseudosequestration secondary to a gastro-pulmonary fistula. As the patient presented with recurrent hemoptysis, she was initially submitted to embolization of the aberrant vessels and later to a definite operation, which consisted on a diversion of the gastric fistula into a Roux-en-Y intestinal loop. It is an exceptional case about late complications of bariatric surgery, and it underlines the importance of discarding these complications even when the clinical manifestations affect another anatomic region different from the operated abdomen.

  8. Early Post-Operative Coronary Thrombosis Following Repair of a Proximal Coronary Artery Fistula.

    Science.gov (United States)

    Chugh, Yashasvi; Lau, Bryan; Taub, Cynthia C

    2016-12-01

    Patients with aneurysmal coronary artery fistulas are often a treatment challenge. We hereby, report a case of aneurysmal left main coronary artery to coronary sinus fistula repair, complicated by an early post-operative thrombosis of the left main coronary artery, necessitating an orthotropic heart transplant. Routine use of peri-procedural and long-term anti-coagulation is usually not a standard recommendation in these cases; however, early institution of the same may prevent flow stasis, thrombus formation and unfavourable outcomes pre- or post-operatively.

  9. Concealed Enterovesical Fistula Associated with Forgotten Intra-Abdominal Haemostat and Intravesical Towel

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    Ademola Alabi Popoola

    2014-01-01

    Full Text Available Introduction. Enterovesical fistula is rare and is often caused by bowel inflammatory diseases and tumours in the urinary bladder or the intestine with local infiltration of bowel or bladder, respectively. The fistula usually presents with lower urinary tract symptoms, pneumaturia, and faecaluria or with food particles in the urine. Intra-abdominal retained surgical foreign bodies have also been reported as causes. Case Presentation. A case of atypical presentation in a woman with enterovesical fistula following abdominal hysterectomy. Investigations confirmed the presence of surgical towel in the urinary bladder and a pair of artery forceps in the abdomen. The towel was removed at cystoscopy after which she presented with food particles in the urine. She later had laparatomy to remove the haemostat and to repair the fistula. Discussion. A typical presentation of enterovesical fistula delayed the diagnosis and treatment in this patient. Conclusion. Managing patients with recurrent urinary tract infection after abdominal operation should include appropriate imaging of the abdomen with emphasis on pelvic organs. Also, surgical operation should always be given the best shot the first time and strict operation room standards and guidelines should always be followed.

  10. High Output Cardiac Failure Resolving after Repair of AV Fistula in a Six-Month-Old

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    Uygar Teomete

    2016-01-01

    Full Text Available Background. Acquired AVF in pediatrics are commonly caused by iatrogenic means, including arterial or venous punctures. These fistulae can cause great hemodynamic stress on the heart as soon as they are created. Case. A six-month-old 25-week gestation infant was referred for respiratory distress. Initial exam revealed tachypnea, tachycardia, and hypertension. There was a bruit noted on her left arm. An ultrasound showed an arteriovenous fistula. Its location, however, precluded intervention because of the high risk for limb-loss. An echocardiogram showed evidence of pulmonary hypertension that was treated with sildenafil and furosemide. However, no improvement was seen. On temporary manual occlusion of the fistula, the patient was noted to have increased her blood pressure and decreased her heart rate, suggesting significant hemodynamic effect of the fistula. The fistula was subsequently ligated and the patient clinically and echocardiographically improved. Conclusion. A patient in high output cardiac failure or pulmonary artery hypertension, especially prematüre patients with preexisting lung disease, should be probed for history of multiple punctures, trauma, or surgery and should have prompt evaluation for AVF. If it can be diagnosed and repaired, most of the cases have been shown to decrease the stress on the heart and reverse the pathologic hemodynamics.

  11. Biliobronchial fistula secondary to percutaneous dilatation of the benign biliary stricture

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    Čolović Radoje

    2012-01-01

    Full Text Available Introduction. Biliobronchial fistula is rare. Very rarely it may be congenital, more frequently it is acquired as a complication of the hydatide cyst of the liver, pyogenic abscess, serious trauma and resection of the liver as well as recurrent cholangitis due to benign bile duct stricture or cholangiolithiasis. The main causes of the biliobronchial fistula are billiary obstruction and infectious lesion (abscess in the liver. Case Outline. We present a 56-year-old man with benign stricture of the hepaticojejunostomy performed after operative common bile duct injury, who developed biliobronchial fistula following repeated percutaneous drainage of the liver abscess and percutaneous dilatation of the strictured anastomosis. Over the years the patient developed atrophy/hypertrophy complex, portal hypertension, grade II esophageal varicosities, ascites and splenomegaly. Although biliobronchial fistula was solved by a successful surgical reconstruction (new wide hepaticojejunostomy, the operation had a limited value as it was performed late after permanent lesions of the liver and intrahepatic bile ducts had already developed. Conclusion. Surgical reconstruction of strictured biliodigestive anastomosis should be considered on time as a possibly better solution than percutaneous dilatation. According to the authors’ knowledge, a similar case of biliobronchial fistula as a complication of percutaneous dilatation of the benign biliary stricture has not been reported before in the literature.

  12. Simultaneous bladder and vaginal reconstruction using ileum in complicated vesicovaginal fistula

    Directory of Open Access Journals (Sweden)

    Sujata K Patwardhan

    2008-01-01

    Full Text Available Objectives: To discuss the outcome of surgical repair in complicated vesicovaginal fistula with simultaneous bladder and vaginal reconstruction using ileum. Materials and Methods: Four female patients in the age group of 12-30 years are included. All the patients had complicated vesicovaginal fistula with vaginal stenosis secondary to obstetric hysterectomy (except one secondary to the genitourinary tuberculosis. Repair of vesicovaginal fistula with simultaneous bladder augmentation, ureteric reimplantation, and reconstruction of vagina using ileum was performed in all the cases. Results: All the patients had successful repair of fistula. Vaginal reconstruction using ileum, resulted in capacious vagina. Adult patients resumed to normal sexual life. Mucus discharge was the only complaint in postoperative period. Conclusions: Malnutrition, anemia, obstructed labor, Intra uterine fetal death (IUFD, postpartum hemorrhage following forceps delivery in a rural setting followed by an emergency obstetric hysterectomy after a delay of 6-8 h (due to transfer to a tertiary center were the few contributing factors leading to the formation of vesicovaginal fistula (VVF. Preoperative assessment of bladder capacity and vaginal capacity in such cases is mandatory. The small bowel is a readily available vascular tissue for restoring bladder and vaginal capacity.

  13. Sentinel Bleeding as a Sign of Gastroaortic Fistula Formation after Oesophageal Surgery

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    M. Uittenbogaart

    2014-01-01

    Full Text Available Gastroaortic fistula formation is a very rare complication following oesophageal resection and, in most cases, leads to sudden death. We report the case of a 65-year-old male with an adenocarcinoma of the oesophagus who underwent neoadjuvant chemoradiation followed by a minimally invasive transthoracic oesophagectomy with gastric tube reconstruction and intrathoracic anastomosis. After an uneventful postoperative course and hospital discharge, the patient reported blood regurgitation on postoperative day 23. Endoscopy revealed an adherent blood clot on the oesophageal wall, which after dislocation caused exsanguination. Autopsy determined the cause of death being massive haemorrhage due to a gastroaortic fistula. The sudden onset of haemorrhage makes this condition particularly difficult to treat. Recognition of warning signs such as thoracic or epigastric pain, regurgitation of blood, or the passing of bloody stools or melena is crucial in the early detection of fistula and may improve patient outcome.

  14. Y-type urethral duplication with posterior perineal fistula: A new variant

    Directory of Open Access Journals (Sweden)

    Sandesh V Parelkar

    2017-05-01

    Full Text Available 13 months old boy presented with constipation and straining during micturition with poor urinary stream and voiding of urine per rectum. Perineal examination revealed posterior perineal fistula. Voiding cysto-urethrogram showed bilateral vesicoureteral reflux with bladder diverticuli, normal dorsal urethra and dye going from urethra to rectum suggestive of Y type urethral duplication. Under stoma cover, he underwent excision of posterior perineal fistula with accessory ventral urethra and anorectoplasty was done. At present patient is passing urine in good stream without straining. The uniqueness of our case is the presence of Y type of urethral duplication with normal calibre dorsal urethra and presence of posterior perineal fistula. Therefore, we consider our case to be an unusual variant of Y type of urethral duplication that has not been described before.

  15. Diagnostic performance of MRI for detection of intestinal fistulas in patients with complicated inflammatory bowel conditions

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, S.; Meuwly, J.Y.; Meuli, R.; Schnyder, P.; Denys, A. [Universitaire Vaudois - CHUV, Service de radiodiagnostic et radiologie interventionnelle, Centre Hospitalier, Lausanne (Switzerland); Chevallier, P. [Hopital Archet II, Imagerie Medicale, Nice (France); Bessoud, B. [Hopital Kremlin-Bicetre, Radiologie Generale, Kremlin-Bicetre (France); Felley, C. [University Hospital, CHUV, Service de Gastroenterologie, Lausanne (Switzerland)

    2007-11-15

    The diagnostic performance of magnetic resonance imaging (MRI) for detection of intestinal fistulas, other than perianal, in patients with known complicated inflammatory bowel conditions (CIBC) was investigated. Our study group consisted of 20 patients (12 women, mean age 43 years) with CIBC, including Crohn's disease (n=13), colonic diverticulitis (n=3), colitis after radiotherapy (n=3) and of postoperative origin (n=1). Eleven surgically proven enteral fistulas were known in ten (50%) of these patients, being of enterovesical (n=3), enterocolic (n=2), enteroenteral (n=2), rectovaginal (n=2), rectovaginovesical (n=1) and of entercutaneous (n=1) localisation. The other ten patients (50%), used as the control group, showed MR features of CIBC, although without any fistulous tract. Multiplanar T1- and T2-weighted sequences had been performed, including gadolinium-enhanced acquisition with fat saturation (1.5 T). MR findings were independently blindly and retrospectively reviewed by three radiologists for the presence and etiology of any fistula, as well as visualization and characterization of the fistulous tract. Results were compared with surgical findings (n=16) and clinical evolution (n=4). Interobserver agreement was calculated. Interobserver agreement kappa for fistula detection was 0.71. Overall sensitivity, specificity and accuracy for fistula detection were 78.6%, 75% and 77.2%, respectively. Sensitivity for fistula characterization was 80.6%, with visualization of the fistulous tract in all cases, whereby T1-weighted gadolinium-enhanced fat-saturated images were considered the most useful sequences. Gadolinium-enhanced MRI is a reliable and reproducible tool for detection of enteral fistulas secondary to inflammatory conditions. (orig.)

  16. CT vaginography: a new CT technique for imaging of upper and middle vaginal fistulas.

    Science.gov (United States)

    Botsikas, Diomidis; Pluchino, Nicola; Kalovidouri, Anastasia; Platon, Alexandra; Montet, Xavier; Dallenbach, Patrick; Poletti, Pierre-Alexandre

    2017-05-01

    Different types of vaginal fistulas is a relatively uncommon condition in the Western world but very frequent in developing countries. In the past, conventional vaginography was the radiological examination of choice for exploring this condition. CT and MRI are now both used for this purpose. Our objective was to test the feasibility and to explore the potential role of a new CT imaging technique implementing vaginal introitus obstruction and opacification of the vagina with iodine contrast agent, to show patency of a fistula. We describe the technical protocol of CT-vaginography as performed in Geneva University Hospitals, including vaginal catheterization with a Foley catheter and obstruction of the introitus by inflating the balloon of the catheter. We also report three cases of patients with suspected vaginal fistula who underwent CT-vaginography. The examinations were technically successful. In one patient, it revealed the presence of fistulous pathways from the vaginal fornix along the bilateral infected surgical prostheses. In a second patient, it showed a fistula between the vagina and the necrotic cavity of a recurrent cervical cancer. In a third patient, it proved the absence of a suspected vaginal fistula. CT-vaginography is a technically feasible CT protocol that provides anatomical and functional information on clinically suspected vaginal fistulas. Advances in knowledge: After the abandon of conventional vaginography in the era of transaxial imaging, the current modalities of imaging vaginal fistulas provide excellent anatomical detail but less functional information concerning the permeability of a vaginal fistulous pathway. We propose the use of CT-vaginography, a technical protocol that we describe in detail.

  17. Diagnostic performance of MRI for detection of intestinal fistulas in patients with complicated inflammatory bowel conditions

    International Nuclear Information System (INIS)

    Schmidt, S.; Meuwly, J.Y.; Meuli, R.; Schnyder, P.; Denys, A.; Chevallier, P.; Bessoud, B.; Felley, C.

    2007-01-01

    The diagnostic performance of magnetic resonance imaging (MRI) for detection of intestinal fistulas, other than perianal, in patients with known complicated inflammatory bowel conditions (CIBC) was investigated. Our study group consisted of 20 patients (12 women, mean age 43 years) with CIBC, including Crohn's disease (n=13), colonic diverticulitis (n=3), colitis after radiotherapy (n=3) and of postoperative origin (n=1). Eleven surgically proven enteral fistulas were known in ten (50%) of these patients, being of enterovesical (n=3), enterocolic (n=2), enteroenteral (n=2), rectovaginal (n=2), rectovaginovesical (n=1) and of entercutaneous (n=1) localisation. The other ten patients (50%), used as the control group, showed MR features of CIBC, although without any fistulous tract. Multiplanar T1- and T2-weighted sequences had been performed, including gadolinium-enhanced acquisition with fat saturation (1.5 T). MR findings were independently blindly and retrospectively reviewed by three radiologists for the presence and etiology of any fistula, as well as visualization and characterization of the fistulous tract. Results were compared with surgical findings (n=16) and clinical evolution (n=4). Interobserver agreement was calculated. Interobserver agreement kappa for fistula detection was 0.71. Overall sensitivity, specificity and accuracy for fistula detection were 78.6%, 75% and 77.2%, respectively. Sensitivity for fistula characterization was 80.6%, with visualization of the fistulous tract in all cases, whereby T1-weighted gadolinium-enhanced fat-saturated images were considered the most useful sequences. Gadolinium-enhanced MRI is a reliable and reproducible tool for detection of enteral fistulas secondary to inflammatory conditions. (orig.)

  18. Arteriovenous Fistula Embolization in Suspected Parauterine Choriocarcinoma

    Directory of Open Access Journals (Sweden)

    Husain Alturkistani

    2016-01-01

    Full Text Available This is a case of choriocarcinoma that did not regress after chemotherapy treatment. A 30-year-old female patient (gravida 2, para 2, presented to our ER with stroke and persistent mild pelvic pain 2 months after a Caesarean section. Computed tomography (CT revealed an ischemic left hemicerebellar region and a hypervascular mass in the pelvic region. This mass was not present on routine fetal ultrasound during pregnancy. The lesion was treated by chemotherapy after closure of a foramen ovale and insertion of an inferior vena cava (IVC filter. After that, 2 courses of EMACO (Etoposide, Methotrexate, Actinomycin D, Cyclophosphamide, and Vincristine chemotherapy regimen were given. Posttreatment CT showed the hypervascular mass without any changes. Arteriography showed the arteriovenous fistulae that were embolized successfully with plugs, coils, and glue. Embolization was considered due to the risk of acute hemorrhagic life-threatening complications. Eight chemotherapy courses were added after embolization. Treatment by endovascular approach and reduction of the hypervascular mass can be a valuable adjunct to chemotherapy treatment of choriocarcinoma.

  19. Parametric color coding of digital subtraction angiography in the evaluation of carotid cavernous fistulas.

    Science.gov (United States)

    Gölitz, P; Struffert, T; Lücking, H; Rösch, J; Knossalla, F; Ganslandt, O; Deuerling-Zheng, Y; Doerfler, A

    2013-06-01

    Angiographic assessment of carotid cavernous fistulas (CCFs) can be complex. Our purpose was to examine whether the use of parametric color coding in the postprocessing of DSA series is advantageous in the evaluation of CCFs. We enrolled 16 patients with angiographically proven CCFs. Endovascular treatment was performed in 14 cases. For postprocessing of digital subtraction angiography (DSA) series, a newly implemented algorithm of parametric color coding was used, turning sequential images of two-dimensional (2D)-DSA series into a single color-coded image. Angiographic data of initial, interventional, and postinterventional 2D-DSA series were compared with color-coded images. Whether parametric color coding could facilitate evaluation of fistula architecture and provide a more precise estimation of fistula venous drainage patterns as well as whether flow analysis could reveal objective changes during and after treatment were investigated. In 56 % of the cases, parametric color coding was observed to facilitate visualization of fistula angioarchitecture. Estimation of fistula drainage flow patterns was considered to be improved in 31 % of the cases. For assessment of hemodynamic changes during and after treatment, parametric color coding was assumed to be helpful in 21 % of the cases, especially because revealing flow changes that were not visible on 2D-DSA series were now visible. Parametric color coding is a fast application tool that might provide additional support in the angiographic evaluation of CCFs. Visualization of complex fistula architecture could be facilitated, and flow analysis might improve assessment of venous drainage patterns, thereby increasing overall diagnostic confidence. During and after treatment, hemodynamic changes that were not visible on 2D-DSA series could now be depicted.

  20. Feasibility of Noninvasive Diagnosis and Treatment Planning in a Case Series with Carotid-Cavernous Fistula using High-Resolution Time-Resolved MR-Angiography with Stochastic Trajectories (TWIST) and Extended Parallel Acquisition Technique (ePAT 6) at 3 T.

    Science.gov (United States)

    Seeger, A; Kramer, U; Bischof, F; Schuettauf, F; Ebner, F; Danz, S; Ernemann, U; Hauser, T-K

    2015-09-01

    The evaluation of carotid-cavernous fistulas (CCFs) and the intracranial vasculature has been predominantly carried out using conventional digital subtraction angiography (DSA). Recent developments in time-resolved magnetic resonance angiography (MRA) provide the opportunity to assess both multiple arterial and venous phases with high temporal and spatial resolution. Here, we investigated the feasibility of this technique to functionally assess CCF prior to intervention. Six consecutive patients with clinical symptoms of a CCF were scheduled for clinically indicated MRA and underwent a protocol that comprised conventional imaging sequences and high resolution time-resolved MRA with interleaved stochastic trajectories (TWIST). The location of the fistulous communication, the flow pattern, and venous drainage were determined by time-resolved MRA and compared with DSA which was available in five out of six patients. Typical morphological findings (including enlargement of the superior ophthalmic vein, exophthalmos) were found in all cases in both conventional MRI and time-resolved MRA source data. The temporal resolution of time-resolved MRA enabled a good separation of the early filling of the cavernous sinus during the arterial phase. Direct fistulous communication was assessed in three patients with good correlation to DSA, whereas indirect CCF could not definitely be visualized. The time-resolved MRA provided information about the flow pattern and the venous drainage of the fistula in all patients, which is essential for therapy planning. Time-resolved MRA provides important morphological and functional information in patients with CCF. Although DSA remains the gold standard for diagnosis and exact classification of fistulas, time-resolved MRA can provide the relevant hemodynamic information to plan interventional treatment as a one-step procedure with a focused diagnostic workup.