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Sample records for atresia tracheo-esophageal fistula

  1. Congenital esophageal atresia with tracheo-esophageal fistula

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

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

    2016-01-01

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

  3. Tracheo-esophageal fistula: Successful palliation after failed esophageal stent

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    Rakesh K Chawla

    2012-01-01

    Full Text Available The incidence of tracheo-esophageal (TO fistula is on the rise, especially after palliative management for esophageal malignancies. We report a case of cancer of esophagus who after chemotherapy and radiotherapy developed TO fistula. Placement of an esophageal stent helped him in taking food orally, but his cough and dyspnoea continued to worsen. Fibreoptic bronchoscopy demonstrated a severely compressed trachea secondary to protrusion of esophageal stent which responded very well to an Ultraflex-covered tracheal stent and the patient achieved relief from cough and dyspnoea.

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

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    Albuquerque K

    1993-10-01

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

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

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    Man Mohan Harjai

    2015-01-01

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

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

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    Olga Lucía Morales Múnera

    2013-07-01

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

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

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    Suresh R. S. Mandrekar

    2013-01-01

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

  8. Trouble shooting with the Tracheo Esophageal Prosthesis

    OpenAIRE

    Thakar, A.; Bahadur, S

    2002-01-01

    Vocal rehabilitation of the laryngectomee can be dramatically improved by the Tracheo-Esophageal Puncture (TEP) technique. The greatest impediment to its increased use in our country has been the failure on the part of the Medical Community to provide these patients with day to day support and guidance on the use of the TEP prosthesis. This article seeks to address this deficiency and provides some guidance on the care and maintenance of the TEP.

  9. END-TO-END VERSUS END-TO-SIDE ANASTOMOSIS IN THE TREATMENT OF ESOPHAGEAL ATRESIA OR TRACHEO-ESOPHAGEAL FISTULA

    OpenAIRE

    ASKARPOUR, Shahnam; OSTADIAN, Nasrollah; Peyvasteh, Mehran; Alavi, Mostafa; Javaherizadeh, Hazhir

    2016-01-01

    Background : Dehiscence of esophageal anastomosis is frequent and there are still controversies which type of anastomosis is preferred to diminish its incidence Aim : To compare end-to-end anastomosis versus end-to-side anastomosis in terms of anastomotic leakage, esophageal stricture and gastroesophageal reflux symptom. Methods : This study was carried out for two year starting from 2012. End-to-side and end-to-side anastomosis were compared in terms of anastomotic leakage, esophageal strict...

  10. [Congenital Esophageal Atresia].

    Science.gov (United States)

    Suzuki, Makoto; Kuwano, Hiroyuki

    2015-07-01

    In this report, we describe the esophageal atresia in terms of current surgical management on the basis of our experience and literatures. Traditionally, infants with esophageal atresia have presented shortly after birth because of an inability to pass an orogastric tube, respiratory distress, or an inability to tolerate feeding. And also, an isolated trachea-esophageal fistula (TEF) usually cases coughing, recurrent pneumonia, or choking during feedings. To ignore these symptoms is to risk a delayed diagnosis. The condition may be associated with other major congenital anomalies such as those seen in the vertebral, anal, cardiac, tracheo-esophageal, renal/radial (VACTER) association, or it may be an isolated defect. Therapeutic strategies for esophageal atresia are a prevention of pulmonary complication by TEF closing and an early establishment of enteral alimentation. We promptly repair healthy infants without performing a gastrostomy and delay repair in infants with high-risk factors such as associated severe cardiac anomaly and respiratory insufficiency. Esophageal atresia has been classically approached through a thoracotomy. The disadvantages of such a thoracotomy have been recognized for a long time, for example winged scapula, elevation of fixation of shoulder, asymmetry of the chest wall, rib fusion, scoliosis, and breast and pectoral muscle maldevelopment. To avoid such disadvantages, thoracoscopic repair was recently reported. PMID:26197921

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

    NARCIS (Netherlands)

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

    1997-01-01

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

  12. Concurrent esophageal atresia with tracheoesophageal fistula and Hirschsprung disease

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    J. Leslie Knod

    2015-11-01

    Full Text Available We describe two cases of concomitant Hirschsprung disease and esophageal atresia and tracheoesophageal fistula in the newborn, both of which were successfully diagnosed and managed in the neonatal period. This is the first report in the English literature to identify the coexistence of these distinct congenital malformations.

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

    OpenAIRE

    Money Gupta; Mahajan, J. K.; Monika Bawa; KLN Rao

    2011-01-01

    Background: A significant number of esophageal atresia and tracheoesophageal fistula patients have long gaps and a high propensity to leak. Anastomotic leak in esophageal atresia is associated with a significant morbidity and mortality. Aim : In a prospective randomized trial, we analyzed the risk factors leading to anastomotic dehiscence and studied the effect of pleural wrap as an additional vascular cover around the esophageal anastomosis. Materials and Methods: Forty patients were divided...

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

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    E. Brandigi

    2013-12-01

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

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

    OpenAIRE

    Go Miyano; Keiichi Morita; Masakatsu Kaneshiro; Hiromu Miyake; Mariko Koyama; Hiroshi Nouso; Masaya Yamoto; Reiji Nakano; Yasuhiko Tanaka; Tomizo Nishiguchi; Takakazu Kawamura; Koji Fukumoto; Naoto Urushihara

    2015-01-01

    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...

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

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    Go Miyano

    2015-01-01

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

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

    Science.gov (United States)

    Miyano, Go; Morita, Keiichi; Kaneshiro, Masakatsu; Miyake, Hiromu; Koyama, Mariko; Nouso, Hiroshi; Yamoto, Masaya; Nakano, Reiji; Tanaka, Yasuhiko; Nishiguchi, Tomizo; Kawamura, Takakazu; Fukumoto, Koji; Urushihara, Naoto

    2015-01-01

    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. PMID:25659560

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

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    Money Gupta

    2011-01-01

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

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

    International Nuclear Information System (INIS)

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

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

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

    2010-08-15

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

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

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    H Davari

    2006-01-01

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

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

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    Bukarica Svetlana S.

    2004-01-01

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

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

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    Isman Firdaus

    2004-12-01

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

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

    OpenAIRE

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

    2016-01-01

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

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

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    Mohammed Amine Benatta

    2014-01-01

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

  6. Review of oesophageal atresia and tracheoesophageal fistula in hospital sultanah bahiyah, alor star. Malaysia from january 2000 to december 2009.

    Science.gov (United States)

    Narasimman, S; Nallusamy, M; Hassan, S

    2013-01-01

    Oesophageal atresia (EA) and tracheoesophageal fistula (TEF) is one of the congenital anomaly occurring in the newborns with the incidence of 1 in 2500 births seen worldwide. A retrospective review of newborns admitted to Hospital Sultanah Bahiyah (HSB) from 1st January 2000 to 31st December 2009 was done. The objective was to look at the influence of birth weight, time of surgical intervention, presence of other congenital anomaly and presence of preoperative pneumonia to the immediate outcome (mortality) of the surgery. There were 47 patients with oesophageal atresia, out of which 26 (55%) were males and 21 (45%) females. The distribution of patients by race were 34 Malays (72%), 9 Chinese (19%) and 4 Indians (9%). The birth weight of the babies range from 0.8 kg to 4.0 kg and there was a significant association with the outcome of the surgery (pborn with congenital malformation and there was a significant association with the outcome of the surgery (p<0.05). Based on the chest roentgenogram, 20 (43%) of them had pneumonia with significant association with the outcome (p<0.05). The mortality rate is 23% and the causes of death were pneumonia (36%), renal failure (18%), cardiac malformation (18%) and multiple congenital malformations (28%). The outcome of EA and TEF is determined mainly by birth weight, congenital malformations and presence of preoperative pneumonia in HSB. PMID:23466767

  7. Reverse gastric tube oesophageal substitution for staged repair of oesophageal atresia and tracheo-oesophageal fistula

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    Christopher Olusanjo Bode

    2014-01-01

    Full Text Available The management of oesophageal atresia and tracheo-oesophageal atresia (OATOF is very challenging. While in developed countries survival of patients with this condition has improved, the outcome in many developing countries has been poor. Primary repair through a thoracotomy (or video-assisted thoracoscopic surgery where available is the gold standard treatment of OATOF. However, in our setting where patients typically present late and with minimum support resources such as Neonatal Intensive Care Unit and total parenteral nutrition; staged repair may be the only hope of survival of these patients and this communication highlights the essential steps of this mode of treatment.

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

    OpenAIRE

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Muffazzal Rassiwala

    2016-01-01

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

  10. Oesophageal atresia

    Directory of Open Access Journals (Sweden)

    Spitz Lewis

    2007-05-01

    Full Text Available Abstract Oesophageal atresia (OA encompasses a group of congenital anomalies comprising of an interruption of the continuity of the oesophagus with or without a persistent communication with the trachea. In 86% of cases there is a distal tracheooesophageal fistula, in 7% there is no fistulous connection, while in 4% there is a tracheooesophageal fistula without atresia. OA occurs in 1 in 2500 live births. Infants with OA are unable to swallow saliva and are noted to have excessive salivation requiring repeated suctioning. Associated anomalies occur in 50% of cases, the majority involving one or more of the VACTERL association (vertebral, anorectal, cardiac, tracheooesophageal, renal and limb defects. The aetiology is largely unknown and is likely to be multifactorial, however, various clues have been uncovered in animal experiments particularly defects in the expression of the gene Sonic hedgehog (Shh. The vast majority of cases are sporadic and the recurrence risk for siblings is 1%. The diagnosis may be suspected prenatally by a small or absent stomach bubble on antenatal ultrasound scan at around 18 weeks gestation. The likelihood of an atresia is increased by the presence of polyhydramnios. A nasogastric tube should be passed at birth in all infants born to a mother with polyhydramnios as well as to infants who are excessively mucusy soon after delivery to establish or refute the diagnosis. In OA the tube will not progress beyond 10 cm from the mouth (confirmation is by plain X-ray of the chest and abdomen. Definitive management comprises disconnection of the tracheooesophageal fistula, closure of the tracheal defect and primary anastomosis of the oesophagus. Where there is a "long gap" between the ends of the oesophagus, delayed primary repair should be attempted. Only very rarely will an oesophageal replacement be required. Survival is directly related to birth weight and to the presence of a major cardiac defect. Infants weighing over

  11. Pulmonary Atresia

    Science.gov (United States)

    ... to repair the defect. Return to main topic: Congenital Heart Disease See on other sites: MedlinePlus https://medlineplus.gov/ency/article/001091.htm Pulmonary atresia American Heart Association www. ...

  12. A Surviving Child With Complete Proximal Tracheal Atresia

    OpenAIRE

    Haight, Ken; Sankaran, Koravangattu; Shokeir, Mohamed

    1984-01-01

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

  13. Tracheoesophageal fistula and esophageal atresia repair

    Science.gov (United States)

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

  14. Jejunum ileal intestinal atresia.

    Directory of Open Access Journals (Sweden)

    Claudio J. Puente Fonseca

    2005-12-01

    Full Text Available The intestinal atresia is one of the most important causes of intestinal obstruction in newborn. They constitute aorund 95% of total intestinal obstructions in this age group. Most of intestinal atresias are jejunoieal atresia. Although it is not frequent their relationship with other congenital anomalies, has been described the association in some cases with defects of intestine rotation, meconium peritonitis, with meconium ileus and rarely with the Hirschsprung diseases. The hereditary character has also been described in certain multiple intestinal atresias. We presented the Good Clinical Practices Guideline for Jejunoileal atresia, approved by consensus in the 1st National Good Clinical Practices Workshop in Pediatric Surgery (Cienfuegos, Cuba, March 7 – 9, 2002.

  15. Motility, digestive and nutritional problems in Esophageal Atresia.

    Science.gov (United States)

    Gottrand, Madeleine; Michaud, Laurent; Sfeir, Rony; Gottrand, Frédéric

    2016-06-01

    Esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) is a rare congenital malformation. Digestive and nutritional problems remain frequent in children with EA both in early infancy and at long-term follow-up. These patients are at major risk of presenting with gastroesophageal reflux and its complications, such as anastomotic strictures. Esophageal dysmotility is constant, and can have important consequences on feeding and nutritional status. Patients with EA need a systematic follow-up with a multidisciplinary team. PMID:26752295

  16. Magnetic compression anastomosis as a nonsurgical treatment for esophageal atresia

    Energy Technology Data Exchange (ETDEWEB)

    Zaritzky, Mario [Hospital de Ninos de La Plata, Department of Radiology, Buenos Aires (Argentina); University of Chicago Medical Center, Department of Radiology, Chicago, IL (United States); Ben, Ricardo [Hospital de Ninos de La Plata, Department of Gastroenterology, Buenos Aires (Argentina); Zylberg, Gaston I.; Yampolsky, Brian [Hospital de Ninos de La Plata, Department of Radiology, Buenos Aires (Argentina)

    2009-09-15

    We describe a unique technique to promote a nonsurgical esophageal anastomosis with magnets in children with esophageal atresia. To evaluate the efficacy of magnetic lengthening of atretic esophageal ends to produce an anastomosis and to communicate our results after more than 2 years of follow-up. Between September 2001 and March 2004, five children were selected for treatment. Two of the children had esophageal atresia without fistula (type A) and three had atresia with fistula converted to type A surgically; however, surgeons failed to achieve an anastomosis because of the width of the gap. Neodymium-iron-boron magnets were used. Daily chest radiographs were taken until union of the magnets was observed. They were then replaced with an orogastric tube. Anastomosis was achieved in all patients in an average of 4.8 days. One patient, with signs of early sepsis, was successfully treated with antibiotics. In four of the five patients, esophageal stenosis developed. At the time of this report, two patients were free of treatment and on an oral diet (after 26 months), two patients required periodic balloon dilatation, and one patient had recently undergone surgery due to recurrent esophageal stenosis not amenable to balloon dilatation. Magnetic esophageal anastomosis is a feasible method in selected patients with esophageal atresia. Esophageal anastomosis was achieved in all patients. The only observed complication of significance was esophageal stenosis. One patient needed surgery because of stenosis. (orig.)

  17. Thinking of VACTERL-H? Rule out Fanconi Anemia according to PHENOS.

    Science.gov (United States)

    Alter, Blanche P; Giri, Neelam

    2016-06-01

    VACTERL-H association includes three of eight features: vertebral anomalies, anal atresia, congenital heart disease, tracheo-esophageal fistula, esophageal atresia, renal, limb anomalies, and hydrocephalus. The VACTERL-H phenotype among cases with FA is considered to be about 5%; the frequency of FA among patients with VACTERL-H is unknown. We examined 54 patients with FA in the National Cancer Institute Inherited Bone Marrow Failure Syndrome Cohort for features of VACTERL-H, including imaging studies (radiology and ultrasound). Eighteen of the fifty-four patients had three or more VACTERL-H features. The presence of VACTERL-H association in 33% of those with FA is much higher than the previous estimate of 5% (P cancer, stem cell transplant, or survival. Early diagnosis will lead to genetic counseling and early surveillance and management of complications of FA. © 2016 Wiley Periodicals, Inc. PMID:27028275

  18. Aortoenteric Fistula

    Directory of Open Access Journals (Sweden)

    Shou-Jiang Tang

    2014-04-01

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

  19. Congenital intestinal atresia.

    Science.gov (United States)

    Davenport, M; Bianchi, A

    1990-09-01

    Surgery for infants with intestinal atresia has evolved along with the development of specialized neonatal surgical units. This once fatal condition now carries a better than 85% chance of survival and an excellent long-term prognosis. Recent advances in bowel preservation techniques have reduced morbidity and improved gut function in both the long and the short term. PMID:2257399

  20. A Very Rare Cause of Anal Atresia: Currarino Syndrome.

    Science.gov (United States)

    Buyukbese Sarsu, Sevgi; Parmaksiz, Mehmet Ergun; Cabalar, Esra; Karapur, Ali; Kaya, Cihat

    2016-05-01

    Currarino syndrome (triad) is an extremely rare condition characterized by presacral mass, anorectal malformation, and sacral bone deformation. The complete form of this syndrome displays all three irregularities. Herein, we report a male case who was admitted to our hospital with symptoms of urinary system infection and persistent constipation 2 years after colostomy operation performed with the indication of rectovestibular fistula and anal atresia, diagnosed as Currarino syndrome based on imaging modalities. In a patient who was admitted because of the presence of anal atresia, in order to preclude potential complications, probable concomitancy of this syndrome should not be forgotten. Early diagnosis is important for the prevention of meningitis, urinary tract infections, and malignant change. PMID:27081429

  1. A case of tetralogy of Fallot associated with left anterior descending coronary artery to pulmonary artery fistula

    Directory of Open Access Journals (Sweden)

    Chander Mohan Mittal

    2011-01-01

    Full Text Available Presence of coronary to pulmonary artery fistula is generally a feature of pulmonary atresia with ventricular septal defect. We present a rare case of left anterior descending coronary artery to pulmonary artery fistula in a patient of tetralogy of Fallot.

  2. [Computerized tomography of the organs of the small pelvis in children with anorectal atresia].

    Science.gov (United States)

    Sitkovskiĭ, N B; Babiĭ, Ia S; Kaplan, V M; Dan'shin, T I; Sil'chenko, M I; Bodnar', V V; Gbenu, A S

    1992-01-01

    In 12 children with the different forms of anorectal atresia, for studying the state of a sphincter apparatus of the rectum and assessment of quality of its bringing down into the perineum after proctoplasty, computerized tomography of the organs of a small pelvis was used. Underdeveloped and undifferentiated musculus levator ani in children with high anorectal atresia and fistula to the urinary bladder was revealed. The method permits to establish exact location of the intestine brought down relative to musculus levator ani and external anal sphincter. PMID:1518247

  3. Intrauterine Intussusception Causing Ileal Atresia

    Directory of Open Access Journals (Sweden)

    Yogesh Kumar Sarin

    2010-11-01

    Full Text Available Intrauterine intussusception (IUI is the one of the rarest recognized causes of jejuno-ileal atresia (JIA. We report on a 15-day old full-term neonate presenting with features of intestinal obstruction, wherein on exploration, a visible ileo-ileal intussusception resulting in ileal atresia was found. The relevant literature has been reviewed.

  4. PYLORIC ATRESIA IN ASSOCIATION WITH MULTIPLE COLONIC ATRESIAS IN A NEONATE: AN UNREPORTED ASSOCIATION

    Directory of Open Access Journals (Sweden)

    Vijay C Pujar

    2012-01-01

    Full Text Available Pyloric atresia is rare cause of gastrointestinal obstruction in neonates and usually occurs as an isolated anomaly. They have been associated with multiple small bowel and colonic atresias but not reported in association with isolated multiple colonic atresias. A case of pyloric atresia oc-curring in association with multiple colonic atresias is being reported here.

  5. Jejunum ileal intestinal atresia. Atresia intestinal yeyuno ileal.

    Directory of Open Access Journals (Sweden)

    Claudio J. Puente Fonseca

    2005-12-01

    Full Text Available The intestinal atresia is one of the most important causes of intestinal obstruction in newborn. They constitute aorund 95% of total intestinal obstructions in this age group. Most of intestinal atresias are jejunoieal atresia. Although it is not frequent their relationship with other congenital anomalies, has been described the association in some cases with defects of intestine rotation, meconium peritonitis, with meconium ileus and rarely with the Hirschsprung diseases. The hereditary character has also been described in certain multiple intestinal atresias. We presented the Good Clinical Practices Guideline for Jejunoileal atresia, approved by consensus in the 1st National Good Clinical Practices Workshop in Pediatric Surgery (Cienfuegos, Cuba, March 7 – 9, 2002.
    La atresia intestinal es una de las causas más importantes de la obstrucción intestinal en el recién nacido. Constituyen el 95 % del total de obstrucciones intestinales en este grupo de edad. La mayoría de las atresias del intestino son yeyunoileales. Aunque no es frecuente su relación con otras anomalías congénitas, se ha descrito la asociación en algunos casos con defectos de rotación del intestino, con peritonitis meconial, con íleo meconial y raras veces con la enfermedad de Hirschsprung. También se ha descrito el carácter hereditario de ciertas atresias intestinales múltiples. Se presenta la Guía de Buenas Prácticas Clínicas para atresia intestinal yeyunoileal, aprobada por consenso en el 1er Taller Nacional de Buenas Prácticas Clínicas en Cirugía Pediátrica (Cienfuegos, 7 al 9 de marzo del 2002.

  6. Atresia in the esophagus Atresia Esofágica.

    Directory of Open Access Journals (Sweden)

    Narciso Hernández Rodríguez

    2005-12-01

    Full Text Available Esophageal atresia is the congenital lack of continuity of the esophagus with or without communication to the airway. Incidence is estimateed in 1 by 3000 to 4500 alive newborns. Cases in brothers are found and children of parents with atresia esophagus, nevertheless not a hereditary is recognized; also there is a greater frequency in twins. We presented the Good Clinical Practices Guideline for Esophageal atresia, approved by consensus in the 2nd National Good Clinical Practices Workshop in Pediatric Surgery (Manzanillo, Cuba, September 31 - October 3, 2002.
    La atresia esofágica es la falta congénita de continuidad del esófago con o sin comunicación a la vía aérea. Se estima una incidencia de 1 cada 3000 a 4 500 neonatos vivos. Se encuentran casos en hermanos e hijos de padres con atresia de esófago, sin embargo no existe un patrón hereditario establecido, también hay una mayor frecuencia en gemelos. Se presenta la Guía de Buenas Prácticas Clínicas para Atresia esofágica, aprobada por consenso en el 2º Taller Nacional de Buenas Prácticas Clínicas en Cirugía Pediátrica (Manzanillo, 31 de septiembre al 3 de octubre del 2002.

  7. Congenital Pyloric Atresia and Associated Anomalies: A Case Series

    Directory of Open Access Journals (Sweden)

    Rahul Gupta

    2013-10-01

    Full Text Available Congenital pyloric atresia (CPA is a very rare surgical condition. Eleven patients with the diagnosis of CPA treated at our hospital were retrospectively studied for the age at diagnosis, sex, presenting symptoms, associated anomalies, operative findings, treatment and outcome. Male: Female is 8:3. The age at diagnosis ranged from one day to three years. Associated anomalies were seen in four (36.6%. These included epidermolysis bullosa (EB in two, oesophageal atresia with distal trachea-oesophageal fistula in one, colonic atresia in one, sensorineural deafness and dysplastic kidney in one patient. All three types of CPA were observed; six (54.5% had type 1, four (36.3% had type 2 and one (9% had type 3 [(core]. Different procedures performed were Heineke–Mickulicz pyloroplasty, Finney's pyloroplasty and gastro-duodenostomy. Post-operatively, nine out of eleven did well while other two died giving an overall survival of 81.8%. Sepsis was the cause of death in both of them.

  8. A Case of Aural Atresia

    OpenAIRE

    Polat, Cahit; Baykara, Murat; SAKALLIOĞLU, Öner; Soylu, Erkan; Yüce, Salim; AKYİĞİT, Abdulvahap

    2013-01-01

    Congenital aural atresia (CAA), pinna, external auditory canal and middle ear deformities is a developmental anomaly in the area. Otoscopic examination in patients with stenosis or atresia of external auditory canal is also not possible. Therefore, the evaluation of these cases high-resolution computed tomography (HRCT) examination is an important option. It also examined to determine suitable candidates for surgery in the planning and operation may lead the way. We wanted to emphasize the im...

  9. Cardiocutaneous fistula

    OpenAIRE

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

    1999-01-01

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

  10. Tracheoesophageal fistula.

    Science.gov (United States)

    Slater, Bethany J; Rothenberg, Steven S

    2016-06-01

    Tracheoesophageal fistula (TEF) is a relatively rare congenital anomaly. Surgical intervention is required to establish esophageal continuity and prevent aspiration and overdistension of the stomach. Since the first successful report of thoracoscopic TEF repair in 2000, the minimally invasive approach has become increasingly utilized. The main advantages of the thoracoscopic technique include avoidance of a thoracotomy, improved cosmesis, and superior visualization of the anatomy and fistula afforded by the laparoscope׳s magnification. PMID:27301604

  11. Optimizing Arteriovenous Fistula Maturation

    OpenAIRE

    Zangan, Steven M.; Falk, Abigail

    2009-01-01

    Autogenous arteriovenous fistulas are the preferred vascular access in patients undergoing hemodialysis. Increasing fistula prevalence depends on increasing fistula placement, improving the maturation of fistula that fail to mature and enhancing the long-term patency of mature fistula. Percutaneous methods for optimizing arteriovenous fistula maturation will be reviewed.

  12. 小剂量舒芬太尼用于维持新生儿Ⅲ型食道闭锁矫治术结扎食管气管瘘前保留自主呼吸通气分析%Small dose Sufentanil used in Neonatal Ⅲ type esophageal atresia and correcting surgery before ligation esophageal tracheal fistula with spontaneous breath

    Institute of Scientific and Technical Information of China (English)

    王媛; 贾英萍; 梁郑

    2014-01-01

    闭锁矫治手术中,采用舒芬太尼慢诱导、结扎食管气管瘘前保留自主呼吸通气对患儿生理功能影响较小,呼吸、循环功能更稳定,肺部并发症较少,是较理想的麻醉和通气方法。%Objective To conclude the better anesthetic method and ventilation method in Neonatal Ⅲ type esophageal atresia and correcting surgery before ligation esophageal tracheal fistula, slow induction by small dose Sufentanil with spontaneous breath and fast induction using Remifentanil with intermittent positive pressure mechanical ventilation,on the funtion of respiratory and circulation. Methods Eighty cases of neonatal Ⅲ esophageal atresia of both sexes,aged 1 -6 days,weighing 1. 75-2. 8 kg,scheduled for pyloromyotomy,were randomly divided into R group and S group( n =40 ). After making the children quiet by inhaling 1% -5% Sevoflurane( oxygen flow 2 L/min),patients in group R received intravenous injection of Remifentanil 1 -2 μg/kg,rocuronium 0. 45 mg/kg,then control the respiratory by intermittent positive pressure mechanical ventilation pressure control mode ( PCV) after endotracheal intubation,and patients in group S received slow intravenous injection of Sufentanil 0. 1-0. 2 μg/(kg·min)with spontaneous breath after endotracheal intubation,then used SIMV﹢PSV pattern after thoracotomy. According to the situation of children with spontaneous breathing, rocuronium 0. 45 mg/kg was injected after ligation of esophageal tracheal fistula,then change the patten to PCV,Remifentanil 0. 1-0. 2 μg/(kg·min)was used at the same time. The two group patients in-haled sevoflurane continuously,MAC value was controled at 0. 8. Monitor arterial blood gas at the points of preoperative,after endotracheal intubation,before and after Ligation fistula,before the end of the op-eration. The blood gas analysis index(PO2,PCO2,SO2,pH),and respiratory monitoring indicators ( HR,MAP,PetCO2 ,SPO2 )between group R and S was compared. Results Circulation

  13. Immediate primary anastomosis for isolated oesophageal atresia: A single-centre experience

    Directory of Open Access Journals (Sweden)

    Ibrahim Uygun

    2015-01-01

    Full Text Available Background: Isolated oesophageal atresia without tracheo-oesophageal fistula represents a major challenge for most paediatric surgeons. Here, we present our experience with six neonates with isolated oesophageal atresia who successfully underwent immediate primary anastomosis using multiple Livaditis circular myotomy. Materials and Methods: All six neonates were gross type A isolated oesophageal atresia (6%, from among 102 neonates with oesophageal atresia, treated between January 2009 and December 2013. Five neonates were female; one was male. The mean birth weight was 2300 (range 1700-3100 g. Results: All six neonates successfully underwent immediate primary anastomosis using multiple myotomies (mean 3; range 2-4 within 10 (median 3 days after birth. The gap under traction ranged from 6 to 7 cm. One neonate died of a major cardiac anomaly. Another neonate was lost to follow-up after being well for 3 months. Three anastomotic strictures were treated with balloon dilatation, and four anastomotic leaks were treated conservatively. The mean duration of follow-up was 33 months. Conclusions: To treat isolated oesophageal atresia, an immediate primary anastomosis can be achieved using multiple myotomies. Although, this approach is associated with high complication rates, as are other similar approaches, these complications can be overcome.

  14. The application of a new cyanoacrylate glue in pediatric surgery for fistula closure.

    Science.gov (United States)

    Hosseini, Seyed Mohammad Vahid; Bahador, Ali; Foroutan, Hamid Reza; Sabet, Babak; Geramizadeh, Bita; Zarenezhad, Mohammad

    2011-03-01

    Surgical glues have been used in pediatric surgery because of the fragility of tissue, and to prevent major surgeries. The present report describes our experience with using a new cyanoacrylate Glubran 2 (Viareggio, Italy) in the treatment of five cases of tracheoesophageal atresia with fistula (one fistula protection, three recurrent fistula, and one unstable patients), two cases of hypospadias, one case of vesicutanouse fistula after bladder extrophy, and one case of cloacal extrophy from January-December 2008. Three cases of recurrent tracheoesophageal atresia with fistula were treated by bronchoscpic glue injection. The other two cases benefited from glue through its ability to plug the fistula and to act as a protecting layer on anastomosis. In two cases with hypospadias excessive use of the glue caused skin necrosis, which was repaired. The wounds of cloacal extrophy were protected from nearby colostomy contamination and infection, and the vesicocutanouse fistula was closed by deepithelialization and sealing with glue. Based on the outcomes of the cases, it may be possible to suggest that Glubran 2 may be used safely in Pediatric Surgery as a sealant for the prevention and treatment of fistulas. PMID:23365480

  15. The Application of a New Cyanoacrylate Glue in Pediatric Surgery for Fistula Closure

    Directory of Open Access Journals (Sweden)

    Seyed Mohammad Vahid Hosseini

    2011-03-01

    Full Text Available Surgical glues have been used in pediatric surgery because of the fragility of tissue, and to prevent major surgeries. The present report describes our experience with using a new cyanoacrylate Glubran 2 (Viareggio, Italy in the treatment of five cases of tracheoesophageal atresia with fistula (one fistula protection, three recurrent fistula, and one unstable patients, two cases of hypospadias, one case of vesicutanouse fistula after bladder extrophy, and one case of cloacal extrophy from January–December 2008. Three cases of recurrent tracheoesophageal atresia with fistula were treated by bronchoscpic glue injection. The other two cases benefited from glue through its ability to plug the fistula and to act as a protecting layer on anastomosis. In two cases with hypospadias excessive use of the glue caused skin necrosis, which was repaired. The wounds of cloacal extrophy were protected from nearby colostomy contamination and infection, and the vesicocutanouse fistula was closed by deepithelialization and sealing with glue. Based on the outcomes of the cases, it may be possible to suggest that Glubran 2 may be used safely in Pediatric Surgery as a sealant for the prevention and treatment of fistulas.

  16. Follicular growth, differentiation and atresia

    Institute of Scientific and Technical Information of China (English)

    JIN Xuan; LIU Yixun

    2003-01-01

    Only limited numbers of primordial follicles in mammalian ovary grow and differentiate to reach the stage of dominate follicles and ovulate. 99% of the follicles in the ovary undergo atresia at various stages of development. Regulation of follicular growth, development and atresia is a complex process and involves interactions between endocrine factors and intraovarian regulators. This review summarized:ⅰ) FSH may not be a survival factor in regulating slow-growing preantral follicles. Some locally produced growth factors, activin and orphan receptors might play a more important role at this stage. ⅱ) Estrogen, activin/inhibin and follistatin coordinate with FSH to regulate and control follicle differentiation. ⅲ) There are two types of follicular atresia induced by apoptosis which originates from GC or oocyte, respectively. Early translation of tPA mRNA into tPA protein in oocyte may be associated with oocyte apoptosis.

  17. Fetal lung growth in laryngeal atresia and tracheal agenesis.

    Science.gov (United States)

    Scurry, J P; Adamson, T M; Cussen, L J

    1989-02-01

    Three cases of airway obstruction in fetuses born at 21, 32 and 40 weeks gestation are reported. The first had laryngeal atresia, cystic dysplastic kidneys, oligohydramnios and immense fluid-filled lungs. The second had upper tracheal agenesis, a tracheo-oesophageal fistula, a cystic dysplastic horseshoe kidney, oligohydramnios and normal-sized lungs. The third had a pin-hole mucosal tract through an otherwise atretic larynx, normal kidneys, no oligohydramnios and normal-sized lungs. Lung weight:body weight ratios, radial alveolar or radial canalicular counts and point-counting of sections of lungs in cases 1 and 2 show that laryngeal or tracheal obstruction may prevent or reduce the pulmonary hypoplasia associated with renal dysplasia, and in cases 2 and 3, that grossly enlarged, hyperplastic lungs may not be seen unless obstruction is complete. PMID:2730470

  18. Esophageal atresia associated with anorectal malformation: Is the outcome better after surgery in two stages in a limited resources scenario?

    OpenAIRE

    Sunita Singh; Ashish Wakhlu; Anand Pandey; Anita Singh; Shiv N Kureel; Jiledar Rawat; Payal Mishra Srivastava

    2012-01-01

    Aims: To analyze whether outcome of neonates having esophageal atresia with or without tracheoesophageal fistula (EA±TEF) associated with anorectal malformation (ARM) can be improved by doing surgery in 2 stages. Materials and Methods : A prospective study of neonates having both EA±TEF and ARM from 2004 to 2011. The patients with favorable parameters were operated in a single stage, whereas others underwent first-stage decompression surgery for ARM. Thereafter, once septicemia was under cont...

  19. Congenital nasolacrimal atresia in 4 alpacas

    OpenAIRE

    Sandmeyer, Lynne S.; Bauer, Bianca S.; Breaux, Carrie B.; Grahn, Bruce H.

    2011-01-01

    Four alpacas, 2 wk to 1 y of age, were diagnosed with congenital atresia of the nasal puncta of the nasolacrimal duct. Dacryocystorhinography confirmed and localized the atresia. All animals were treated successfully by surgical creation of nasal puncta and patency was ensured by placement of a surgical stent for several weeks.

  20. Pyloric atresia associated with epidermolysis bullosa

    International Nuclear Information System (INIS)

    Since the first reported case of pyloric atresia and epidermolysis bullosa in 1977 by Korber and Glasson, this association has been firmly established. We present a new case giving particular emphasis to the theory that pyloric atresia is secondary to the primary disease epidermolysis bullosa. (orig.)

  1. Pyloric atresia associated with epidermolysis bullosa

    Energy Technology Data Exchange (ETDEWEB)

    Garcia Hernandez, J.B.; Orense, M.; Celorio, C.; Canga, C.

    1987-07-01

    Since the first reported case of pyloric atresia and epidermolysis bullosa in 1977 by Korber and Glasson, this association has been firmly established. We present a new case giving particular emphasis to the theory that pyloric atresia is secondary to the primary disease epidermolysis bullosa.

  2. Tricuspid atresia. A review of 68 cases.

    Science.gov (United States)

    Shariatzadeh, A N; King, H; Girod, D; Shumacker, H B

    1977-04-01

    Sixty-eight patients with tricuspid atresia were seen at Indiana University during the past 30 years. Long term survivors treated without operation emerged from our review. In these, there was a combination of tricuspid atresia and transposition of the great vessels. PMID:856550

  3. Gallbladder Duplication Associated with Gastro-Intestinal Atresia.

    Science.gov (United States)

    Gupta, Rahul; Gupta, Shilpi; Sharma, Pramila; Bhandari, Anu; Gupta, Arun Kumar; Mathur, Praveen

    2016-01-01

    Gallbladder duplication in association with other GIT anomalies is a rare entity. We report two neonates; one with duodenal atresia and the other newborn with pyloric atresia, ileal atresia and colonic atresia, both were associated with gallbladder duplication which has not been reported earlier. PMID:27123398

  4. Pulmonary arteriovenous fistula

    Science.gov (United States)

    Pulmonary arteriovenous fistula is an abnormal connection between an artery and vein in the lungs. As a result, blood passes ... Pulmonary arteriovenous fistulas are usually the result of abnormal development of the blood vessels of the lung. Most occur in ...

  5. Thoracoscopic repair of congenital tracheo-oesophageal fistula manifesting in an adult

    Directory of Open Access Journals (Sweden)

    Hrishikesh P Salgaonkar

    2014-01-01

    Full Text Available Congenital trcheo-oesophageal fistula (TOF without oesophageal atresia is usually diagnosed and managed in the neonatal period. Its presentation in adulthood is a rarity. Traditional treatment of a TOF in adults involves its repair via a thoracotomy. We report the case of a 23-year-old man diagnosed with an H-type TOF during workup undertaken for his symptoms of gastro-oesophageal reflux. This fistula located at the level of third thoracic vertebra was repaired successfully using a thoracoscopic approach.

  6. Epidemiology of small intestinal atresia in Europe

    DEFF Research Database (Denmark)

    Best, Kate E; Tennant, Peter W G; Addor, Marie-Claude;

    2012-01-01

    The epidemiology of congenital small intestinal atresia (SIA) has not been well studied. This study describes the presence of additional anomalies, pregnancy outcomes, total prevalence and association with maternal age in SIA cases in Europe....

  7. MRI in perianal fistulae

    International Nuclear Information System (INIS)

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

  8. Atresia of the gastrointestinal tract: imaging evaluation

    International Nuclear Information System (INIS)

    A wide spectrum of congenital anomalies may affect the gastrointestinal tract at any level from the esophagus to the anus. Atresia is an important cause of gastrointestinal obstruction with high morbidity rate in neonates. Different pathogenetic mechanisms could cause this malformation and the two classical explanations are: a defect of recanalization of the intestinal tube or an interruption of blood supply during intrauterine life. The authors present a literature review with an iconographic essay of imaging findings in children with gastrointestinal atresia. (author)

  9. Sirenomelia with oesophageal atresia: a rare association.

    Science.gov (United States)

    Sathe, Pragati Aditya; Ghodke, Ratnaprabha Kundlikrao; Kandalkar, Bhuvaneshwari Mahendra

    2014-02-01

    We are reporting a rare case of sirenomelia with oesophageal atresia. Sirenomelia is a lethal sporadic defect of which lower gastrointestinal tract anomalies are characteristic findings. Respiratory and upper gastrointestinal tract malformations like oesophageal atresia occur in about 20-35% of cases. Though its occurrence has been described, it has been reported only rarely. This report aims at describing this uncommon association along with its histological features. PMID:24701519

  10. Sirenomelia with Oesophageal Atresia: A Rare Association

    OpenAIRE

    Sathe, Pragati Aditya; Ghodke, Ratnaprabha Kundlikrao; Kandalkar, Bhuvaneshwari Mahendra

    2014-01-01

    We are reporting a rare case of sirenomelia with oesophageal atresia. Sirenomelia is a lethal sporadic defect of which lower gastrointestinal tract anomalies are characteristic findings. Respiratory and upper gastrointestinal tract malformations like oesophageal atresia occur in about 20-35% of cases. Though its occurrence has been described, it has been reported only rarely. This report aims at describing this uncommon association along with its histological features.

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

    OpenAIRE

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

    2013-01-01

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

  12. Tracheoesophageal fistula in utero: 22 cases

    International Nuclear Information System (INIS)

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

  13. Primary Transanal Management of Rectal Atresia in a Neonate.

    Science.gov (United States)

    M, Braiek; A, Ksia; I, Krichen; S, Belhassen; K, Maazoun; S, Ben Youssef; N, Kechiche; M, Mekki; A, Nouri

    2016-01-01

    Rectal atresia (RA) with a normal anus is a rare anomaly. We describe a case of rectal atresia in a newborn male presenting with an abdominal distension and failure of passing meconium. The rectal atresia was primarily operated by transanal route. PMID:27123404

  14. Wind sock deformity in rectal atresia

    International Nuclear Information System (INIS)

    Rectal atresia is a rare anorectal deformity. It usually presents with neonatal obstruction and it is often a complete membrane or severe stenosis. Windsock deformity has not been reported in rectal atresia especially, having been missed for 2 years. A 2-year-old girl reported only a severe constipation despite having a 1.5-cm anal canal in rectal examination with scanty discharge. She underwent loop colostomy and loopogram, which showed a wind sock deformity of rectum with mega colon. The patient underwent abdominoperineal pull-through with good result and follow-up. This is the first case of the wind sock deformity in rectal atresia being reported after 2 years of age. (author)

  15. Wind sock deformity in rectal atresia

    Directory of Open Access Journals (Sweden)

    Hosseini Seyed

    2009-01-01

    Full Text Available Rectal atresia is a rare anorectal deformity. It usually presents with neonatal obstruction and it is often a complete membrane or severe stenosis. Windsock deformity has not been reported in rectal atresia especially, having been missed for 2 years. A 2-year-old girl reported only a severe constipation despite having a 1.5-cm anal canal in rectal examination with scanty discharge. She underwent loop colostomy and loopogram, which showed a wind sock deformity of rectum with mega colon. The patient underwent abdominoperineal pull-through with good result and follow-up. This is the first case of the wind sock deformity in rectal atresia being reported after 2 years of age.

  16. Comparison between Two Cecostomy Techniques for Treatment of Atresia Coli in Cattle and Buffalo Calves

    Directory of Open Access Journals (Sweden)

    Mohamad Abdelfattah Abdelrhman, Aiman Mahmoud Seddek*1 and Hossam Ahmad Bakr2

    2013-07-01

    Full Text Available The study aimed at determination of the cecostomy technique that will preserve the long-term maximal diameter of the created fistula. The subjects of the study were 79 newly born cattle and buffalo calves suffered from atresia coli, recti and ani. The calves were grouped into four groups for evaluation of incisional and herniation cecostomy techniques either on the right or left flank. With each technique, 4 cm diameter permanent fistula was created and evaluated at the 1stweek, and 1st, 4th and 8th months post-surgery. Both of the short and long-term complications were recorded and managed conservatively. Follow up could be achieved for 45 calves only and all of them showed stunted growth. The results revealed wider stoma in the calves operated by herniation technique, and in those operated on the right flank, moreover the operated cattle calves had wider stoma than buffalo calves. It is concluded that the right flank herniation technique has a beneficial effect on long-term preserving of a wider diameter of the created fistula.

  17. Tricuspid atresia and pulmonary atresia in a child with Rubinstein-Taybi syndrome.

    Science.gov (United States)

    Loomba, Rohit S; Geddes, Gabrielle

    2015-01-01

    Rubinstein-Taybi syndrome is a well-characterized condition causing distinctive physical characteristics, intellectual disability, and multiple congenital malformations. Cardiac abnormalities are found in a third of individuals with this condition and usually consist of isolated septal defects or patent ductus arteriosus, although more complex congenital lesions have been described. We present the first reported case of tricuspid atresia and pulmonary atresia with hypoplasia of the right ventricle in the setting of Rubenstein-Taybi syndrome. PMID:26085772

  18. Tricuspid atresia and pulmonary atresia in a child with Rubinstein-Taybi syndrome

    OpenAIRE

    2015-01-01

    Rubinstein-Taybi syndrome is a well-characterized condition causing distinctive physical characteristics, intellectual disability, and multiple congenital malformations. Cardiac abnormalities are found in a third of individuals with this condition and usually consist of isolated septal defects or patent ductus arteriosus, although more complex congenital lesions have been described. We present the first reported case of tricuspid atresia and pulmonary atresia with hypoplasia of the right vent...

  19. Tricuspid atresia and pulmonary atresia in a child with Rubinstein-Taybi syndrome

    Directory of Open Access Journals (Sweden)

    Rohit S Loomba

    2015-01-01

    Full Text Available Rubinstein-Taybi syndrome is a well-characterized condition causing distinctive physical characteristics, intellectual disability, and multiple congenital malformations. Cardiac abnormalities are found in a third of individuals with this condition and usually consist of isolated septal defects or patent ductus arteriosus, although more complex congenital lesions have been described. We present the first reported case of tricuspid atresia and pulmonary atresia with hypoplasia of the right ventricle in the setting of Rubenstein-Taybi syndrome.

  20. Atresia of the gastrointestinal tract: imaging evaluation; Atresia do trato gastrintestinal: avaliacao por metodos de imagem

    Energy Technology Data Exchange (ETDEWEB)

    Figueiredo, Sizenildo da Silva; Nobrega, Bruno Barcelos da; Ribeiro, Luiza Helena Vilela; Costa, Marlos Augusto Bittencourt; Monteiro, Soraya Silveira; Lederman, Henrique Manoel [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: brunoradiol@hotmail.com; Oliveira, Galba Leite [Irmandade Santa Casa de Misericordia de Sao Paulo, SP (Brazil). Dept. de Diagnostico por Imagem; Esteves, Edward [Goias Univ., Goiania, GO (Brazil). Faculdade de Medicina. Dept. de Cirurgia e Urologia Pediatrica

    2005-04-01

    A wide spectrum of congenital anomalies may affect the gastrointestinal tract at any level from the esophagus to the anus. Atresia is an important cause of gastrointestinal obstruction with high morbidity rate in neonates. Different pathogenetic mechanisms could cause this malformation and the two classical explanations are: a defect of recanalization of the intestinal tube or an interruption of blood supply during intrauterine life. The authors present a literature review with an iconographic essay of imaging findings in children with gastrointestinal atresia. (author)

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

    Science.gov (United States)

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

    2015-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Debangshu Ghosh

    2015-01-01

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

  3. Improving arteriovenous fistula cannulation skills.

    Science.gov (United States)

    Ball, Lynda K

    2005-01-01

    Cannulation of arteriovenous fistulae is technically more challenging than cannulation of arteriovenous grafts. With the advent of the National Vascular Improvement Initiative, Fistula First, the United States has seen an increase in the number of arteriovenous fistulae. The problem we now face is how to refocus and reeducate nurses to the intricacies of arteriovenous fistula cannulation. Through evidenced-based practice and current best-demonstrated practices, this article will provide the tools needed to improve arteriovenous fistulae cannulation skills. PMID:16425809

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

    OpenAIRE

    Debangshu Ghosh; Somnath Saha; Sumit Kumar Basu

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    D. Wong

    2013-01-01

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

  6. The contribution of fetal MR imaging to the assessment of oesophageal atresia

    International Nuclear Information System (INIS)

    Present challenges are to improve the diagnosis rate of oesophageal atresia (OA) and evaluate as completely as possible a fetus affected by OA, specifically the type of OA and the length of the gap. Our aim was to evaluate the accuracy of fetal MR imaging (fMRI) for diagnosis of OA. We reviewed fMRI performed because of sonographic suspicion of an OA. The signs reviewed included stomach size, ''pouch sign'', bowing of the trachea and visualization of the lower oesophageal lumen. The fetuses were assigned by consensus as having or not having EA, as well as having a tracheaoesophageal fistula (TOF). All findings were correlated with postnatal data. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Se, Sp, PPV and NPV of the technique were respectively 91 %, 100 %, 100 % and 88 %. The presence of the pouch sign yielded corresponding values of 82 %, 100 %, 100 % and 78 %. Mid-tracheal bowing was correlated positively with EA. The type of atresia was correctly evaluated in 90 % of patients. fMRI is useful for the diagnosis of EA through the visualization of the oesophageal pouch or through associated signs such as tracheal bowing. Visualization of the lower oesophageal lumen seems to be a good sign of TEF. (orig.)

  7. The contribution of fetal MR imaging to the assessment of oesophageal atresia

    Energy Technology Data Exchange (ETDEWEB)

    Hochart, V.; Verpillat, P.; Bigot, J.; Avni, F.E. [CHRU Lille, Jeanne de Flandre Hospital, Department of Pediatric Radiology, Lille (France); Langlois, C. [EA2694 USDL CHRU Lille, Department of Biostatistics, Lille (France); Garabedian, C.; Debarge, V.H. [CHRU Lille, Jeanne de Flandre Hospital, Department of Obstetrics and Gynecology, Lille (France); Sfeir, R. [CHRU Lille, Jeanne de Flandre Hospital, Department of Pediatric Surgery, Reference Center for Congenital Anomalies of the Esophagus, Lille (France)

    2014-10-11

    Present challenges are to improve the diagnosis rate of oesophageal atresia (OA) and evaluate as completely as possible a fetus affected by OA, specifically the type of OA and the length of the gap. Our aim was to evaluate the accuracy of fetal MR imaging (fMRI) for diagnosis of OA. We reviewed fMRI performed because of sonographic suspicion of an OA. The signs reviewed included stomach size, ''pouch sign'', bowing of the trachea and visualization of the lower oesophageal lumen. The fetuses were assigned by consensus as having or not having EA, as well as having a tracheaoesophageal fistula (TOF). All findings were correlated with postnatal data. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Se, Sp, PPV and NPV of the technique were respectively 91 %, 100 %, 100 % and 88 %. The presence of the pouch sign yielded corresponding values of 82 %, 100 %, 100 % and 78 %. Mid-tracheal bowing was correlated positively with EA. The type of atresia was correctly evaluated in 90 % of patients. fMRI is useful for the diagnosis of EA through the visualization of the oesophageal pouch or through associated signs such as tracheal bowing. Visualization of the lower oesophageal lumen seems to be a good sign of TEF. (orig.)

  8. AB193. Rectourethral fistula

    Science.gov (United States)

    Jiang, Hai

    2016-01-01

    Objective To investigate the treatment of rectourethral fistula. Methods Eleven cases of male patients with rectourethral fistula were treated in our department from 2011 to 2015. Age 16–66 years old. Causes: three cases of patients with congenital closed anus, four cases of traumatic pelvic fracture with urethral distraction and rectum injury, four cases after radical prostatectomy. The size of the fistula was 0.5–1.5 cm. In addition to the leakage of urine in the large fistula, urine mixed with stool samples. Three patients with congenital closed anal postoperative patients with posterior or anterior median sagittal approach for resection of the fistula, hierarchical closed urethral and rectal wall defect, at least three layer (between the urethral and rectal suture layer), indwelling catheter for 3–4 weeks, no cystostomy. Sigmoid colostomy underwent prior to the surgery. Of which six cases were repaired by perineal approach, one case by abdominal perineal approach, one case by abdominal repair. According to size of fistula and the surrounding scar decide whether or not to adopt tissue interposition, this group of five cases with gracilis muscle flap, one case with bulbocavernosus muscle flap interposed between the rectum and urethra; one case repaired by sigmoid colon pull-through procedure. Post-operation indwelling catheterization for 3–4 weeks with cystostomy. Results A total of 10 patients were successful, and no leakage of urine was found after removal of the catheter. One patient improved, occasionally a small amount of drops of urine voiding from anus. Reoperation was successful after 6 months. Recovered enteric continuity 3–6 months post-operation. Conclusions The median sagittal approach provide good exposure for the repair of congenital rectourethral fistula; perineal approach is a good choice for patients caused by trauma or surgery; complete resection of scar around the fistula, tension-free anastomosis, tissue interposition and sigmoid

  9. Management of Enterocutaneous Fistulas

    OpenAIRE

    Kaushal, Manish; Carlson, Gordon L.

    2004-01-01

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

  10. Coronary arterial fistulas

    Directory of Open Access Journals (Sweden)

    Qureshi Shakeel A

    2006-12-01

    Full Text Available Abstract A coronary arterial fistula is a connection between one or more of the coronary arteries and a cardiac chamber or great vessel. This is a rare defect and usually occurs in isolation. Its exact incidence is unknown. The majority of these fistulas are congenital in origin although they may occasionally be detected after cardiac surgery. They do not usually cause symptoms or complications in the first two decades, especially when small. After this age, the frequency of both symptoms and complications increases. Complications include 'steal' from the adjacent myocardium, thrombosis and embolism, cardiac failure, atrial fibrillation, rupture, endocarditis/endarteritis and arrhythmias. Thrombosis within the fistula is rare but may cause acute myocardial infarction, paroxysmal atrial fibrillation and ventricular arrhythmias. Spontaneous rupture of the aneurysmal fistula causing haemopericardium has also been reported. The main differential diagnosis is patent arterial duct, although other congenital arteriovenous shunts need to be excluded. Whilst two-dimensional echocardiography helps to differentiate between the different shunts, coronary angiography is the main diagnostic tool for the delineation of the anatomy. Surgery was the traditional method of treatment but nowadays catheter closure is recommended using a variety of closure devices, such as coils, or other devices. With the catheter technique, the results are excellent with infrequent complications. Disease name and synonyms Coronary arterial fistulas Coronary arterial fistulas or malformations

  11. Fetal MRI of hereditary multiple intestinal atresia with postnatal correlation

    International Nuclear Information System (INIS)

    Hereditary multiple intestinal atresia (HMIA) is an extremely uncommon cause of congenital bowel obstruction. The morbidity and mortality of this disease differ significantly from those of isolated intestinal atresias and non-hereditary forms of multiple intestinal atresia. Most notably, despite successful operative repairs of the atresias found in this disease, HMIA maintains a 100% lethality rate from continued post-operative intestinal failure and an associated severe immunodeficiency. We present a case of HMIA evaluated with fetal MRI and subsequently diagnosed by a combination of corroborative postnatal imaging with surgical exploration and pathological examination. (orig.)

  12. Pyloric atresia-Three cases and review of literature

    Directory of Open Access Journals (Sweden)

    Sandesh V Parelkar

    2014-01-01

    Full Text Available Pyloric atresia (PA is a rare congenital anomaly that constitutes approximately 1% of all intestinal atresias, and its incidence is approximately 1 in 100,000 live births. PA may occur as an isolated condition or associated with other abnormalities, the most common being Junctional epidermolysis bullosa (JEB. Evidence suggests that PA-EB (Pyloric Atresia - Epidermolysis Bullosa Syndrome is a distinct entity. In this report, we present three cases of pyloric atresia, one of which was associated with Junctional epidermolysis bullosa. The literature on the subject is also reviewed.

  13. A Rare Case of Jejunal Atresia Due to Intrauterine Intussusception.

    Science.gov (United States)

    Joshi, Sanjeev B; Kinhal, Vidyadhar; Desai, Mahesh; Tilak; Choudhari, Fazal Ur Rehman

    2015-09-01

    Intestinal atresia is generally caused by intrauterine vascular obstructions involving mesenteric vessels. Intrauterine intussusceptions (IUI) are one of these disruptive events. Intestinal intussusceptions affects children commonly between 3 months and 3 years of age, but it rarely affects in intrauterine life. The relationship between intrauterine intussusception and intestinal atresia has been demonstrated by few cases in literature, suggesting intrauterine intussusception as a rare cause of intestinal atresia. We report a 7-day-old full term neonate presenting with intrauterine intussusceptions (jejuno-jejunal) resulting in jejunal atresia. PMID:26500958

  14. Chronic Pulmonary Aspergillosis Complicating Bronchial Atresia

    Directory of Open Access Journals (Sweden)

    Mazen O. Al-Qadi

    2014-01-01

    Full Text Available Bronchial atresia is a rare pulmonary developmental anomaly characterized by the presence of a focal obliteration of a segmental or lobar bronchial lumen. The lung distal to the atretic bronchus is typically emphysematous along with the presence of mucus filled ectatic bronchi (mucoceles. BA is usually asymptomatic but pulmonary infections can rarely develop in the emphysematous lung distal to the atretic bronchus. We present a unique case of chronic pulmonary aspergillosis (CPA in a patient with BA with no evidence of immune dysfunction. The patient was treated initially with voriconazole and subsequently underwent surgical excision of the involved area. On follow-up, she has done extremely well with no evidence for recurrence. In summary, we describe the first case of chronic pulmonary aspergillosis in an immunocompetent patient with bronchial atresia.

  15. Ultrasonographic findings of type IIIa biliary atresia

    International Nuclear Information System (INIS)

    To describe the ultrasonographic (US) findings of type IIIa biliary atresia. We retrospectively reviewed a medical database of patients pathologically confirmed to have biliary atresia, Kasai type IIIa, between January 2002 and May 2013 (n=18). We evaluated US findings including the visible common bile duct (CBD), triangular cord thickness, gallbladder size and shape, and subcapsular flow on color Doppler US; laboratory data; and pathological hepatic fibrosis grades. We divided them into two groups-those with visible (group A) and invisible (group B) CBD on US-and compared all parameters between the two groups. CBD was visible on US in five cases (27.8%; group A) and invisible in 13 cases (72.2%; group B). US was performed at an earlier age in group A than in group B (median, 27 days vs. 60 days; P=0.027) with the maximal age of 51 days. A comparison of the US findings revealed that the triangular cord thickness was smaller (4.1 mm vs. 4.9 mm; P=0.004) and the gallbladder length was larger (20.0 mm vs. 11.7 mm; P=0.021) in group A. The gallbladder shape did not differ between the two groups, and the subcapsular flow was positive in all cases of both groups. There was no significant difference in the laboratory data between the two groups. Upon pathological analysis, group A showed low-grade and group B showed low- to high-grade hepatic fibrosis. When CBD is visible on US in patients diagnosed with type IIIa biliary atresia, other US features could have a false negative status. A subcapsular flow on the color Doppler US would be noted in the type IIIa biliary atresia patients.

  16. A case of tracheal stenosis following radiation after mastectomy

    Energy Technology Data Exchange (ETDEWEB)

    Ohta, Yuuji; Nakano, Yuusuke; Adachi, Akira; Nagayasu, Takeshi; Morinaga, Masafumi; Shingu, Hiroshi; Tagawa, Tsutomu (Tagawa City Hospital, Fukuoka (Japan))

    1991-06-01

    We experienced a case of a cervical tracheal stenosis caused by irradiation of the neck lymphnodes after mastectomy. We treated a 43-year-old female with right breast cancer (T3N1M0 stage IIIa) who underwent standard radical mastectomy (Br+Ax+Mj+Mn) on May 1984, and had a {sup 60}Co irradiation of 50 Gy to axillar, parasternal and supraclavicular areas, for two months after surgery. She had complained of severe stridor and dyspnea since February 1985, and subsequently suffered from a pneumonia in the left lower lobe. She was admitted to our hospital and undergone steroid inspiration. A silicon T-tube was inserted into the trachea. Her symptoms had improved for two years, but a tracheo-esophageal fistula and pneumonia developed. We performed a resection of a tracheo-esophageal fistula. She died following to suddenly massive hemorrhage from tracheo-bracheochephalic artery fistula on the 7 postoperative day. (author).

  17. Bone conduction hearing in congenital aural atresia.

    Science.gov (United States)

    Zhang, Lichun; Gao, Na; Yin, Yanbo; Yang, Lin; Xie, Youzhou; Chen, Ying; Dai, Peidong; Zhang, Tianyu

    2016-07-01

    Previous researches focusing on BC hearing mechanisms proved that the two routes, (1) EAC sound radiation and (2) inertial of ossicular chain, partially contribute to normal BC hearing. Therefore, the BC hearing for those patients with congenital aural atresia should partially decrease theoretically due to their abnormal anatomy. However, there are not many studies which mention these patients' BC hearing up till now. The objective of this study is to investigate congenital aural atresia patient's BC hearing by analysis of pre-surgical audiogram and to study their potential BC hearing mechanisms using animal modeling and their ABR measurements. The study methoed involves analyzing 75 patients' pre-operative audiogram. Then we produced an animal model by surgery to measure their BC hearing threshold changes. Clinical data showed that those patients had some BC hearing loss; and there were 25 cases (25/75, 33.3 %) which present with typical Carhart's Notch. The animal experiments proved that inertia of ossicular chain contribute to partial BC hearing, which demonstrated that the inertia produced more affects on high frequencies by comparing with low frequencies. The patients with congenital aural atresia present BC hearing loss, which could be mainly ascribed to the absence of inertia of ossicular chain. PMID:26205153

  18. Role of preoperative tracheobronchoscopy in newborns with esophageal atresia:A review

    Institute of Scientific and Technical Information of China (English)

    Filippo; Parolini; Giovanni; Boroni; Stefania; Stefini; Cristina; Agapiti; Tullia; Bazzana; Daniele; Alberti

    2014-01-01

    Preoperative tracheobronchoscopy(TBS) in the diag-nostic assessment of newborns affected by esophageal atresia(EA) was described in 1981. Nevertheless, the value of the procedure is actually much debated; only a few studies have clearly explored the advantages of TBS and this procedure is not yet routinely included inthe diagnostic and therapeutic assessment in many in-ternational pediatric surgery settings. Routine preoper-ative TBS is a safe procedure that enables the accurate examination of the tracheobronchial tree, the visualiza-tion of tracheoesophageal fistula and the diagnosis of tracheomalacia or associated respiratory anomalies. When a distal fistula is found, its occlusion with a Fog-arty balloon catheter improves mechanical ventilation and facilitates surgical repair. This review provides a detailed overview on the use of TBS in newborns with EA, focusing on technical aspects, anesthesiological management, indications and limits. The benefits and risks of the procedure are also compared with alterna-tive diagnostic tools, such as an esophageal contrast study, computed tomography scan and ultrasound.

  19. Congenital parotid fistula

    Directory of Open Access Journals (Sweden)

    Shiggaon Natasha

    2014-01-01

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

  20. Congenital parotid fistula.

    Science.gov (United States)

    Natasha, Shiggaon

    2014-01-01

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

  1. Congenital biliary atresia: liver injury begins at birth

    DEFF Research Database (Denmark)

    Makin, Erica; Quaglia, Alberto; Kvist, Nina;

    2009-01-01

    BACKGROUND: The timing of onset of liver injury in biliary atresia (BA) is not known, although in approximately 10% of cases, biliary pathologic condition associated with the biliary atresia splenic malformation syndrome must begin well before birth. METHODS: The study involved retrospective case...

  2. Cholecystocolic fistula: A diagnostic enigma

    International Nuclear Information System (INIS)

    Cholecystocolic fistula is a rare biliary-enteric fistula with a variable clinical presentation. Despite modern diagnostic tools, a high degree of suspicion is required to diagnose it preoperatively. Biliary-enteric fistulae have been found in 0.9% of patients undergoing biliary tract surgery. The most common site of communication of the fistula is a cholecystoduodenal (70%), followed by cholecystocolic (10-20%), and the least common is the cholecystogastric fistula accounting for the remainder of cases. These fistulae are treated by open as well as laparoscopic surgery, with no difference in intraoperative and postoperative complications. We report here a case of obstructive jaundice, which was investigated with a plain film of the abdomen, abdominal ultrasonography, and endoscopic retrograde cholangiopancreatography, but none of these gave us any clue to the presence of the fistula was discovered incidentally during an open surgery and was appropriately treated. (author)

  3. Atresia revisited: two basic patterns of atresia of bovine antral follicles.

    Science.gov (United States)

    Irving-Rodgers, H F; van Wezel, I L; Mussard, M L; Kinder, J E; Rodgers, R J

    2001-11-01

    Our observations of bovine follicles indicated that the original histological classifications of atresia were inaccurate. A detailed histological, ultrastructural and immunohistochemical study of antral follicles from bovine ovaries collected from an abattoir and from animals whose large follicles had been monitored by ultrasonography was conducted to investigate this further. Nidogen and CD68 were immunolocalized to observe the follicular basal lamina and macrophages, respectively. In randomly collected ovaries, approximately one quarter of all antral follicles were undergoing antral atresia, as designated in this study. Antral atresia was characterized by early destruction of the layers of the membrana granulosa closest to the antrum, whereas the most basal cells remained intact. Numerous pyknotic nuclei were observed in the most antral layers and in the antrum close to the membrana granulosa. This is the classic description of atretic follicles and was observed at all sizes of follicle development and almost universally in large follicles (> 5 mm in diameter), including dominant follicles. Basal atretic follicles, as designated in this study, were almost as prevalent as the antral atretic follicles, and were characterized by initial destruction of the most basal layer of granulosa cells, whereas the cells in the most antral layers remained associated with each other and were predominantly healthy. Pyknotic nuclei and the nuclei of dying basal cells budded into apoptotic bodies were observed rarely. The basal lamina of basal atretic follicles was often breached by macrophages, which were phagocytosing dying basal granulosa cells. The theca was characterized by an increased deposition of collagen, and the cells were orientated randomly, rather than lying parallel to the membrana granulosa as in healthy follicles. Basal atresia occurred in small (basal atretic follicles were originally identified incorrectly in the literature. Thus, on the basis of the results of

  4. Fetal Heterotaxy with Tricuspid Atresia, Pulmonary Atresia, and Isomerism of the Right Atrial Appendages at 22 Weeks

    Directory of Open Access Journals (Sweden)

    Julia E. Solomon

    2013-10-01

    Full Text Available We report the accurate prenatal diagnosis at 22 weeks gestation of right atrial isomerism in association with tricuspid atresia. Several distinctive sonographic features of isomerism of the right atrial appendages were present in this fetus: complex cardiac abnormality, ventriculoarterial discordance, juxtaposition of the aorta and the inferior vena cava to the right side, pulmonary atresia, and anomalous pulmonary venous return to the morphological right atrium. Tricuspid atresia, which is an extremely rare lesion within heterotaxy spectrum disorders, was present. Postnatal investigations confirmed all prenatally diagnosed abnormalities, with additional findings of pulmonary atresia with discontinuous pulmonary arteries and bilateral arterial ducts, asplenia, and bilateral eparterial bronchi. To our knowledge, tricuspid atresia in the setting of isomerism of the right atrial appendages has not previously been diagnosed or reported prenatally. Because of the complexity of cardiac lesions that may be present in cases of atrial isomerism, these disorders should be considered even if sonographic findings are uncommon or atypical.

  5. Videokymographic and acoustic analysis of vibration of silicone lips for use in tracheo-esophageal shunt valves

    Czech Academy of Sciences Publication Activity Database

    Šidlof, Petr; Veselý, Jan; Švec, J. G.; Šram, F.; Horáček, Jaromír

    Groningen: University Medical Center Groningen, 2005. s. 37-37. [International Congress on Surgical and Prosthetic Rehabilitation after Larygectomy /10./. 17.04.2005-20.04.2005, Gröningen] Institutional research plan: CEZ:AV0Z20760514 Keywords : voice prosthese * laryngectomy * phoniatrics Subject RIV: BI - Acoustics

  6. Fistula in ano

    DEFF Research Database (Denmark)

    Madsen, S M; Myschetzky, P S; Heldmann, U; Rasmussen, O O; Thomsen, H S

    1999-01-01

    Patients suspected of having perianal suppurative disease often undergo a combination of several potentially painful, invasive procedures to establish or rule out the diagnosis. To evaluate the accuracy of low-field magnetic resonance imaging (MRI) in distinguishing patients with active anal fist...... fistulae and patients with no active fistulation we performed a retrospective study....

  7. Venous Aneurysm Complicating Dialytic Arteriovenous Fistula

    OpenAIRE

    Arjun K.Nambiar; Anand, K. T.; Jayakrishnan, A. G.

    2012-01-01

    A case of venous aneurysm complicating arteriovenous fistula created for chronic haemodialysis is presented. The patient underwent successful ligation and excision of the fistula and creation of a fistula on the opposite limb.

  8. Percutaneous transvenous balloon occlusion of arteriovenous fistula

    International Nuclear Information System (INIS)

    The closure of arteriovenous fistulas, using a balloon catheter introduced through the vein draining the fistula, is discussed. The application of this method to the closure of an iatrogenic vertebrovertebral fistula is described. (orig.)

  9. Structural changes occurring during atresia in sheep ovarian follicles.

    Science.gov (United States)

    Hay, M R; Cran, D G; Moor, R M

    1976-07-01

    The structural changes that characterize primary, secondary and tertiary atresia in sheep Graafian follicles have been studied by means of histological, histochemical and ultrastructural techniques. In primary atresia vacuoles representing swollen endoplasmic reticulum are prominent along the antral border together with disorganized granulosa cells containing pyknotic nuclei. Phagocytic cells, which increase in number as atresia progresses, were seen within the membrana granulosa and are considered to be transformed granulosa cells. Even in follicles classified as nonatretic, a few antral vacuoles and occasional pyknotic nuclei are present. During secondary atresia there is a large increase in the number of cells with pyknotic nuclei; many of these nuclei had been extruded and had fused to form the characteristic Feulgen-positive atretic bodies found along the edge of the antral cavity. These bodies usually have a diameter of up to 15 mum but occasionally reached as much as 400 mum. A second area of degeneration is frequently present in the membrana granulosa, two or three cell layers from the basal lamina, and it is at this level that exfoliation of granulosa cells occurs in tertiary atresia. In contrast to the membrana granulosa, there are during secondary atresia, only slight indications of degeneration in the cumulus. In tertiary atresia the membrana granulosa is highly disorganized; the atretic bodies are often fewer in number than at earlier stages. The basal lamina remains essentially intact. It is at this stage that the first clear signs of degeneration occur in the theca interna. Despite some disintegration of the cumulus, the integrity of the oocyte is maintained and its nucleus remains vesicular. Changes in the thecal microcirculation may plan a key role in atresia: adjacent to the basal lamina of non-atretic follicles, there is a well-developed capillary network which is significantly reduced as atresia progresses. PMID:991198

  10. Surgical Management of Enterocutaneous Fistula

    International Nuclear Information System (INIS)

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

  11. Atresia biliar: continuamos operando tarde Biliary atresia: we still operate too late

    OpenAIRE

    Carlos O. Kieling; dos Santos, Jorge L.; Sandra M.G. Vieira; Cristina T Ferreira; Ana R. R. Linhares; Andréa L. Lorentz; da Silveira, Themis R.

    2008-01-01

    OBJETIVO: Analisar a idade na cirurgia de crianças com atresia biliar e a sobrevida sem necessidade de transplante de fígado. O estudo foi realizado no Hospital de Clínicas de Porto Alegre. MÉTODOS: Foram revisados os prontuários dos pacientes operados entre 1982 e 2007, residentes no Rio Grande do Sul. RESULTADOS: Dos 112 casos estudados de crianças com atresia biliar, 38 (33,9%) ocorreram de 1982 a 1989, 46 (41,1%) de 1990 a 1999 e 28 (25,0%) a partir de 2000. Em 12 (10,7%) casos, não foi r...

  12. Arteriovenous fistula following lumbar laminectomy

    International Nuclear Information System (INIS)

    A case of iatrogenic aortocaval fistula is presented. The fistula arose from lumbar disc surgery. Its presence was immediately suspected on ultrasound and computed tomogram, and was promptly confirmed by angiography. Ultrasound and computed tomogram also precisely define the anatomy between the aorta or its branches and the IVC or its tributaries. Sudden deterioration of the patient's condition necessitated surgical correction of the fistula before the elected date. The successful corrective operation is described

  13. Tubercular fistula-in-ano

    International Nuclear Information System (INIS)

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

  14. Secondary aortoduodenal fistula

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

  15. Genetics Home Reference: epidermolysis bullosa with pyloric atresia

    Science.gov (United States)

    ... cause epidermolysis bullosa with pyloric atresia. J Invest Dermatol. 2005 Jan;124(1):111-5. Citation on ... on Epidermolysis Bullosa, Santiago, Chile, 2005. Int J Dermatol. 2007 Aug;46(8):781-94. Citation on ...

  16. Urogenital abnormalities and atresia of the gastrointestinal tract

    Directory of Open Access Journals (Sweden)

    Dobanovački Dušanka

    2005-01-01

    Full Text Available Introduction. The goal of the study was to investigate the frequency of urogenital congenital abnormalities among atresias of the digestive system and analyze fetal maldevelopment. The study also deals with gastrointestinal and urogenital embryology. Material and methods. This retrospektive study analyzed the clinical status of 55 new-borns admitted to the Pediatric Surgery Clinic in Novi Sad due to atresia of the gastrointestinal tract during 1995-2003. All atresias were classified at primordial gut levels (foregut, midgut and hindgut. The incidence of associated abnormalities, especially urogenital, was analyzed. Diagnostic procedures included standard methods: clinical investigation, ultrasound, native and contrast medium radiography, etc. Results. Results showed that urogenital anomalies were present in 21 (38.18% newborns with gastrointestinal atresia. Foregut atresia was diagnosed in 14 newborns and it was associated with urogenital congenital anomalies in 9 (64.28% newborns. Midgut atresias were found in 15 patients and in 4 (22.22% they were associated with urogenital anomalies. Hindgut atresias were established in 23 and in 8 (34.78% cases they were associated with urogenital anomalies. Discussion and conclusions. It was confirmed that foregut atresias are commonly accompanied by associated abnormalities. That is why the fourth gestational week is important when both gastroinestinal and urogenital systems are developed. When midgut differentiates into its own derivates, the frequency of congenital anomalies decreases for a short period, and then increases again during foregut development (seventh and eighth gestational weeks. There were no information on environmental teratogenic factors in maternal history. These abnormalities may be explained by complex urorectal development and separation of two systems. .

  17. SMALL BOWEL DIVERTICULOSIS WITH JEJUNAL ATRESIA

    Directory of Open Access Journals (Sweden)

    Srinivas

    2015-07-01

    Full Text Available A 24 year s old primigravida had presented to us in third trimester with an antenatal ultrasound diagnosis of intestinal obstruction in the fetus and polyhydramnios. The parents were counseled and the obstetrician was advised to conduct the delivery as per obstetric indication, the patient delivered at 36 wks by an emergency LSCS. The baby was 1.8Kgs in weight and had an APGAR score of 9 and 10 at 1 and 5 minutes of life. Baby had significant bilious aspirate and did not pass meconium, it did not have dysmorphic featu res or any other associated anomalies, abdomen was soft and no masses were palpable. X ray abdomen revealed three gas bubbles with distal paucity of gas (Triple bubble sign. With the above findings a diagnosis of jejunal atresia was made and a laparotomy was planned on day 2 of life.

  18. Modern management of anal fistula.

    Science.gov (United States)

    Limura, Elsa; Giordano, Pasquale

    2015-01-01

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

  19. 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...

  20. Congenital bronchoesophageal fistula in adults

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  1. Urethrorectal fistula in a horse.

    OpenAIRE

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

    1999-01-01

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

  2. Fistula gastrocólica Gastrocolic fistula

    Directory of Open Access Journals (Sweden)

    Alexandre Cruz Henriques

    1999-08-01

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

  3. Experimental model of arteriovenous fistula in pigs

    International Nuclear Information System (INIS)

    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

  4. Hereditary Multiple Gastrointestinal Atresia associated with Choledochal Cyst: A Rare Entity with Management Dilemma

    Directory of Open Access Journals (Sweden)

    P Raj

    2014-07-01

    Full Text Available Multiple intestinal atresias are rare and its treatment is challenging. Here, we present a case of multiple gastrointestinal atresia associated with choledochal cyst posing us a surgical challenge.

  5. Atresia Folicular en Ovarios de Prochilodus lineatus Follicular Atresia in Ovaries of Prochilodus lineatus

    OpenAIRE

    C Flores Quintana; T Blanco Cohene; R Arbués; H Domitrovic; González, J.

    2012-01-01

    Durante el período reproductivo, en el ovario de los teleósteos se forman cíclicamente folículos primarios, los que maduran y son liberados en el momento de la ovulación. Sin embargo, algunos de ellos desarrollan un proceso de atresia con degeneración y reabsorción, el que para ser considerado un evento fisiológico debería predominar al final del ciclo reproductivo. Las características morfológicas de ovarios de Prochilodus lineatus fueron analizadas para identificar la presencia de folículos...

  6. Multidetector CT and MRI of ostial atresia of the coronary sinus, associated collateral venous pathways and cardiac anomalies

    International Nuclear Information System (INIS)

    Aim: To analyse the multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) findings in patients with atresia of the coronary sinus orifice (CSA). Materials and methods: MDCT findings of 15 consecutive adult patients with CSAs were retrospectively analysed. The patients underwent contrast-enhanced electrocardiography-gated MDCT (n = 13) or both CT and MRI (n = 2). Results: The mean size of the coronary sinus (CS) was 14.2 mm (range 5.5–24 mm) and 11 patients (73.3%) showed CS dilatation (diameter ≥12 mm). The mean length of the atretic CS segment was 2.9 mm (range 0–8 mm). Different forms of venous collateral pathways were observed in the CSA patients. Nine (60%) of the 15 CSA patients had communication between the right atrium (RA; n = 6) or LA (n = 5) and CS via intraseptal veins; six patients (40%) had persistent left superior caval veins; communications were also observed between the CS and RA (n = 4) or LA (n = 4); two patients had collateral venous pathways between dilated cardiac veins with RA; two patients had unroofing of the CS as outlet channels. Nine patients (60%) had cardiac anomalies: coronary artery fistula to the pulmonary artery (n = 6) or left ventricular base and CS (n = 1), atrial septal defects (n = 2), and a ventricular septal defect (n = 1). Conclusion: CSA patients have venous collateral pathways and a high incidence of associated cardiovascular anomalies such as coronary artery fistulae and atrial septal defects.

  7. Case report: Upper neck pouch sign in the antenatal diagnosis of esophageal atresia

    OpenAIRE

    Garg, Mukesh Kumar

    2009-01-01

    Prenatal diagnosis of esophageal atresia remains a challenge for the imaging consultant. On antenatal USG, the finding of an absent or small stomach in the setting of polyhydramnios used to be considered suspicious of esophageal atresia. However, these findings have a low positive predictive value. The upper neck pouch sign is another sign that helps in the antenatal diagnosis of esophageal atresia. In this paper, I report a case of esophageal atresia that was diagnosed on USG at 27 weeks of ...

  8. Spinal dural arteriovenous fistulas

    International Nuclear Information System (INIS)

    The spinal dural arteriovenous fistula (SDAVF) is an important cause of a slowly progressive sensorimotor transverse lesion in mostly elderly patients. The disease affects men in 80% of the cases. Per year and per 1 Million inhabitants only 5-10 new cases of the disease have to be expected. Although rare, the serious disease should not be missed. Diagnosis can be made by MRI and spinal angiography. The result of treatment depends on early diagnosis. The arteriovenous shunt is located within the dural layer of the spinal canal. It connects branches of a radiculomeningeal artery with the veins of the spinal cord. Spinal cord supplying vessels are not primarily involved. Arterialisation of the venous part of the spinal cord circulation results in a chronic congestive myelopathy, which can well be demonstrated by MR imaging. The role of selective spinal angiography is to detect and exactly localize the site of the avshunt, which is rather difficult in some cases. Therapeutic alternatives are effective embolization of the fistula with liquid agents or surgical dysconnection. (orig.)

  9. Traumatic subarachnoid-pleural fistula

    International Nuclear Information System (INIS)

    Traumatic subarachnoid-pleural fistulas are rare. The authors found nine cases reported since 1959. Seven have been secondary to trauma and two following thoracotomy. One patient's death is thought to be directly related to the fistula. The diagnosis should be suspected in patients with a pleural effusion and associated vertebral trauma. The diagnosis can usually be confirmed with contrast or radioisotopic myelography. Successful closure of the fistula will usually occur spontaneously with closed tube drainage and antibiotics; occasionally, thoracotomy is necessary to close the rent in the dura

  10. Atresia biliar: continuamos operando tarde Biliary atresia: we still operate too late

    Directory of Open Access Journals (Sweden)

    Carlos O. Kieling

    2008-10-01

    Full Text Available OBJETIVO: Analisar a idade na cirurgia de crianças com atresia biliar e a sobrevida sem necessidade de transplante de fígado. O estudo foi realizado no Hospital de Clínicas de Porto Alegre. MÉTODOS: Foram revisados os prontuários dos pacientes operados entre 1982 e 2007, residentes no Rio Grande do Sul. RESULTADOS: Dos 112 casos estudados de crianças com atresia biliar, 38 (33,9% ocorreram de 1982 a 1989, 46 (41,1% de 1990 a 1999 e 28 (25,0% a partir de 2000. Em 12 (10,7% casos, não foi realizada a portoenterostomia. A idade na cirurgia variou de 25 a 297 dias (mediana: 80,5; IIQ25-75: 61,3-109,0 dias; em 20,5% dos casos, a idade das crianças foi menor do que 60 dias. Não houve diferença na idade, no momento do diagnóstico, entre as 3 décadas. Os pacientes do interior do estado (mediana: 87,0; IIQ25-75: 69,0-115,0 dias foram encaminhados significativamente (p = 0,007 mais tarde do que os da região metropolitana de Porto Alegre (RS (mediana: 68,0; IIQ25-75: 55,5-98,0 dias. A proporção de pacientes com menos de 60 dias foi significativamente menor (p = 0,013 nos oriundos do interior. A sobrevida com fígado nativo do total dos pacientes foi de 46,2% em 2 anos, diminuindo progressivamente até 15,3% em 20 anos. Os pacientes operados com menos de 60 dias tiveram maior sobrevida com fígado nativo (log rank OBJECTIVE: To analyze the age at surgery for children with biliary atresia and their survival periods without need for liver transplantation. The study was performed at Hospital de Clínicas de Porto Alegre, in Porto Alegre, state of Rio Grande do Sul, Brazil. METHODS: The medical records of patients operated between 1982 and 2007 who were residents of the state of Rio Grande do Sul were reviewed. RESULTS: Of the 112 cases of children with biliary atresia studied, 38 (33.9% occurred between 1982 and 1989, 46 (41.1% between 1990 and 1999 and 28 (25.0% after 2000. Portoenterostomy was not performed for 12 cases (10.7%. Age at surgery

  11. Sonographic Diagnosis of Arterioportal Fistula

    Directory of Open Access Journals (Sweden)

    Canan Alkim

    2010-01-01

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

  12. Operative considerations for rectovaginal fistulas

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  13. Imaging findings of bronchial atresia in fetuses, neonates and infants

    Energy Technology Data Exchange (ETDEWEB)

    Alamo, Leonor; Meuli, Reto [University Hospital of Lausanne (CHUV) and University of Lausanne (UNIL), Department of Diagnostic and Interventional Radiology, Lausanne (Switzerland); Vial, Yvan [University Hospital of Lausanne (CHUV) and University of Lausanne (UNIL), Department of Obstetrics and Gynecology, Lausanne (Switzerland); Gengler, Carole [University Hospital of Lausanne (CHUV) and University of Lausanne (UNIL), Department of Pathology, Lausanne (Switzerland)

    2016-03-15

    Congenital lung malformations are increasingly detected before birth. However, bronchial atresia is rarely identified in utero and not always recognized in neonates. There are two types of atresia: (1) proximal, located at the level of the mainstem or the proximal lobar bronchi, which is extremely rare and usually lethal during pregnancy, causing a tremendous volume increase of the distal involved lung with secondary hypoplasia of the normal lung, and (2) peripheral, located at the segmental/subsegmental bronchial level, which may present as an isolated lesion or as part of a complex congenital malformation. Prenatal findings are mostly nonspecific. Postnatal exams show overinflated lung areas and focal bronchial dilations. The typical fluid-filled bronchoceles are not always observed in neonates but develop progressively in the first months of life. This pictorial essay describes the spectrum of imaging findings of bronchial atresia in fetuses, neonates and infants. (orig.)

  14. Imaging findings of bronchial atresia in fetuses, neonates and infants

    International Nuclear Information System (INIS)

    Congenital lung malformations are increasingly detected before birth. However, bronchial atresia is rarely identified in utero and not always recognized in neonates. There are two types of atresia: (1) proximal, located at the level of the mainstem or the proximal lobar bronchi, which is extremely rare and usually lethal during pregnancy, causing a tremendous volume increase of the distal involved lung with secondary hypoplasia of the normal lung, and (2) peripheral, located at the segmental/subsegmental bronchial level, which may present as an isolated lesion or as part of a complex congenital malformation. Prenatal findings are mostly nonspecific. Postnatal exams show overinflated lung areas and focal bronchial dilations. The typical fluid-filled bronchoceles are not always observed in neonates but develop progressively in the first months of life. This pictorial essay describes the spectrum of imaging findings of bronchial atresia in fetuses, neonates and infants. (orig.)

  15. Retrospective Study of a Series of Choanal Atresia Patients

    Science.gov (United States)

    Manica, Denise; Schweiger, Cláudia; Netto, Cátia C Saleh; Kuhl, Gabriel

    2013-01-01

    Introduction Although it has been more than 250 years since the first description of choanal atresia (CA), there are still doubts about this abnormality. The differences between unilateral and bilateral forms are seldom discussed. Objectives Aggregate data from patients diagnosed with CA, grouping patients with unilateral and bilateral forms. Methods Retrospective study. Results Eighteen patients were included: 12 (66.6%) presented bilateral atresia, of which 77.8% were mixed bony-membranous type and 22.2% were pure bony type. From the 12 patients with bilateral atresia, 10 presented related malformations, 3 of whom had CHARGE syndrome (coloboma, heart defects, choanal atresia, retardation of growth and development, genitourinary problems, ear abnormalities). From the remaining 6 patients with unilateral atresia, only 2 showed malformations, 1 renal and 1 cardiac. All patients with unilateral atresia needed only 1 surgical procedure, and patients with the bilateral form needed a median of 2.85 interventions (p = 0.003). The median age of surgical procedure in the unilateral group was 6 years, ranging from 6 months to 18 years, and in the bilateral group was 25 days, ranging from 6 days to 6 years (p = 0.003). The median interval between diagnosis and surgery was 9 months in the unilateral group, ranging from 1 month to 18 years, and in the bilateral group was 1 day, ranging from 1 day to 2 months (p = 0.001). Discussion and Conclusions Success rates with the endoscopic approach vary from 62 to 100%. Nonetheless, most of these reports present results without considering the number of compromised sides. In our opinion, unilateral and bilateral cases involve distinct patients (taking into account the related malformations), have diverging clinical presentations, and show discrepant restenosis rates and therefore could be considered in different groups of analysis. PMID:25992054

  16. MISSED CONGENITAL PYLORIC ATRESIA WITH GASTRIC PERFORATION IN A NEONATE

    Directory of Open Access Journals (Sweden)

    Yousuf Aziz Khan

    2012-04-01

    Full Text Available Congenital pyloric atresia is a rare anomaly accounting for less than 1% of upper GI atresias. It may occur in isolation or in association with other congenital anomalies, epidermolysis bullosa being the most frequent. It presents with upper abdominal distension, non-bilious vomiting or rarely with complications as aspiration pneumonia, electrolyte imbalance or gastric perforation. Though iatrogenic gastric perforations secondary to aggressive resuscitation with bag-mask ventilation and nasogastric intubation are the most frequent in newborns, neonatal gastric perforation due to congenital outlet obstruction have rarely been reported.

  17. Jejunoileal atresia and cystic fibrosis: don’t miss it

    OpenAIRE

    Siersma Carolien L; Rottier Bart L; Hulscher Jan BF; Bouman Katelijne; van Stuijvenberg Margriet

    2012-01-01

    Abstract Background While an increased prevalence of cystic fibrosis (CF) in patients with jejunal atresia and ileal atresia (JIA) has been described previously, it still may not be a practice routine to indicate a sweat test or DNA test for CFTR mutations in newborns presenting with JIA. Leading textbooks do not mention JIA as a possible presenting clinical feature of CF. We describe two cases of JIA with a delayed diagnosis of CF (4 months [post mortem] and 19 months). This led to a retrosp...

  18. Atresia ani in the dog: a retrospective study.

    Science.gov (United States)

    Vianna, Maria L; Tobias, Karen M

    2005-01-01

    Congenital anomalies of the rectum and anus are rare in dogs. The most frequently reported anomaly is atresia ani. Four types of atresia ani have been reported, including congenital anal stenosis (Type I); imperforate anus alone (Type II) or combined with more cranial termination of the rectum as a blind pouch (Type III); and discontinuity of the proximal rectum with normal anal and terminal rectal development (Type IV). An increased incidence was found in females and in several breeds, including miniature or toy poodles and Boston terriers. Surgical repair is the treatment of choice, but postoperative complications can occur, including fecal incontinence and colonic atony secondary to prolonged preoperative distension. PMID:16141183

  19. Pyloric atresia: A report of ten patients

    Directory of Open Access Journals (Sweden)

    Amine Ksia

    2013-01-01

    Full Text Available Pyloric atresia (PA is uncommon. It occurs in 1:100000 live births. Neonates usually present soon after birth with copious non-bilious vomiting. The treatment is surgical and its prognosis is poor, especially, when it is associated with epidermolysis bullosa (EB. The aim of this study was to evaluate the clinical presentation, diagnosis, operative management, post-operative courses, and outcome in infant with PA, based in our cases and literature review. Charts of 10 patients who underwent surgery for PA in the department of paediatric surgery in a Teaching Hospital in Tunisia (Monastir between 1990 and 2012 were reviewed. Data were analysed for demographic, clinical, therapeutic, and prognostic characteristics. The average of age at presentation was 2 days and there were six males and four females. The main presenting symptoms were non-bilious vomiting in 90% of cases. Abdominal X-ray showed gastric dilatation with an absence of gas in the rest of the intestinal tract in 90%, and a pneumoperitoneum in one. The surgical approach was laparotomy in all cases. Gastric perforation was observed in one patient and was completely repaired. The distribution of the anatomic variations was type A in nine cases and type B in one. Five patients underwent excision of the diaphragm and Heineke-Mikulicz pyloroplasty and gastroduodenostomy in the other five cases. Identified associated anomalies were Down′s syndrome in one and EB in 2 (20%, one family has three affected sibling. Post-operative mortality rate was 70%. No standard surgical approach can be adopted a better management of PA or the associated anomalies depends on an early diagnosis and the availability of neonatal intensive care unit.

  20. Video Assisted Anal Fistula Treatment in a Child with Perianal Fistula

    Science.gov (United States)

    Iqbal, Asif; Dar, Sajid Hameed; Liaqat, Faheem

    2016-01-01

    Perianal fistula formation is a rare complication in children after rectal biopsy. Perianal fistula may become difficult to treat; therefore a lot of surgical options are present. One of these options is video assisted anal fistula treatment (VAAFT). We present a 6-year-old female who developed perianal fistula following rectal biopsy for which VAAFT was done successfully. PMID:26816676

  1. Computerised biofeedback achieving continence in high anal atresia.

    OpenAIRE

    Owen-Smith, V H; Chesterfield, B W

    1986-01-01

    Computerised biofeedback has been used to attempt to improve continence in three boys with high anal atresia. The results obtained so far have been extremely encouraging. Over a period of six months progressive improvement has taken place and been maintained in each child.

  2. Theca interna: the other side of bovine follicular atresia.

    Science.gov (United States)

    Clark, Leigh J; Irving-Rodgers, Helen F; Dharmarajan, Arun M; Rodgers, Raymond J

    2004-10-01

    Currently, histological classifications of ovarian follicular atresia are almost exclusively based on the morphology of the membrana granulosa without reference to the theca interna. Atresia in the bovine small antral ovarian follicle has been redefined into antral or basal atresia where cell death commences initially within antral or basal regions of the membrana granulosa, respectively. To examine cell death in the theca interna in the two types of atretic follicles, bovine ovaries were collected and processed for immunohistochemistry and light microscopy. Follicles were classified as healthy, antral atretic, or basal atretic. Follicle diameter was recorded and sections stained with lectin from Bandeiraea simplicifolia to identify endothelial cells or with an antibody to cytochrome P450 cholesterol side-chain cleavage to identify steroidogenic cells and combined with TUNEL labeling to identify dead cells. The numerical density of steroidogenic cells within the theca interna was significantly reduced (P basal atretic follicles in comparison with other follicles. Cell death was greater in both endothelial cells (P basal atretic follicles compared with healthy and antral atretic follicles. Thus, we conclude that the theca interna is susceptible to cell death early in atresia, particularly in basal atretic follicles. PMID:15175236

  3. Optimizing management of pancreaticopleural fistulas

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  4. 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.

  5. Endovascular management of acute bleeding arterioenteric fistulas

    DEFF Research Database (Denmark)

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

    2008-01-01

    The objective of this study was to review the outcome of endovascular transcatheter repair of emergent arterioenteric fistulas. Cases of abdominal arterioenteric fistulas (defined as a fistula between a major artery and the small intestine or colon, thus not the esophagus or stomach), diagnosed...

  6. Management of dural arteriovenous fistula

    International Nuclear Information System (INIS)

    Objective: To evaluate the treatment of dural arteriovenous fistula with various methods especially attention for the efficacy. Methods: 32 DAVF patients were treated with transarterial NBCA, GDC, free fibril coils and PVA embolization; also with transvenous coil embolization at the venous tip of the fistula orifice or endovascular stenting, fistula clipping in craniectomy. Results: Five of the 8 cases with DAVF in anterior cranial fossa were cured and 3 improved clinically. Eleven of the 14 patients with DAVF in cavernous region were cured and 3 improved clinically. Among five cases with DAVF in transverse sinus, 2 were cured by transvenous intrasinus embolization and one by sinus isolation; 2 showed improvement after transarterial embolization. Four patients with multiple fistulas of DVAF involving superior sagittal sinus were improved by combined treatment. One patient with DAVF in jugular venous region was treated with multiple sessions of combined methods. Conclusions: Direct clipping is effective in treatment of DAVF in anterior cranial fossa. Transvenous approach is favourable for managing DAVF in transverse sinus and cavernous sinus. Combined endovascular and surgical treatment should be considered for complicated DAVF, focusing on embolization of venous part of the fistulae. (authors)

  7. Esophageal atresia associated with anorectal malformation: Is the outcome better after surgery in two stages in a limited resources scenario?

    Directory of Open Access Journals (Sweden)

    Sunita Singh

    2012-01-01

    Full Text Available Aims: To analyze whether outcome of neonates having esophageal atresia with or without tracheoesophageal fistula (EA±TEF associated with anorectal malformation (ARM can be improved by doing surgery in 2 stages. Materials and Methods : A prospective study of neonates having both EA±TEF and ARM from 2004 to 2011. The patients with favorable parameters were operated in a single stage, whereas others underwent first-stage decompression surgery for ARM. Thereafter, once septicemia was under control and ventilator care available, second-stage surgery for EA±TEF was performed. Results: Total 70 neonates (single stage = 20, 2 stages = 30, expired after colostomy = 9, only EA±TEF repair needed = 11 were enrolled. The admission rate for this association was 1 per 290. Forty-one percent (24/70 neonates had VACTERL association and 8.6% (6/70 neonates had multiple gastrointestinal atresias. Sepsis screen was positive in 71.4% (50/70. The survival was 45% (9/20 in neonates operated in a single stage and 53.3% (16/30 when operated in 2 stages (P = 0.04. Data analysis of 50 patients revealed that the survived neonates had significantly better birth weight, better gestational age, negative sepsis screen, no cardiac diseases, no pneumonia, and 2-stage surgery (P value 0.002, 0.003, 0.02, 0.02, 0.04, and 0.04, respectively. The day of presentation and abdominal distension had no significant effect (P value 0.06 and 0.06, respectively. This was further supported by stepwise logistic regression analysis. Conclusions: In a limited resources scenario, the survival rate of babies with this association can be improved by treating ARM first and then for EA±TEF in second stage, once mechanical ventilator care became available and sepsis was under control.

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

    International Nuclear Information System (INIS)

    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.)

  9. 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.)

  10. Unilateral pulmonary veins atresia: evaluation by computed tomography; Atresia unilateral das veias pulmonares: avaliacao por tomografia computadorizada

    Energy Technology Data Exchange (ETDEWEB)

    Eifer, Diego Andre; Arsego, Felipe Veras, E-mail: felipesoarestorres@gmail.com [Hospital de Clinicas de Porto Alegre (HCPA), RS (Brazil). Serv. de Radiologia; Torres, Felipe Soares [Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS (Brazil). Escola de Medicina

    2013-11-15

    Unilateral pulmonary vein atresia is a rare congenital condition. In addition to cardiac malformations or pulmonary hypertension, patients may present with recurrent pulmonary infections or hemoptysis in childhood or adolescence. The authors report a case where the typical findings of such condition were observed at computed tomography in an adult patient. (author)

  11. Atresia folicular en peces teleósteos: una revisión Follicular atresia in teleost fish: a review

    Directory of Open Access Journals (Sweden)

    I Valdebenito

    2011-01-01

    Full Text Available Muchas especies de peces de importancia económica han sido intensamente explotadas, provocando el colapso de sus pesquerías. Por este motivo, en algunas de estas especies se han hecho intentos por lograr cultivar individuos con fines comerciales, obteniendo relativo éxito. Se ha observado que cuando algunas especies son mantenidas en cautiverio o bajo intensa presión de explotación en su medio natural presentan disfunciones reproductivas que conducen a la aparición de atresia folicular. Este es un proceso poco estudiado en peces y la caracterización realizada por varios autores, arroja diferencias de criterios y nomenclatura que dificultan aún más su comprensión. El objetivo de la presente investigación es realizar una revisión bibliográfica de la atresia folicular en peces y contribuir a su comprensión y estudio. La atresia folicular es un proceso degenerativo observado en algunos oocitos en cualquier momento de su desarrollo. La aparición de atresia folicular se ha relacionado con condiciones degenerativas normales debido a cambios estacionales en la actividad gonadal, afecciones sanitarias, o bien, a condiciones de manejo inadecuadas en peces mantenidos en cultivo. Este proceso se ha postulado como un mecanismo que permite reciclar componentes y energía. Sin embargo, en especies como el puye (Galaxias maculatus, la trucha garganta cortada (Salmo clarki, entre otras, se ha observado la presencia de una atresia folicular con características patológicas, en la cual la reabsorción del vitelo no ocurre, causando el endurecimiento de los folículos más desarrollados, lo que puede conducir finalmente a la muerte de la hembra.Many fish species with economic importance have been heavily exploited, causing the collapse of their fisheries. For this reason, there have been attempts to cultivate fish species for commercial purposes, resulting in varying success. It has been observed that when some species are kept in captivity or under

  12. Diagnosis and Surgical Management of Uroenteric Fistula.

    Science.gov (United States)

    Gill, Harcharan S

    2016-06-01

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

  13. Anal atresia and the Klein-Waardenburg syndrome.

    OpenAIRE

    Nutman, J; Nissenkorn, I; Varsano, I; Mimouni, M.; Goodman, R M

    1981-01-01

    A 3-month-old male infant with type I Klein-Waardenburg syndrome with an imperforated anus and a perineal fistula is reported. The possible association of this gastrointestinal malformation with the KW syndrome is discussed.

  14. 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.)

  15. TUBERCULOUS SIALO-CUTANEOUS FISTULA

    OpenAIRE

    Bapi Lal; Shyamashis; Dilip Chandra; Smarajit; Tapan Das

    2013-01-01

    ABSTRACT: Tuberculosis of the parotid gland is a rare clinica l entity. We present a case of parotid gland tuberculosis that presented with a sial o-cutaneous fistula. This case was successfully treated with antituberculous drugs onl y without any surgical excision.

  16. TUBERCULOUS SIALO-CUTANEOUS FISTULA

    Directory of Open Access Journals (Sweden)

    Bapi Lal

    2013-04-01

    Full Text Available ABSTRACT: Tuberculosis of the parotid gland is a rare clinica l entity. We present a case of parotid gland tuberculosis that presented with a sial o-cutaneous fistula. This case was successfully treated with antituberculous drugs onl y without any surgical excision.

  17. Vesicouterine fistula and blind vagina

    International Nuclear Information System (INIS)

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

  18. Congenital pyloric atresia (CPA): report of two cases, with review of literature

    International Nuclear Information System (INIS)

    We are reporting two neonates with isolated pyloric atresia, with an objective to emphasize the importance of considering this rare condition in the differential diagnosis of upper intestinal atresias. Both had no-bilious vomiting and epigastric fullness. X-ray showed a dilated gastric shadow with no evidence of gas in the rest of the abdomen. On exploration they had pyloric atresia which was corrected with gastroduodenostromy. Congenital pyloric atresia is a rare condition, which presents with features of gastric outlet obstruction. It can be diagnosed antenatally but the picture can mimic other conditions. Epidermolysis bullosa has a strong association with it and require skin biopsy for diagnosis. (author)

  19. BIRTH INJURY RELATED UNILATERAL ANTERIOR NARES PARTIAL FIBROUS ATRESIA: A RARE CASE REPORT

    Directory of Open Access Journals (Sweden)

    Jayagar

    2016-02-01

    Full Text Available Congenital atresia of anterior nares has been rarely reported and it may co-exist along with posterior choanal atresia. (1,2 In our case, birth injury caused by forceps delivery has caused unilateral anterior nares partial atresia. Twenty eight years old male patient came with the complaints of left nostril blocked sensation since birth, aggravated with attacks of upper respiratory tract infections. On examination he had left anterior nares partial atresia caused by fibrous bands as a result of birth injury due to instrumental delivery. Rhinoplasty performed to open-up left nostril and patient relieved of his symptoms and also on cosmetic appearance

  20. A newborn with duodenal atresia and a gastric perforation

    Directory of Open Access Journals (Sweden)

    Akcora Bulent

    2010-01-01

    Full Text Available Congenital duodenal atresia complicated by gastric perforation (GP is a very rare and a very mortal condition. Only three newborns could be cured in the reported 13 cases. We report a successfully treated newborn with this complicated disease. A 2-day-old male was hospitalized with prediagnosis of duodenal obstruction. Twelve hours later, significant abdominal distention occurred promptly. At laparotomy, GP and preampullary duodenal atresia were detected. Gastrorrhaphy and duodenoduodenostomy were performed in the same operation. The patient was discharged on the 15th postoperative day. This complicated disease can be treated by early diagnosis and surgical intervention. We choose one-stage operation because of the clean peritoneal cavity. However, generalized peritonitis may require two-stage operation in delayed cases.

  1. [Esophageal atresia: oral behavior in the neonatal period].

    Science.gov (United States)

    Lecoufle, A

    2012-09-01

    The term "abnormal oral behavior" is now frequently used for very different entities. In esophageal atresia, oral behavior can be altered by esophageal dysfunction, but many other mechanisms can be involved. In this respect, the main goal is to prevent these abnormal oral behaviors: how can the early consequences of treatment of esophageal atresia on oral behavior be minimized? How can hospital care be improved? Our goal is to restore to the mouth its fundamental role of giving pleasure despite intrusive treatments, to set up early multidisciplinary preventive actions around orality, and to organize a longitudinal follow-up of speech therapy for these children, in order to be able to help them in the different oral and feeding stages. PMID:22885002

  2. UNILATERAL MEMBRANOUS ATRESIA WITH OSSICULAR MALROTATION AND CONGENITAL CHOLESTEATOMA

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    Sibhithran

    2016-03-01

    Full Text Available INTRODUCTION Congenital cholesteatoma is a rare entity, arising from aberrant epithelial remnants left at the time of closure of the neural groove between the third and fifth week of fetal life with incidence ranging from 4 to 24%. Congenital membranous atresia is more common on right side and unilateral presentation is a rarity in females which is seen in our case. Here we report a rare case of 44 year old female with bilateral hard of hearing which is more on right side with ear discharge and was diagnosed by CT scan to have congenital unilateral membranous atresia with rare finding of ossicular malrotation associated with congenital cholesteatoma which are extremely rare combination of findings in a single patient. Knowing such rarity may help in appropriate surgical approach when confronted with such cases in clinical practice.

  3. Management of Postpneumonectomy Bronchopleural Fistulae

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    Kemal Karapinar

    2016-04-01

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

  4. Prenatal diagnosis of junctional epidermolysis bullosa associated with pyloric atresia.

    OpenAIRE

    Nazzaro, V; Nicolini, U; Luca, L. (Luigi) de; Berti, E.; Caputo, R.

    1990-01-01

    Prenatal diagnosis of junctional epidermolysis bullosa associated with pyloric atresia was carried out in a couple at risk. Their two previous children had died during the first months of life of the same disorder despite surgery for the pyloric abnormality. Ultrastructural study of fetal skin biopsies obtained at 18 weeks' gestation showed dermal-epidermal separation at the lamina lucida level, while ultrasound showed marked stomach dilatation. Light microscopy of pyloric tissue obtained aft...

  5. The Modified Kimura's Technique for the Treatment of Duodenal Atresia

    OpenAIRE

    Biagio Zuccarello; Antonella Spada; Antonio Centorrino; Nunzio Turiaco; Maria Rosaria Chirico; Saveria Parisi

    2009-01-01

    Background/Purpose. Kimura's diamond-shaped-duodenoduodenostomy (DSD) is a known technique for the correction of congenital intrinsic duodenal obstruction. We present a modification of the technique and review the advantages of this new technique. Methods. From 1992 to 2006, 14 newborns were treated for duodenal atresia. We inverted the direction of the duodenal incisions: a longitudinal incision was made in the proximal duodenum while the distal was opened by transverse incision. Results...

  6. MRI in children following surgery for anal and rectal atresia

    International Nuclear Information System (INIS)

    MRI of the pelvis was performed in 17 children following surgical correction of anal and rectal atresias and in five children without ano-rectal malformations. A muscle score was used to characterize the muscles of the pelvic floor and their relationship to the rectum. There was close agreement between the MRI muscle score and clinical continence. MRI provided additional information that should improve continence following conservative and surgical treatment. (orig.)

  7. Neonatal Bartter syndrome associated with ileal atresia and cystic fibrosis

    OpenAIRE

    Akuma, A. O.; Mittal, S K; Sambo, A. A.

    2013-01-01

    A rare case of neonatal Bartter syndrome presenting with severe hyperkalemia is reported in a preterm child born to consanguineous parents. This child also had ileal atresia, and meconium plugs were found at laparotomy. The diagnosis of cystic fibrosis was subsequently made on genetic testing. Despite full intensive care management and surgical interventions, he died of respiratory failure after 70 days. This is the first reported case of such conglomeration of pathologies in a newborn child....

  8. Prenatal diagnosis of small bowel atresia: A case report

    OpenAIRE

    Jamal A; Mesdaghi Nia S

    2000-01-01

    In this paper we report a case of jejunal atresia that was detected pre-nataly. Polyhydramnios and multiple dilated bowel loops in the lower part of fetal abdomen in ulterasonography helped us to diagnose this abnormality. Post-natal barium enema showed it and also it was confirmed by laparotomy confirmed it. Pre-natal diagnosis is important in these cases to facilitate delivery in centers where expert team of specialists are available to allow optimal neonatal care.

  9. Prenatal diagnosis of small bowel atresia: A case report

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    Jamal A

    2000-09-01

    Full Text Available In this paper we report a case of jejunal atresia that was detected pre-nataly. Polyhydramnios and multiple dilated bowel loops in the lower part of fetal abdomen in ulterasonography helped us to diagnose this abnormality. Post-natal barium enema showed it and also it was confirmed by laparotomy confirmed it. Pre-natal diagnosis is important in these cases to facilitate delivery in centers where expert team of specialists are available to allow optimal neonatal care.

  10. Congenital Pyloric Atresia; a report of two cases

    International Nuclear Information System (INIS)

    Congenital pyloric atresia (CPA) is a very rare malformation that constitutes less than 1% of all gas upper gastrointestinal atresias. It is a unique malformation that is commonly seen as an isolated lesion, but can also occur in association with other genetically determined conditions such as hereditary multiple intestinal atresias (HMIA). This is a report of two cases of isolated isolated CPA, outlining aspects of diagnosis and management. A 2-day-old female, a product of 35-weeks gestation via a low cesarean delivery due to a transverse lie to a 25-year-old mother who had gestational insulin dependent diabetes and polyhydraminos was referred because of non-bile stained vomiting. Her abdominal x-ray showed dilated stomach with no gas distally. Gastrograffin meal confirmed the diagnosis of gastric outlet obstruction. She was found to have pyloric artesia. This was excised via longitudinal incision in the pylorus, which was then closed transversely. Subsequently she did well. A 1-year -old female was evaluated because of persistent non-bile stained vomiting. Abdominal x-ray showed dilated stomach with no gas distally and barium meal confirmed the diagnosis of gastric outlet obstruction. She was operated and on during surgery was found to have congenital pyloric atresia. This was excised via longitudinal incsion in the pylorus. She did well. CPA is divided in three types: 1) Pyloric membrane 2) Pyloric artesia without a gap 3) Pyloric artesia with a gap. Both our patients have pyloric diaphagrams. The treatment of CPA is surgical and depends on the type of arteseia. For those with pyloric diaphagram or pyloric artesia without a gap the treatment is excision of diphagaram. This is also of importance in case there is more than one diaphagram. For those with pyloric artesia with a gap, if the gap is short, they should be treated with a Finny or Heineke-Mickulicz pyloroplasty, but if the gap is long then a gastroduodenostomy becomes the treatment of choice

  11. Behavioral features of CHARGE syndrome (Hall-Hittner syndrome) comparison with Down syndrome, Prader-Willi syndrome, and Williams syndrome.

    Science.gov (United States)

    Graham, John M; Rosner, Beth; Dykens, Elisabeth; Visootsak, Jeannie

    2005-03-15

    CHARGE syndrome, or Hall-Hitner syndrome (HHS), has been delineated as a common syndrome that includes coloboma, choanal atresia, cranial nerve dysfunction (particularly asymmetric facial palsy and neurogenic swallowing problems), characteristic ear abnormalities, deafness with hypoplasia of the cochlea and semicircular canals, genital hypoplasia, and variable heart defects, orofacial clefting, tracheo-esophageal fistula, renal anomalies, thymic/parathyroid hypoplasia, spine anomalies, short broad neck with sloping shoulders, and characteristic facial features. We conducted behavioral and personality assessments in 14 boys with HHS syndrome aged 6-21 years, and compared their characteristics with similar data from 20 age-matched boys with Down syndrome (DS), 17 boys with Prader-Willi syndrome (PWS), and 16 boys with Williams syndrome (WS). We used the Reiss Profile of Fundamental Goals and Motivation Sensitivities, the Achenbach Child Behavior Checklist (CBCL), and the Aberrant Behavior Checklist (ABC). All 14 boys with HHS were legally deaf, and 10 of the 14 were also legally blind. In comparison these other syndromes, boys with HHS had behavior that resembled autistic spectrum disorder. They were socially withdrawn, lacked interest in social contact, and manifested reduced seeking of attention from others, with hyperactivity and a need to maintain order. Though the boys with HHS showed decreased social interaction, they were not as socially impaired as in classic autism. Their language was delayed due to dual sensory impairment, cranial nerve deficits, and chronic medical problems, but their language style was not abnormal (no echolalia or jargon, no scripted phrases, and no pronoun reversal). Boys with HSS appeared frustrated, but they were not aggressive, or at risk for delinquency, manifesting few stereotypic behaviors or unusual preoccupations. They did not have a restricted repertoire of activities and interests. Their behavioral features appeared to be due

  12. DUODENAL WEBS: AN EXPERIENCE WITH 18 PATIENTS

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    Yogesh Kumar Sarin

    2012-04-01

    Full Text Available Aim: To describe the management and outcome of patients with duodenal webs, managed over a period of 12 ½ years in our unit.Methods: It is a retrospective case series of 18 patients with congenital duodenal webs, managed in our unit, between 1999 and 2011. The medical record of these patients was retrieved and analyzed for demographic details, clinical presentation, associated anomalies, and outcome. Results: The median age of presentation was 8 days (range 1 day to 1.5 years. Antenatal diagnosis was made in only 2 (11.1% patients. The commonest presentation was bilious vomiting. Associated anomalies were present in 8/18 patients, common being malrotation of gut. Down’s syndrome was seen in 2 patients and congenital heart disease in 1 patient. One patient had double duodenal webs. There was a delay in presentation of more than 5 days of life in 11/18 (61% patients. Three patients who presented beyond neonatal age group had fenestrated duodenal membranes causing partial obstruction. In addition, the diagnosis was missed in patients operated for malrotation elsewhere (n=2, imperforate anus (n=2 and esophageal atresia with tracheo-esophageal fistula (n=1. A lateral duodenotomy with excision of the obstructive membrane was done in all patients. A trans-anastomotic tube (TAT for enteral feeding was used in 8 patients The mortality rate was 4/18 (22%; the main causes being sepsis, prematurity, very low birth weight and associated congenital anomalies. The mean hospital stay for the 14 survivors was 18 days. Total parental nutrition (TPN was not given to any patient.Conclusions: Congenital duodenal webs are different as the diagnosis is often missed especially in case of perforated webs. Outcome depends upon the time of presentation and associated anomalies. The use of TAT feeding for nutritional support is an easy alternative to TPN.

  13. Diagnosis and treatment of the congenital intestinal atresia in newborn infants%先天性肠闭锁88例诊疗体会

    Institute of Scientific and Technical Information of China (English)

    邵雷朋; 潘登; 王献良

    2013-01-01

    Objective To study the diagnosis and treatment of the congenital intestinal atresia in newborn infants, discuss the factors affecting prognosis. Methods The clinic data of 88 cases with the congenital intestinal atresia, including the imaging data, pathological types, surgery methods and curative effective, was retrospectively analyzed. Results 76 of 88 cases were cured, total cure rate was 86.3%. 8 cases were operated secondly because of adhesive elius or stoma fistula. 12 cases including 3 cases with volvulus, 2 cases with SBS, 1 case with biliary atresia, 1 case with anal atresia, gave up treatment during or after operation. Conclusion Early diagnosis, reducing the motality of the infants associated other anomalies, choosing the proper operational methods, choosing the proper length intestinal resection, can reduce the complication and degrade the mortality.%  目的探讨新生儿肠闭锁的外科诊断、治疗及降低死亡率的影响因素.方法回顾性分析新生儿肠闭锁88例的临床资料、影像、病理类型、手术治疗及疗效.结果本组治愈76例,治愈率86.3%,其中8例进行了2次手术(包括6例粘连性肠梗阻、2例吻合口瘘).术后死亡及放弃治疗12例(包括合并肠扭转3例,短肠综合征2例,胆道闭锁1例,肛门闭锁1例).结论早诊断,增加患儿出生体重,降低合并严重畸形患儿出生率,选择合适的手术方式,根据闭锁两端肠管的病理改变拟定的肠切除范围可作为临床参考,可减少并发症发生,降低死亡率.

  14. Oesophageal elongation with traction sutures (FOKER procedure in a newborn baby with long-gap oesophageal atresia (LGEA: Maybe too early, maybe too dangerous?

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    Holger Till

    2013-01-01

    Full Text Available In children with long gap oesophageal atresia (LGEA, the FOKER technique (oesophageal elongation with traction sutures has been criticized for its high complication rate. We advocate analysing such problems to increase the safety in the future. The present case report will focus on timing. A female newborn (3000 g with LGEA (gap of 5 cm was delivered in an outward hospital. On day two of life, she received traction sutures on both pouches. By day five, all sutures had torn out, and a primary anastomosis was attempted. However, it leaked severely. Thus, on day ten, the oesophagus was approached from the neck converting the proximal end into a spit fistula and closing the distal end blindly. Furthermore, the gastro-oesophageal (GE- junction was wrapped with a Teflon sling. When the baby arrived in our institution, she suffered from cavernous oesophageal masses extending from the thoracic inlet down to the diaphragm and fistulas draining them into the neck as well as into the right lung. Moreover, the Teflon sling had dislodged allowing for GE-reflux. In several stages, the oesophageal remnants were resected without any complications. Finally, Prof. Alaa Hamza performed a colonic interposition, which is working well today. In conclusion, the present case aims to caution paediatric surgeons to apply traction sutures for oesophageal elongation in newborns with LGEA.

  15. Treatment strategies in the management of jejunoileal and colonic atresia

    Directory of Open Access Journals (Sweden)

    Chadha Rajiv

    2006-01-01

    Full Text Available BACKGROUND/PURPOSE: The purpose of this prospective study was to review the operative findings, treatment strategies, as well as the results of management of 46 consecutive cases of jejunoileal and colonic atresia, managed over a 2-year period. MATERIALS AND METHODS: There were 42 patients with jejunoileal atresia (JIA and 4 with colonic atresia (CA. The 4 group types were: type I-membranous (n=20, type II- blind ends separated by a fibrous cord (n=6, type IIIa- blind ends with a V-shaped mesenteric defect (n=10, type IIIb- apple-peel atresia (n=4 and type IV- multiple atresias (n=6. Primary surgery for JIA consisted of resection with a single anastomosis (n=37, anastomosis after tapering jejunoplasty (n=3, multiple anastomosis (n=1 and a Bishop-Koop ileostomy (n=1. For CA, resection with primary anastomosis was performed. A single end-to-oblique anastomosis after adequate resection of dilated proximal bowel, was the preferred surgical procedure. In the absence of facilities for administering TPN, early oral/nasogastric (NG tube feeding was encouraged. In patients with anastomotic dysfunction, conservative treatment of the obstruction followed after its resolution by gradually increased NG feeds, was the preferred treatment protocol. RESULTS: Late presentation or diagnosis with hypovolemia, electrolyte imbalance, unconjugated hyperbilirubinemia (n=25 and sepsis (n=6, were significant preoperative findings. After resection and anastomosis, significant shortening of bowel length was seen in 16 patients (34.7%. Postoperative complications included an anastomotic leak (n=3, a perforation proximal to the anastomosis in 1 and anastomotic dysfunction in 5 patients. Full oral or NG tube feeding was possible only by the 13th to 31st postoperative day (POD, after the primary surgery in patients with anastomotic dysfunction and those undergoing reoperation. Overall, 38 patients survived (82.6%. Mortality was highest in patients with type IIIb or type IV

  16. Management of Complex Perineal Fistula Disease.

    Science.gov (United States)

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

    2016-06-01

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

  17. Spontaneous enterocutaneous fistula due to femoral hernia

    OpenAIRE

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

    2012-01-01

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

  18. ANTIMICROBIAL ACTIVITY OF CASSIA FISTULA LINN. LEGUMES

    OpenAIRE

    Chauhan Neelam; Bairwa Ranjan; Sharma Komal; Chauhan Nootan

    2011-01-01

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

  19. Conservative Management of an Iatrogenic Arteriovenous Fistula

    OpenAIRE

    Miller, Robert J.H; MacRae, Jennifer M; Mustata, Stefan

    2014-01-01

    Background Arteriovenous fistula is an uncommon complication of central venous catheterization that often requires invasive repair. Case Report We report the case of an arteriovenous fistula that presented as ongoing pain following removal of a tunneled central venous catheter. The fistula resolved spontaneously following a period of compression and observation. Conclusion Our study highlights the etiology of this uncommon complication as well as suggesting a role for conservative management.

  20. Hypertension Caused by Renal Arteriovenous Fistula

    OpenAIRE

    An, Hye-Sung; Kang, Tae-Gon; Yun, Hyun-Jin; Kim, Myo-Jing; Jung, Jin-A; Yoo, Jae-Ho; Lee, Young-Seok

    2009-01-01

    We describe a case of secondary hypertension caused by renal arteriovenous fistula. An 8-year old girl was hospitalized with a severe headache, vomiting, and seizure. Renal angiography demonstrated multiple renal arteriovenous fistula and increased blood renin concentration in the left renal vein. Thus, left renal arteriovenous fistula and renin induced secondary hypertension were diagnosed. Her blood pressure was well controlled by medication with angiotensin converting enzyme inhibitor.

  1. Coronary Arteriovenous Fistula Causing Hydrops Fetalis

    OpenAIRE

    Nilüfer Çetiner; Sinem Altunyuva Usta; Figen Akalın

    2014-01-01

    Fetal heart failure and hydrops fetalis may occur due to systemic arteriovenous fistula because of increased cardiac output. Arteriovenous fistula of the central nervous system, liver, bone or vascular tumors such as sacrococcygeal teratoma were previously reported to be causes of intrauterine heart failure. However, coronary arteriovenous fistula was not reported as a cause of fetal heart failure previously. It is a rare pathology comprising 0.2–0.4% of all congenital heart diseases even dur...

  2. Lacrimal gland fistula after upper eyelid blepharoplasty

    Directory of Open Access Journals (Sweden)

    Mohsen Bahmani Kashkouli

    2011-01-01

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

  3. Emphysematous prostatic abscess with rectoprostatic fistula

    Directory of Open Access Journals (Sweden)

    Po-Cheng Chen

    2014-12-01

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

  4. 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.

  5. Choanal atresia as a feature of ectrodactyly-ectodermal dysplasia-clefting (EEC) syndrome.

    OpenAIRE

    Christodoulou, J; McDougall, P N; Sheffield, L J

    1989-01-01

    We report here a father and daughter with digital abnormalities, nasolacrimal duct obstruction, and variable alopecia. The father had a cleft lip and palate and the daughter had choanal atresia. We propose they both have the EEC syndrome and show the variable expressivity of this disorder. Choanal atresia has not been previously reported in this condition.

  6. Spontaneous esophageal-pleural fistula

    Directory of Open Access Journals (Sweden)

    Sameer Vyas

    2011-01-01

    Full Text Available Spontaneous esophageal-pleural fistula (EPF is a rare entity. We describe a case in a middle-aged female who presented with severe retrosternal chest pain and shortness of breadth. Chest computed tomography showed right EPF and hydropneumothorax. She was managed conservatively keeping the chest tube drainage and performing feeding jejunostomy. A brief review of the imaging finding and management of EPF is discussed.

  7. Bilorrhea secondary to bronchobiliary fistula.

    Science.gov (United States)

    Olivencia-Yurvati, A H; Rollins, Christine

    2014-01-01

    Bronchobiliary fistula (BBF) is a rare condition which occurs most commonly as a complication of hydatid cyst liver disease. The following report describes a patient who presented with biliptysis 6 months following decortication of an empyema that had occurred following partial hepatectomy of a colon cancer metastasis. This is the only case to our knowledge that describes the presentation of a BBF in this context. The patient was diagnosed with BBF and successfully underwent open thoracotomy for fistulectomy and repair. PMID:25058780

  8. Bilorrhea Secondary to Bronchobiliary Fistula

    OpenAIRE

    Olivencia-Yurvati, A.H.; Rollins, Christine

    2014-01-01

    Bronchobiliary fistula (BBF) is a rare condition which occurs most commonly as a complication of hydatid cyst liver disease. The following report describes a patient who presented with biliptysis 6 months following decortication of an empyema that had occurred following partial hepatectomy of a colon cancer metastasis. This is the only case to our knowledge that describes the presentation of a BBF in this context. The patient was diagnosed with BBF and successfully underwent open thoracotomy ...

  9. Tracheoesophageal Fistula; A Case Report

    OpenAIRE

    ÖZDEN, Okan; Gün, İsmet

    2012-01-01

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

  10. Spontaneous esophageal-pleural fistula

    OpenAIRE

    Sameer Vyas; Mahesh Prakash; Lileshwar Kaman; Nidhi Bhardwaj; Niranjan Khandelwal

    2011-01-01

    Spontaneous esophageal-pleural fistula (EPF) is a rare entity. We describe a case in a middle-aged female who presented with severe retrosternal chest pain and shortness of breadth. Chest computed tomography showed right EPF and hydropneumothorax. She was managed conservatively keeping the chest tube drainage and performing feeding jejunostomy. A brief review of the imaging finding and management of EPF is discussed.

  11. Choledochoduodenal fistula of ulcer etiology

    Directory of Open Access Journals (Sweden)

    Čolović Radoje

    2010-01-01

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

  12. Atresia of the bilateral pulmonary veins: a rare and dismal anomaly identified on cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo; Park, Sang-Hyub; Koo, Hyun Jung; Cho, Young Hoon; Lee, Eunsol [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of)

    2014-08-15

    Imaging findings of bilateral pulmonary vein atresia have not been described. To describe cardiac CT findings and clinical outcomes of bilateral pulmonary vein atresia. Three newborns with bilateral pulmonary vein atresia were encountered at our institution during a period of 8 years. We evaluated prenatal echocardiographic findings, clinical presentations, postnatal echocardiographic findings, chest radiographic findings, cardiac CT findings and clinical outcomes. All newborns presented immediately after birth with severe cyanosis, respiratory distress and acidosis that were unresponsive to medical management. Prenatal and postnatal echocardiographic studies and chest radiography were misleading, inconclusive or nonspecific in making the diagnosis in these children; however cardiac CT clearly demonstrated atresia of the bilateral pulmonary veins with multiple small mediastinal collateral veins and pulmonary edema. Surgical treatments were not feasible for this anomaly. Their clinical outcomes were universally dismal and all infants died within 3 days. Cardiac CT provides an accurate diagnosis of bilateral pulmonary vein atresia and leads to prompt treatment decision in these children. (orig.)

  13. Atresia of the bilateral pulmonary veins: a rare and dismal anomaly identified on cardiac CT

    International Nuclear Information System (INIS)

    Imaging findings of bilateral pulmonary vein atresia have not been described. To describe cardiac CT findings and clinical outcomes of bilateral pulmonary vein atresia. Three newborns with bilateral pulmonary vein atresia were encountered at our institution during a period of 8 years. We evaluated prenatal echocardiographic findings, clinical presentations, postnatal echocardiographic findings, chest radiographic findings, cardiac CT findings and clinical outcomes. All newborns presented immediately after birth with severe cyanosis, respiratory distress and acidosis that were unresponsive to medical management. Prenatal and postnatal echocardiographic studies and chest radiography were misleading, inconclusive or nonspecific in making the diagnosis in these children; however cardiac CT clearly demonstrated atresia of the bilateral pulmonary veins with multiple small mediastinal collateral veins and pulmonary edema. Surgical treatments were not feasible for this anomaly. Their clinical outcomes were universally dismal and all infants died within 3 days. Cardiac CT provides an accurate diagnosis of bilateral pulmonary vein atresia and leads to prompt treatment decision in these children. (orig.)

  14. 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.

  15. Bronchial atresia in a neonate with congenital cytomegalovirus infection

    Directory of Open Access Journals (Sweden)

    Abdullah A Yousef

    2013-01-01

    Full Text Available Bronchial atresia (BA is characterized by a mucus-filled bronchocele in a blind-ending segmental or lobar bronchus with hyperinflation of the obstructed segment of the lung. We describe a neonate who presented on his 9 th day of life with respiratory distress. Chest computed tomography showed a soft tissue density involving the right middle lobe (RML. RML lobectomy confirmed the diagnosis of BA. Cytomegalovirus was detected by polymerase chain reaction in blood, urine, and tracheal aspirates which may provide further insight into the pathogenesis of BA.

  16. Study on congenital microtia and atresia after external canal plasty

    International Nuclear Information System (INIS)

    In treating congenital microtia and atresia, we conduct simultaneous external canal plasty, tympanoplasty, and auricle elevation with plastic surgeons about 6 months after auricleplasty by only plastic surgeons. The results are good both cosmetically and functionally. We report 13 cases in which hearing did not improve satisfactorily after surgery using postoperative high-resolution computed tomography (HRCT) of the temporal bone. Lateral healing was seen in 9 (69%), new bone proliferation in 3 (23%), malpositioning of a cartilage block in 2 (15%), and both lateral healing and malpositioning of a cartilage block in 1 (7.6%). (author)

  17. Tracheal Atresia with Segmental Esophageal Duplication: An Unusual Anatomic Arrangement.

    Science.gov (United States)

    Gaerty, Kirsten; Thomas, Joseph T; Petersen, Scott; Tan, Edwin; Kumar, Sailesh; Gardener, Glenn; Armes, Jane

    2016-01-01

    An unusual anatomic configuration of segmental tracheal agenesis/atresia with esophageal duplication on autopsy in a fetus that demised in utero at 29 weeks is reported. The mother was scanned initially for a cardiac anomaly at 20 weeks and on follow-up scan at 27 weeks had polyhydramnios and underwent amnioreduction. The final autopsy diagnosis was vertebral, ano-rectal, cardiac, tracheoesophageal, renal, and limb malformations (VACTERL). We discuss the autopsy findings along with the embryological mechanisms and compare the configuration with Floyd's classification for tracheal agenesis. The difficulties in prenatal diagnosis are discussed. PMID:26367770

  18. 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.)

  19. Vector Volume Flow in Arteriovenous Fistulas

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  20. Gastro-peritoneo-cutaneous fistula following splenectomy

    OpenAIRE

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

    2009-01-01

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

  1. Minimal Invasive Coronary Artery Fistula Ligation

    OpenAIRE

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

    2014-01-01

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

  2. Iliac Arteriovenous Fistula Complicating Lumbar Laminectomy

    OpenAIRE

    Chiariello, Luigi; Marino, Benedetto; Nigri, Antonio; Macrina, Francesco; Ruvolo, Giovanni; SINATRA, RICCARDO

    1983-01-01

    An iliac arteriovenous fistula may rarely complicate lumbar laminectomy, particularly at the L4-L5 level. We present such a complication in a 45-year-old man who presented in our institution with a postlaminectomy iliac arteriovenous fistula and severe congestive heart failure. Repair of the fistulous orifice and tubular reconstruction of the iliac artery were successfully performed.

  3. Idiopathic Aortic Root to Right Atrial Fistula.

    Science.gov (United States)

    Campisi, Salvatore; Cluzel, Armand; Vola, Marco; Fuzellier, Jean Francois

    2016-06-01

    An aorta to right atrium fistula is rare. We report a case of idiopathic aortic root to right atrial fistula with right heart failure and review the literature. doi: 10.1111/jocs.12751 (J Card Surg 2016;31:373-375). PMID:27109166

  4. Pathogenesis of biliary atresia: defining biology to understand clinical phenotypes

    Science.gov (United States)

    Asai, Akihiro; Miethke, Alexander; Bezerra, Jorge A.

    2016-01-01

    Biliary atresia is a severe cholangiopathy of early infancy that destroys extrahepatic bile ducts and disrupts bile flow. With a poorly defined disease pathogenesis, treatment consists of the surgical removal of duct remnants followed by hepatoportoenterostomy. Although this approach can improve the short-term outcome, the liver disease progresses to end-stage cirrhosis in most children. Further improvement in outcome will require a greater understanding of the mechanisms of biliary injury and fibrosis. Here, we review progress in the field, which has been fuelled by collaborative studies in larger patient cohorts and the development of cell culture and animal model systems to directly test hypotheses. Advances include the identification of phenotypic subgroups and stages of disease based on clinical, pathological and molecular features. Stronger evidence exists for viruses, toxins and gene sequence variations in the aetiology of biliary atresia, triggering a proinflammatory response that injures the duct epithelium and produces a rapidly progressive cholangiopathy. The immune response also activates the expression of type 2 cytokines that promote epithelial cell proliferation and extracellular matrix production by nonparenchymal cells. These advances provide insight into phenotype variability and might be relevant to the design of personalized trials to block progression of liver disease. PMID:26008129

  5. T-Tube Efficacy in the Management of Intestinal Atresia

    Directory of Open Access Journals (Sweden)

    A Sedighi

    2005-09-01

    Full Text Available Background: In the study, we evaluated efficacy and complications of T-tube application in treatment of intestinal atresia in newborns. Methods: In this randomized clinical trial study, 40 neonates with intestinal atresia were studied. The patients were divided into two comparable groups. After preparation of general conditions for operation, the surgery was applied under general anesthesia. In the first group, primary end-to-end anastomosis with T-tube application and in the second group only primary end-to-end anastomosis was done. Baseline variables (age, sex and birth weight, signs of disease, interval between surgery and beginning of oral nutrition, duration of hospitalization, post operation complications and mortality were compared between the two groups. Results: Age, sex, birth weight, age in operation time, frequency of abdominal distention, bilious vomiting, failure of meconium pass and congenital anomalies were not different significantly. Also interval between surgery and beginning of oral nutrition was not different. In 2 of 20 neonates (10% in T-tube group post operation complications occurred, but in the other group, 9 neonates of 14 neonates (64.3% complications were seen after operation (p=0.002. Two neonates (10% in T-tube group and 8 neonates (40% in the other group died during post operation follow up (p=0.03. Conclusion: It seems that primary end-to-end anastomosis with T-tube application in neonates with intestinal obstruction decreased complications and mortality rate. More similar studies with larger samples are recommended.

  6. 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.

  7. Multiple intracranial dural arteriovenous fistula

    Directory of Open Access Journals (Sweden)

    Abdolkarim Rahmanian

    2013-01-01

    Full Text Available Dural arteriovenous fistula (DAVF is also known as dural arteriovenous malformation. Two forms of DAVF have been introduced, however, here we present an exceptional case of DAVF with unique origin and drainage. In this study, we present a rare case of multiple DAVFs in a 50 year old man with right parietal intraparenchymal hemorrhage. MRI showed two round right parieto-occipital masses with flow void intensity adjacent to superior sagittal sinus (SSS. Another pathology connected to SSS by an abnormal cortical vein was detected anterior to first lesion. This study showed that both DAVFs were simultaneously drained in SSS in our patient.

  8. A tiny dural arteriovenous fistula

    Institute of Scientific and Technical Information of China (English)

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

    2003-01-01

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

  9. Congenital aplasia of the optic chiasm and esophageal atresia: a case report

    Directory of Open Access Journals (Sweden)

    Madonia Maurizio

    2011-08-01

    Full Text Available Abstract Introduction The complete absence of the chiasm (chiasmal aplasia is a rare clinical condition. Hypoplasia of the optic nerve and congenital nystagmus are almost invariably associated characteristics. Microphthalmos or anophthalmos are common features in chiasmal aplasia, while central nervous system abnormalities are less frequent. Esophageal atresia can be isolated or syndromic. In syndromic cases, it is frequently associated with cardiac, limb, renal or vertebral malformations and anal atresia. More rarely, esophageal atresia can be part of anophthalmia-esophageal-genital syndrome, which comprises anophthalmia or microphthalmia, genital abnormalities, vertebral defects and cerebral malformations. Here, a previously unreported case of chiasmal aplasia presenting without microphthalmos and associated with esophageal atresia is described. Case presentation Aplasia of the optic chiasm was identified in a Caucasian Italian 8-month-old boy with esophageal atresia. An ultrasound examination carried out at 21 weeks' gestation revealed polyhydramnios. Intrauterine growth retardation, esophageal atresia and a small atrial-septal defect were subsequently detected at 28 weeks' gestation. Repair of the esophageal atresia was carried out shortly after birth. A jejunostomy was carried out at four months to facilitate enteral feeding. The child was subsequently noted to be visually inattentive and to be neurodevelopmentally delayed. Magnetic resonance imaging revealed chiasmal aplasia. No other midline brain defects were found. His karyotype was normal. Conclusion If achiasmia is a spectrum, our patient seems to depict the most severe form, since he appears to have an extremely severe visual impairment. This is in contrast to most of the cases described in the literature, where patients maintain good--or at least useful-- visual function. To the best of our knowledge, the association of optic nerve hypoplasia, complete chiasmal aplasia, esophageal

  10. Three Distinct Urethral Fistulae 35 Years After Pelvic Radiation

    OpenAIRE

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

    2014-01-01

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

  11. Hepatic portocholecystostomy for biliary atresia: a 25-year follow-up and review.

    Science.gov (United States)

    Schecter, Samuel C; Courtier, Jesse; Cho, Soo-Jin; Saadai, Payam; Hirose, Shinjiro; Mackenzie, Tippi C; Miniati, Doug

    2013-01-01

    We report the successful salvage of a patient's native liver 25 years after hepatic portocholecystostomy for biliary atresia. Our case demonstrates the effectiveness of biliary specific, high-resolution CT imaging in the diagnosis of, and operative planning for complex cases of biliary obstruction. We also report the longest-term pathologic follow-up of biliary atresia after hepatic portocholecystostomy. Life-long follow-up of patients with biliary atresia is important to prevent life-threatening complications of biliary stasis/obstruction. PMID:23331828

  12. Apparent gut excretion of Tc-99m-DISIDA in case of extrahepatic biliary atresia

    International Nuclear Information System (INIS)

    Patient had DISIDA scan at 39 days of age to exclude biliary atresia. Gut excretion was seen 18 h after injection and the diagnosis of neonatal hepatitis was made. Because of continued elevated liver function values, liver biopsy was performed and demonstrated findings consistent with biliary atresia. Exploratory laparotomy performed 8 days after the scan showed patient cystic duct, bule duct, and gall-bladder, but an atretic common hepatic duct. This case is an example of documented biliary atresia demonstrating gut excretion on the DISIDA scan. (orig.)

  13. Ground zero: not asthma at all.

    Science.gov (United States)

    de Benedictis, Fernando Maria; de Benedictis, Diletta; Mirabile, Lorenzo; Pozzi, Marco; Guerrieri, Arcangela; Di Pillo, Sabrina

    2015-09-01

    Upper airway obstruction is commonly misdiagnosed as asthma. We report on four children with recurrent respiratory symptoms who had been erroneously diagnosed as having asthma and who received anti-asthma medication for several years. The evaluation of spirometry tracing was neglected in all cases. Subglottic stenosis, tracheomalacia secondary to tracheo-esophageal fistula, double aortic arch, and vocal cord dysfunction were suspected by direct inspection of the flow-volume curves and eventually diagnosed. The value of clinical history and careful evaluation of spirometry tracing in children with persistent respiratory symptoms is critically discussed. PMID:26059018

  14. Esophageal Atresia: Migration of the gastrostomy tube into the bronchus

    Directory of Open Access Journals (Sweden)

    Hosseini Seyed Mohammad

    2008-01-01

    Full Text Available A 2-day-old baby boy, 38 weeks gestation, weight 2000 g was brought due to hypersalivation and imperforate anus with gasless abdomen on plain X-ray. He underwent a gastrostomy tube insertion and colostomy. In contrast study of the stomach, on the 5th postoperative day, the dye spilled into the tracheo bronchial tree and the catheter was seen,entering the right main bronchus. The patient underwent right thoracotomy and the presence of fistula and catheter were confirmed. The fistula and distal esophagus were closed and fixed to the prevertebral fascia because of a long gap. He is under follow-up and recieving home care for a later delayed primary anastomosis.

  15. The changing face of obstetric fistula surgery in Ethiopia

    Science.gov (United States)

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

    2016-01-01

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

  16. Post-traumatic recto-spinal fistula

    International Nuclear Information System (INIS)

    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.)

  17. Post-traumatic recto-spinal fistula.

    Science.gov (United States)

    Lantsberg, L; Laufer, L; Greenberg, G; 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. PMID:10663732

  18. Post-traumatic recto-spinal fistula

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-01-01

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

  19. A Minimally Invasive Approach for Postoperative Pancreatic Fistula

    International Nuclear Information System (INIS)

    Pancreas fistula is a well-known and severe complication of pancreaticoduodenectomy. It is difficult to control with conservative therapy, inducing further complications and severe morbidity. Until now, re-operation has been the only way to resolve pancreatic fistula causing complete dehiscence of the pancreatic-enteric anastomosis (complete pancreatic fistula). Percutaneous transgastric fistula drainage is one of the treatments for pancreatic fistula. This procedure allows both pancreas juice drainage and anastomosis re-construction at the same time. This is effective and minimally invasive but difficult to adapt to a long or complicated fistula. In particular, dilatation of the main pancreatic duct is indispensable. This paper reports the successful resolution of a postoperative pancreatic fistula by a two-way-approach percutaneous transgastric fistula drainage procedure. Using a snare catheter from the fistula and a flexible guidewire from the transgastric puncture needle, it can be performed either with or without main pancreatic duct dilatation

  20. Syndromic association of cleft palate, bilateral choanal atresia, curly hair, and congenital hypothyroidism.

    OpenAIRE

    Buntincx, I M; Van Overmeire, B; Desager, K; Van Hauwaert, J

    1993-01-01

    We describe a patient with the unusual association of cleft palate, bilateral choanal atresia, curly hair, and congenital hypothyroidism. This association has been reported before in two brothers and may represent a new syndrome.

  1. Assessment of liver fibrosis by Fibroscan as compared to liver biopsy in biliary atresia

    OpenAIRE

    Shen, Qiu-Long; Chen, Ya-Jun; Wang, Zeng-Meng; Zhang, Ting-Chong; Pang, Wen-Bo; Shu, Jun; Peng, Chun-Hui

    2015-01-01

    AIM: To evaluate liver stiffness measurement (LSM) using non-invasive transient elastography (Fibroscan) in comparison with liver biopsy for assessment of liver fibrosis in children with biliary atresia (BA).

  2. Epidemiology of small intestinal atresia in Europe: a register-based study.

    LENUS (Irish Health Repository)

    Best, Kate E

    2012-09-01

    The epidemiology of congenital small intestinal atresia (SIA) has not been well studied. This study describes the presence of additional anomalies, pregnancy outcomes, total prevalence and association with maternal age in SIA cases in Europe.

  3. Fecundity regulation by atresia in turbot Scophthalmus maximus in the Baltic Sea

    DEFF Research Database (Denmark)

    Nissling, A.; Thorsen, A.; da Silva, Filipa

    2016-01-01

    spawned) v. potential fecundity (number of developing oocytes), suggesting significant variability in reproductive potential. The extent of fecundity regulation in relation to fish condition (Fulton’s condition factor) is discussed, suggesting an association between levels of atresia and fish condition......Down-regulation of fecundity through oocyte resorption was assessed in Baltic Sea turbot Scophthalmus maximus at three locations in the period from late vitellogenesis in April to spawning during June to July. The mean±s.d. total length of the sampled fish was 32⋅7±3⋅1 cm and mean±s.d. age was 6......⋅2±1⋅5 years. Measurements of atresia were performed using the ‘profile method’ with the intensity of atresia adjusted according to the ‘dissectormethod’ (10⋅6% adjustment; coefficient of determination was 0⋅675 between methods). Both prevalence (portion of fish with atresia) and intensity (calculated as the...

  4. Thoracoscopic traction technique in long gap esophageal atresia: entering a new era

    OpenAIRE

    van der Zee, David C.; Gallo, Gabriele; Tytgat, Stefaan H. A.

    2015-01-01

    Objective To describe the evolution from delayed management of long gap esophageal atresia to thoracoscopic treatment directly after birth without the placement of a gastrostomy. Background Long gap esophageal atresia remains a challenge for pediatric surgeons. Over the years, several techniques have been described to deal with the problem of the distance between the proximal and distal esophagus. More recently, a traction technique has been advocated. With the advent of minimal invasive surg...

  5. Pancreaticobronchial Fistula: A Complication of Acute Pancreatitis

    Directory of Open Access Journals (Sweden)

    Dorota Overbeck-Zubrzycka

    2011-01-01

    Full Text Available Context Pancreaticobronchial fistula is a rare complication of severe pancreatitis. Various diagnostic methods have been described previously. Case report The presentation, diagnostic methods, management and 5-year follow-up of a 40-year-old woman with severe gallstone induced pancreatitis complicated by a pancreaticobronchial fistula were reviewed. Diagnosis was made on the endotracheal intubation when amylase rich-fluid was drained via the tube and confirmed by CT scanning. Successful management was achieved by an open pancreatic necrosectomy, during which air bubbles were seen emerging from the pancreatic collection which supported the diagnosis of the fistula. Five-year follow-up did not reveal any complications. Conclusions Pancreaticobronchial fistulas have the potential to cause severe respiratory complications and mortality. Awareness of this condition is important in the treatment of complicated cases of pancreatitis.

  6. Ovarian Follicular Atresia of Ewes during Spring Puerperium

    Directory of Open Access Journals (Sweden)

    Radoslava Vlčková

    2012-01-01

    Full Text Available The distribution of healthy and atretic follicles on the ovarian surface of improved Valachian ewes 17, 24, and 32 days postpartum is reported in this study. The number of healthy follicles was higher on day 24 postpartum and their mean diameter tended to increase to day 32 (P<0.05 with the greatest diameter of 5 mm. 78–81% of atretic follicles ≥3 mm in diameter was observed where apoptosis began in the follicular cells situated at the follicular cavity. The early atretic follicles are characterized by the presence of mitotic pictures. In one ewe 24 days postpartum, small regressive follicular cysts were observed. Contracting atresia is characterized by thickening of the theca interna even to 190 μm. Progesterone and oestradiol-17β concentrations were maintained at relatively low levels, but with no significant difference between the days postpartum.

  7. Atresia of large ovarian follicles of the rat

    Directory of Open Access Journals (Sweden)

    Maria Słomczyn´ ska

    2011-08-01

    Full Text Available In the rat, at the beginning of pregnancy a cohort of antral follicles develops until the preovulatory stage. However, these follicles, differentiating in the hyperprolactinemic milieu, produce only small amount of estradiol, do not ovulate and undergo rapid degeneration. They constitute an interesting physiological model of atresia. In the present study, we analysed the development and subsequent degeneration of such follicles. The study was performed on Wistar female rats killed in succession between days 1-9 of pregnancy. Excised ovaries were submitted to a routine histological procedure. Paraffin sections were subjected to hematoxylin and eosin staining or in situ DNA labelling. Histological and TUNEL staining revealed that the investigated group of follicles grew slower than that on the corresponding days of the estrous cycle and reached a preovulatory size and morphological appearance on day 5 of pregnancy. They did not ovulate and between days 6 and 9 of pregnancy an increasing number of apoptotic cells appeared within these follicles. They were localized predominantly in the antral granulosa layer, especially near the cumulus oophorus complex (COC and in the region linking the COC with the follicular wall. The COC and the theca layer were much less affected. In late stages of atresia, also cumulus cells became apoptotic but degenerating oocytes did not exhibit positive TUNEL staining. Only limited number of the theca cells have undergone apoptosis and generally they were not hypertrophied. Our findings indicate that much smaller than normal amount of intrafollicular estradiol was sufficient to support a normal, according to the morphological criteria, although slower development of antral follicles to the late preovulatory stage.

  8. Posttraumatic Stress Reactions in Parents of Children Esophageal Atresia

    Science.gov (United States)

    Le Gouëz, Morgane; Alvarez, Luis; Rousseau, Véronique; Hubert, Philippe; Abadie, Véronique; Lapillonne, Alexandre; Kermorvant-Duchemin, Elsa

    2016-01-01

    Objective The aim of this study was to investigate psychological stress in parents of children with esophageal atresia and to explore factors associated with the development of Posttraumatic Stress disorder (PTSD). Design Self-report questionnaires were administered to parents of children with EA. Domains included: (1) sociodemographic data, current personal difficulties, assessment scales for the quality of life and for the global health status of the child (2) French-validated versions of the Perinatal Posttraumatic Stress disorder Questionnaire and of the State-Trait Anxiety Inventory. Associations between PTSD and severity of the neonatal course, presence of severe sequelae at 2 years of age, and quality of life and global health status of children according to their parents’ perception were studied. Setting A Tertiary care University Hospital Results Among 64 eligible families, 54 parents of 38 children (59%) participated to the study. PTSD was present in 32 (59%) parents; mothers were more frequently affected than fathers (69 vs 46%, p = 0.03). Four mothers (8%) had severe anxiety. PTSD was neither associated with neonatal severity nor with severe sequelae at 2 years. Parents with PTSD rated their child’s quality of life and global health status significantly lower (7.5 vs 8.6; p = 0.01 and 7.4 vs 8.3; p = 0.02 respectively). Conclusions PTSD is frequent in parents of children with esophageal atresia, independently of neonatal severity and presence of severe sequelae at 2 years of age. Our results highlight the need for a long-term psychological support of families. PMID:26953589

  9. Vesicoovarian Fistula on an Endometriosis Abscessed Cyst

    OpenAIRE

    Tran, C; M. Even; Carbonnel, M.; Preaux, F.; Isnard, F.; Rault, A.; Rouanne, M.; Ayoubi, J. M.

    2014-01-01

    We report the case of a patient who developed a vesicoovarian fistula on an endometriosis abscessed cyst. The patient presented with an advanced endometriosis stage IV complicated with a right ovarian abscessed cyst of 10 cm. A first coelioscopy with cystectomy was realized. After surgery, a voiding cystography highlighted a fistula between the ovarian abscess and the bladder. A second surgery by median laparotomy was realized with the resection of the right ovarian abscess and the resection ...

  10. Pharyngocutaneous fistula after anterior cervical spine surgery

    OpenAIRE

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

    2009-01-01

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

  11. Radiology in cutaneous sinuses and fistulae

    International Nuclear Information System (INIS)

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

  12. Radiology in cutaneous sinuses and fistulae

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-12-01

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

  13. Bronchobiliary Fistula Evaluated with Magnetic Resonance Imaging

    International Nuclear Information System (INIS)

    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

  14. Tracheoesophageal fistula associated with paracoccidioidomicosis

    Directory of Open Access Journals (Sweden)

    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.

  15. Functional pulmonary atresia in newborn with normal intracardiac anatomy: Successful treatment with inhaled nitric oxide and pulmonary vasodilators

    Directory of Open Access Journals (Sweden)

    Gürkan Altun

    2013-01-01

    Full Text Available Functional pulmonary atresia is characterized by a structurally normal pulmonary valve that does not open during right ventricular ejection. It is usually associated with Ebstein′s anomaly, Uhl′s anomaly, neonatal Marfan syndrome and tricuspid valve dysplasia. However, functional pulmonary atresia is rarely reported in newborn with anatomically normal heart. We report a newborn with functional pulmonary atresia who had normal intracardiac anatomy, who responded to treatment with nitric oxide and other vasodilator therapy successfully.

  16. Supra-transumbilical laparotomy (STL approach for small bowel atresia repair: Our experience and review of the literature

    Directory of Open Access Journals (Sweden)

    Ernesto Leva

    2013-01-01

    Full Text Available Background: Supra-Transumbilical Laparotomy (STL has been used in paediatric surgery for a broad spectrum of abdominal procedures. We report our experience with STL approach for small bowel atresia repair in newborns and review previous published series on the topic. Patients and Methods: Fourteen patients with small bowel atresia were treated via STL approach at our Institution over a 5-year period and their charts were retrospectively reviewed. Results: STL procedure was performed at mean age of 3.1 day. No malrotation disorders were detected with pre-operative contrast enema. Eight patients (54.1% presented jejunal atresia, five (35.7% ileal atresia, and one (7.1% multiple ileal and jejunal atresias. Standard repair with primary end-to-back anastomosis was performed in all but one patient. In the newborn with multiple atresia, STL incision was converted in supra-umbilical transverse incision due to difficulty of exposition. After surgery, one patient developed anastomotic stricture, and another developed occlusion due to adhesions: Both infants required second laparotomy. No infections of the umbilical site were recorded, and cosmetic results were excellent in all patients. Conclusions: Increasing evidence suggests that STL approach for small bowel atresia is feasible, safe and provides adequate exposure for small bowel atresia surgery. When malrotation and colonic/multiple atresia are pre-operatively ruled out, STL procedure can be choosen as first approach.

  17. Atresia das vias biliares extra-hepáticas: conhecimentos atuais e perspectivas futuras Extrahepatic biliary atresia: current concepts and future directions

    Directory of Open Access Journals (Sweden)

    Elisa de Carvalho

    2007-04-01

    Full Text Available OBJETIVOS: Apresentar uma revisão atualizada sobre atresia das vias biliares extra-hepáticas, com ênfase em etiopatogenia, abordagens diagnósticas e terapêuticas e prognóstico. FONTES DOS DADOS: Foram selecionadas pelos sites de busca médica (MEDLINE e PubMed pesquisas relacionadas à atresia biliar, utilizando as seguintes palavras-chave: biliary atresia,etiopathogenesis, diagnosis, treatment, prognosis, children. SÍNTESE DOS DADOS A atresia das vias biliares extra-hepáticas é a principal indicação de transplante hepático na faixa etária pediátrica. Quanto à etiologia, o citomegalovírus, o reovírus e o rotavírus têm sido os agentes mais estudados como possíveis desencadeadores da obstrução imunomediada da árvore biliar. A resposta imune, especialmente o predomínio da resposta TH1 e do interferon gama, a susceptibilidade genética e as alterações do desenvolvimento embrionário da árvore biliar são aspectos que podem participar na etiopatogênese da obliteração das vias biliares extra-hepáticas. Ainda hoje, o único tratamento disponível é a portoenterostomia, cujos resultados são melhores quando realizada nos primeiros 2 meses de vida. Em relação ao prognóstico, as crianças não tratadas vão a óbito na totalidade, por complicações relacionadas à hipertensão portal e à cirrose hepática, e mesmo os casos tratados necessitam, em sua maioria, do transplante hepático. CONCLUSÃO: A atresia das vias biliares extra-hepáticas continua sendo a principal indicação de transplante hepático em crianças, e a mudança deste panorama depende de um melhor entendimento da etiopatogenia da obstrução biliar nos diferentes fenótipos da doença. Investigações futuras a respeito do papel do interferon gama e de outras citocinas são necessárias para avaliar se esses aspectos seriam potenciais alvos de intervenção terapêutica.OBJECTIVE: To provide an updated review on extrahepatic biliary atresia, focusing

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

    Directory of Open Access Journals (Sweden)

    Pierre-Marie Tebeu

    2014-09-01

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

  19. Modified prosthesis for the treatment of malignant esophagotracheal fistula

    International Nuclear Information System (INIS)

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

  20. Post-Traumatic Arteriovenous Fistula of the Scalp

    OpenAIRE

    Ki, Hee Jong; Lee, Hyun Koo; Hur, Jin Woo; Lee, Jong Won

    2015-01-01

    Arteriovenous fistula of the scalp is relatively rare disease. We report a traumatic arteriovenous fistula of the scalp treated with complete surgical excision and review the literature with regard to etiology, pathogenesis, and management of these unusual lesions.

  1. Imaging diagnosis of dural and direct cavernous carotid fistulae

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-07-15

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

  2. Endovascular Management of Acute Bleeding Arterioenteric Fistulas

    International Nuclear Information System (INIS)

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

  3. Splenic arteriovenous fistula treated with percutaneous transarterial embolization

    DEFF Research Database (Denmark)

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

    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....... The arteriovenous fistula was successfully treated with percutaneous transarterial embolization and the patient gained almost complete recovery. This case demonstrates the usefulness of embolization of an otherwise surgical demanding arteriovenous fistula Udgivelsesdato: 2008/11...

  4. Formation of a vesicovaginal fistula in a pig model

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  5. Development of Indirect Cavernous Dural Arteriovenous Fistula after Trapping for Direct Carotid Cavernous Fistula: A Case Report

    OpenAIRE

    YOSHINO, H.; Ishihara, H.; Oka, F.; S. Kato; M. Suzuki

    2011-01-01

    A 60-year-old man with direct carotid cavernous fistula (CCF) due to a motor vehicle accident underwent internal carotid artery trapping following high-flow external carotid to internal carotid artery bypass (EC-IC bypass). Follow-up angiography revealed ipsilateral complex indirect cavernous arteriovenous fistula. Although the traumatic indirect CCF angioarchitecture differs from cavernous-sinus dural arteriovenous fistula (CS-DAVF), the present indirect fistula was similar to the latter. Co...

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  7. Ultrasound-guided percutaneous cholecysto-cholangiography for the exclusion of biliary atresia in infants

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Kyung Min; Ryeom, Hun Kyu; Choe, Byung Ho; Kim, Kap Cheol; Kim, Jong Yeol; Lee, Jong Min; Kim, Hye Jeong; Lee, Hee Jung [Kyungpook National University Hospital, Daegu (Korea, Republic of)

    2006-08-15

    The aim of this study is to determine the feasibility and effectiveness of performing an ultrasound-guided percutaneous cholecysto-cholangiogram (PCC) for excluding biliary atresia as the cause of neonatal jaundice. Between Oct. 2003 and Feb. 2005, six ultrasound-guided PCC procedures were performed to five jaundiced infants (4 females and 1 male; mean age: 60 days old) for whom possibility of biliary atresia could not be ruled out by the DISIDA scan as the cause of their neonatal jaundice. Gallbladder puncture was performed under ultrasound guidance with a 23-gauge needle. Contrast material injection during fluoroscopic examination was performed after dilatation of the gallbladder lumen with normal saline under ultrasound guidance. The criteria used for excluding biliary atresia were complete visualization of the extrahepatic biliary trees and/or contrast excretion into the duodenum. The complications and final diagnosis was assessed according to the clinical and laboratory findings. The procedures were successful in all the patients without any complication. Biliary atresia could be ruled out in all the patients. The final diagnosis was neonatal cytomegalovirus hepatitis in two patients, total parenteral nutrition-associated cholestasis in two patients, and combined cytomegalovirus hepatitis and total parenteral nutrition-associated cholestasis in one patient. Ultrasound-guided PCC is a feasible and effective method for the early definitive exclusion of biliary atresia as the cause of neonatal jaundice. By the technique of injecting normal saline before contrast injection, PCC can be done even in a totally collapsed or very small gallbladder.

  8. Association of Nasal Nostril Stenosis with Bilateral Choanal Atresia: A Case Report

    Directory of Open Access Journals (Sweden)

    Shahin Abdollahifakhim

    2014-01-01

    Full Text Available Introduction: Neonatal nasal airway obstruction induces various degrees of respiratory distress. The management of this disease, including surgical repair, will depend on the severity and location of the obstruction. We describe here a case of congenital nasal nostril stenosis that required surgical repair for stenting of both nares after coanal atresia repair.   Case Report: A 2 days old female newborn referred to neonatal department of Tabriz Children’s Hospital affiliated to the University of Medical Sciences of Tabriz, Iran on the 3rd of December, 2011 immediately after birth with respiratory distress due to bilateral coanal atresia and nasal hypoplasia with very small nostrils. CT scan showed normal brain and bilateral choanal atresia with normal size Pyriform apertures.   Conclusion: Nasal obstruction can lead to airway compromise and respiratory distress. Congenital bony nasal deformities are being recognized as an important cause of newborn airway obstruction. Nasal hypoplasia is seen in many craniofacial syndromes. Although our patient had hypoplastic nostrils with respiratory distress due to bilateral coanal atresia, correction of hypoplastic nostrils was necessary for completing the operation of choanal atresia.

  9. Ultrasound-guided percutaneous cholecysto-cholangiography for the exclusion of biliary atresia in infants

    International Nuclear Information System (INIS)

    The aim of this study is to determine the feasibility and effectiveness of performing an ultrasound-guided percutaneous cholecysto-cholangiogram (PCC) for excluding biliary atresia as the cause of neonatal jaundice. Between Oct. 2003 and Feb. 2005, six ultrasound-guided PCC procedures were performed to five jaundiced infants (4 females and 1 male; mean age: 60 days old) for whom possibility of biliary atresia could not be ruled out by the DISIDA scan as the cause of their neonatal jaundice. Gallbladder puncture was performed under ultrasound guidance with a 23-gauge needle. Contrast material injection during fluoroscopic examination was performed after dilatation of the gallbladder lumen with normal saline under ultrasound guidance. The criteria used for excluding biliary atresia were complete visualization of the extrahepatic biliary trees and/or contrast excretion into the duodenum. The complications and final diagnosis was assessed according to the clinical and laboratory findings. The procedures were successful in all the patients without any complication. Biliary atresia could be ruled out in all the patients. The final diagnosis was neonatal cytomegalovirus hepatitis in two patients, total parenteral nutrition-associated cholestasis in two patients, and combined cytomegalovirus hepatitis and total parenteral nutrition-associated cholestasis in one patient. Ultrasound-guided PCC is a feasible and effective method for the early definitive exclusion of biliary atresia as the cause of neonatal jaundice. By the technique of injecting normal saline before contrast injection, PCC can be done even in a totally collapsed or very small gallbladder

  10. Biliary Atresia - Translational Research on Key Molecular Processes Regulating Biliary Injury and Obstruction

    Directory of Open Access Journals (Sweden)

    Jorge A. Bezerra

    2006-06-01

    Full Text Available Biliary atresia is the most common cause of pathologic jaundice in young infants andresults from the obstruction of the extrahepatic bile ducts by an inflammatory and fibroobliterativeprocess. Although the pathogenesis of the disease is multifactorial, recentpatient- and animal-based studies began deciphering the molecular pathways involved in biliaryinjury and duct obstruction. Using large-scale genomics and immunostaining of liversfrom children with biliary atresia, investigators have discovered unique molecular signaturesof dominant proinflammatory cytokines at the time of diagnosis. To study hypotheses generatedfrom these patient-based studies, the anatomical and inflammatory profiles of a mousemodel of rotavirus-induced biliary atresia were analyzed and found to share striking similaritieswith the human profiles. Then, using these mice in mechanistic studies, interferongamma(IFNγ has been shown to regulate the biliary tropism of lymphocytes to the biliarysystem, and to play a critical role in the inflammatory obstruction of extrahepatic bile ducts.The ability to combine human studies with a laboratory model of neonatal biliary injury andobstruction opens a new era of opportunities to advance the field of biliary atresia, and todevelop new therapeutic strategies to improve long-term outcome with the native liver ofchildren with biliary atresia.

  11. The Management of Delayed Post-Pneumonectomy Broncho-Pleural Fistula and Esophago-Pleural Fistula.

    Science.gov (United States)

    Noh, Dongsub; Park, Chang-Kwon

    2016-04-01

    Broncho-pleural fistula (BPF) and esophago-pleural fistula (EPF) after pulmonary resection are challenging to manage. BPF is controlled by irrigation and sterilization, but such therapy is not sufficient to promote closure of EPF, which usually requires surgical management. However, it is generally difficult to select an appropriate surgical method for closure of BPF and EPF. Here, we report a case of concomitant BPF and EPF after left completion pneumonectomy, in which both fistulas were closed through a right thoracotomy. PMID:27066439

  12. The Modified Kimura's Technique for the Treatment of Duodenal Atresia

    Directory of Open Access Journals (Sweden)

    Biagio Zuccarello

    2009-01-01

    Full Text Available Background/Purpose. Kimura's diamond-shaped-duodenoduodenostomy (DSD is a known technique for the correction of congenital intrinsic duodenal obstruction. We present a modification of the technique and review the advantages of this new technique. Methods. From 1992 to 2006, 14 newborns were treated for duodenal atresia. We inverted the direction of the duodenal incisions: a longitudinal incision was made in the proximal duodenum while the distal was opened by transverse incision. Results. Our “inverted-diamond-shaped-duodenoduodenostomy” (i-DSD allowed postoperative oral feeding to start on days 2 to 3, peripheral intravenous fluids discontinuity on days 3 to 8 (median values 3.6; time to achieve full oral feeds on days 8 to 12 (median values 9.4; the length of hospitalisation ranged from 10 and 14 days (median value 11.2. No complications related to the anastomosis, by Viz leakage, dehiscence, biliary stasis, or stenosis were observed. Conclusions. The i-DSD provides a safe procedure to protect the ampulla of Vater from injury and avoids any formation of a blind loop. The results show that patients who have i-DSD achieve full oral feeds in a very short time period and, consequently, the length of hospitalisation is also significantly reduced.

  13. Vesicovaginal Fistula-A-5 Year Review

    Directory of Open Access Journals (Sweden)

    Vineet Kaur

    2002-01-01

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

  14. Eyelid liquoric fistula secondary to orbital meningocele

    Directory of Open Access Journals (Sweden)

    Renato Antunes Schiave Germano

    2015-02-01

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

  15. Endovascular treatment of hemodialysis arteriovenous fistulas

    DEFF Research Database (Denmark)

    Heerwagen, Søren T; Hansen, Marc A; Schroeder, Torben V; Ladefoged, Søren D; Lönn, Lars

    2012-01-01

    Purpose: The purpose of this study was to investigate if the immediate hemodynamic outcome of an endovascular intervention on a dysfunctional hemodialysis arteriovenous fistula is a prognostic factor for primary patency. Methods: This was a prospective observational study including 61 consecutive...... patients with dysfunctional arteriovenous fistulas referred to our endovascular unit. Patients were treated in accordance with institutional standard protocol including immediate pre- and post-interventional blood flow measurements using an intravascular catheter system. The primary endpoint was primary...... potential predictor variables. Results: Post interventional flow did not significantly influence primary patency (p = 0.76). Primary patency was found to be affected by having a history of previous intervention(s) (p = 0.008, hazard ratio 2.9) or low fistula age (P=.038, hazard ratio 0.97 [one...

  16. Benign Duodenocolic Fistula: a Case Report

    Directory of Open Access Journals (Sweden)

    Marzieh Soheili

    2015-10-01

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

  17. Eguchipsammia fistula Microsatellite Development and Population Analysis

    KAUST Repository

    Mughal, Mehreen

    2012-12-01

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

  18. Pancreatic Pseudocyst Pleural Fistula in Gallstone Pancreatitis

    Directory of Open Access Journals (Sweden)

    Sala Abdalla

    2016-01-01

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

  19. Vesicovaginal fistula repair through vaginal approach

    International Nuclear Information System (INIS)

    Objectives: To evaluate the outcome of trans-vaginal repair of vesico-vaginal fistula through vaginal approach. Study Design: Prospective study. Material and Methods: This study was carried out in Department of Urology, Shaikh Zayed Postgraduate Medical Institute and National institute of Kidney Diseases, Lahore for the period extending from April 2009 to April 2014. Total 17 patients were included in the study. History, physical examination and findings on investigations were reviewed. In all patients cystoscopy and vaginal examination was performed to see fistula site and ureteral orfices. Then trans-vaginal repair was done in all cases. Results: VVF repair was performed on 17 patients aging 25 to 45 years (mean 35.83 ± 7.37 years). The symptoms preceded for a period of 3 months to 8 years. The cause was gynecological hysterectomy 8 (47.05%), obstetric C-section 7 (41.17%) and obstructed labor 2(11.76%). In three of our patients VVF was previously repaired trans-abdominally. On cystoscopy no patients had more than one fistula. In two (11.76%) patients fistula was supratrigonal. The average size of fistula was 2.05 em, detail of fistula site and size is given in table. One patient had leakage on second postop day that was managed with change of Foleys catheter. Successful repair was achieved in all patients and no patient required second attempt. No ureteric injury and other complications were observed. Conclusion: Trans-vaginal repair of VVF avoid laparotomy and bladder bisection. It has reduced hospital stay and morbidity. (author)

  20. CAROTID CAVERNOUS FISTULA: A RARE CASE REPORT

    Directory of Open Access Journals (Sweden)

    Satish Prasad

    2015-01-01

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

  1. Laparoscopic repair for vesicouterine fistulae

    Directory of Open Access Journals (Sweden)

    Rafael A. Maioli

    2015-10-01

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

  2. Diagnosis of osteopetrosis in bilateral congenital aural atresia: Turning point in treatment strategy

    Science.gov (United States)

    Verma, Ritu; Jana, Manisha; Bhalla, Ashu Seith; Kumar, Arvind; Kumar, Rakesh

    2016-01-01

    Aural atresia is a rare congenital malformation of the external and middle ear. There are several syndromic associations of this anomaly with those involving the first and second branchial arches. Occurrence of aural atresia with sclerosing skeletal dysplasia is unknown and has never been reported. The co-existence of a sclerosing dysplasia can make the surgical treatment in aural atresia difficult and risky; and the auditory improvement may not be as expected. Moreover, internal auditory canal narrowing and hence sensorineural hearing loss in sclerosing dysplasia might add to the already existing conductive hearing loss in such patients. In this case report we have described an unknown association of bilateral microtia with sclerosing skeletal dysplasia (autosomal dominant osteopetrosis) and clinical implications of these two conditions occurring together leading to a change in the management plan. PMID:27170934

  3. Seasonal prevalence and intensity of follicular atresia in Baltic cod Gadus morhua callarias L

    DEFF Research Database (Denmark)

    Kraus, Gerd; Tomkiewicz, Jonna; Diekmann, R.; Köster, Fritz

    2008-01-01

    In the present study, 307 ovaries of eastern Baltic cod Gadus morhua callarias sampled during the prespawning and spawning season 2000 were analysed histologically to estimate the seasonal prevalence and intensity of atresia. The number of atretic oocytes per ovary was estimated using a combination...... of the physical disector method and volume fraction (Delesse principle). Atretic oocytes were observed in 32% of the ovaries. Prevalence of atresia was independent of female size, but increased significantly with declining female condition from prespawning and through the spawning stages. The...... population egg loss due to atresia amounted to 4.6% indicating that Baltic cod was performing close to maximum productivity, i.e. potential egg production. (c) 2008 The Authors Journal compilation (c) 2008 The Fisheries Society of the British Isles....

  4. Cholangitis and Choledocholithiasis After Repair of Duodenal Atresia: A Case Report

    Directory of Open Access Journals (Sweden)

    Atia Zaka-ur-Rab

    2011-04-01

    Full Text Available Cholelithiasis is a rare but known complication of surgery for duodenal atresia. Occurrence of choledocholithiasis as sequelae of duodenoduodenostomy is still rarer. Biliary stasis resulting from compression of common bile duct due to periductal fibrosis may predispose to gallstone formation. We are reporting a case of choledocholithiasis in a 6 year old child as a late post-operative complication of duodenoduodenostomy (for duodenal atresia in the neonatal period. To the best of our knowledge this is the first case of its kind reported in English literature. Cholecystectomy followed by choledocholithotomy was done and the patient had an uneventful recovery. Upper abdominal pain in any patient with a history of surgery for duodenal atresia in the past warrants a thorough evaluation for any biliary tract anomaly, cholecystitis, cholangitis, cholelithiasis or choledocholithiasis.

  5. microRNA-222 modulates liver fibrosis in a murine model of biliary atresia

    Energy Technology Data Exchange (ETDEWEB)

    Shen, Wen-jun; Dong, Rui; Chen, Gong, E-mail: chengongzlp@hotmail.com; Zheng, Shan

    2014-03-28

    Highlights: • The RRV infected group showed cholestasis, retardation and extrahepatic biliary atresia. • miR-222 was highly expressed, and PPP2R2A was inhibited in the murine biliary atresia model. • miR-222 profoundly modulated the process of fibrosis in the murine biliary atresia model. • miR-222 might represent a potential target for improving biliary atresia prognosis. - Abstract: microRNA-222 (miR-222) has been shown to initiate the activation of hepatic stellate cells, which plays an important role in the pathogenesis of liver fibrosis. The aim of our study was to evaluate the role of miR-22 in a mouse model of biliary atresia (BA) induced by Rhesus Rotavirus (RRV) infection. New-born Balb/c mice were randomized into control and RRV infected groups. The extrahepatic bile ducts were evaluated. The experimental group was divided into BA group and negative group based on histology. The expression of miR-222, protein phosphatase 2 regulatory subunit B alpha (PPP2R2A), proliferating cell nuclear antigen (PCNA) and phospho-Akt were detected. We found that the experimental group showed signs of cholestasis, retardation and extrahepatic biliary atresia. No abnormalities were found in the control group. In the BA group, miR-222, PCNA and Akt were highly expressed, and PPP2R2A expression was significantly inhibited. Our findings suggest that miR-222 profoundly modulated the process of fibrosis in the murine BA model, which might represent a potential target for improving BA prognosis.

  6. microRNA-222 modulates liver fibrosis in a murine model of biliary atresia

    International Nuclear Information System (INIS)

    Highlights: • The RRV infected group showed cholestasis, retardation and extrahepatic biliary atresia. • miR-222 was highly expressed, and PPP2R2A was inhibited in the murine biliary atresia model. • miR-222 profoundly modulated the process of fibrosis in the murine biliary atresia model. • miR-222 might represent a potential target for improving biliary atresia prognosis. - Abstract: microRNA-222 (miR-222) has been shown to initiate the activation of hepatic stellate cells, which plays an important role in the pathogenesis of liver fibrosis. The aim of our study was to evaluate the role of miR-22 in a mouse model of biliary atresia (BA) induced by Rhesus Rotavirus (RRV) infection. New-born Balb/c mice were randomized into control and RRV infected groups. The extrahepatic bile ducts were evaluated. The experimental group was divided into BA group and negative group based on histology. The expression of miR-222, protein phosphatase 2 regulatory subunit B alpha (PPP2R2A), proliferating cell nuclear antigen (PCNA) and phospho-Akt were detected. We found that the experimental group showed signs of cholestasis, retardation and extrahepatic biliary atresia. No abnormalities were found in the control group. In the BA group, miR-222, PCNA and Akt were highly expressed, and PPP2R2A expression was significantly inhibited. Our findings suggest that miR-222 profoundly modulated the process of fibrosis in the murine BA model, which might represent a potential target for improving BA prognosis

  7. Management of fistula-in-ano with special reference to ligation of intersphincteric fistula tract

    Directory of Open Access Journals (Sweden)

    Mohanlal Khadia

    2016-01-01

    Full Text Available Context: The surgical management of fistula-in-ano is still debatable and no clear recommendations have been made available until now. The present study analyses the results of ligation of intersphincteric fistula tract (LIFT technique in treating fistula-in-ano in particular with recurrence, healing time, and continence status. Aims: LIFT in the management of patients of fistula-in-ano of cryptoglandular origin. Settings and Design: Prospective study. Materials and Methods: This is a prospective study of 52 patients admitted from September 2012 to August 2014. Patients were managed with LIFT technique and results of LIFT technique were compared with other studies in terms of recurrence rate, incontinence rate, and other postoperative complications. Results: A total of 52 patients were studied. Median follow-up was 24 weeks. Primary healing was achieved in 32 (71.11% patients. Thirteen patients (28.88% had a recurrence. No patient reported any subjective decrease incontinence after the procedure. Conclusions: LIFT technique is simple and easy to learn. With this method fistula-in-ano could be easily treated even at primary health care level. LIFT technique is a simple and novel modified approach for the treatment of fistula-in-ano with rapid healing rate and without any resultant incontinence.

  8. Development of infantile hypertrophic pyloric stenosis in patients treated for oesophageal atresia. A case report

    DEFF Research Database (Denmark)

    Qvist, N; Rasmussen, L; Hansen, L P; Pedersen, S A

    1986-01-01

    Two cases of infantile hypertrophic pyloric stenosis (IHPS) developed in 74 patients treated for oesophageal atresia. Treatment of oesophageal atresia is frequently followed by vomiting and failure to thrive due to gastrooesophageal reflux or anastomotic stricture. The diagnose of IHPS must be...... considered in such patients under the age of 8 weeks as symptoms of IHPS are similar to those of gastrooesophageal reflux. The diagnose of IHPS is strongly supported by the presence of a non-carbonic alkalosis. Contrast studies including oesophagus, stomach and duodenum are to be made early in the course, as...

  9. Bart’s Syndrome Associated Corpus Callosum Agenesis and Choanal Atresia

    OpenAIRE

    Saeed, Muhammad; Anwar ul HAQ; Khaqan QADIR

    2014-01-01

    How to Cite This Article: Saeed M, Haq A, Qadir Kh.Bart’s Syndrome Associated Corpus Callosum Agenesis and Choanal Atresia. Iran J Child Neurol. 2014 Autumn;8(4): 76-79.AbstractObjectiveBart’s syndrome is defined as congenital localized absence of skin, and associated with epidermolysis bullosa. A newborn with Bart’s syndrome is reported because it is a very rare condition, especially when associated with corpus callosum agenesis and concomitant choanal atresia. Clinically it is characterized...

  10. Congenital bronchial atresia coexistent with intralobar pulmonary sequestration: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Han, Young Min; Ku, Ja Hong; Lee, Dong Keun; Chung, Kyung Ho; Kim, Chong Soo; Sohn, Myung Hee; Choi, Ki Chul [Chonbuk National University Medical School, Jeonju (Korea, Republic of)

    1995-02-15

    Bronchial atresia coexistent with intralobar pulmonary sequestration is so rare that only two cases have been reported in the literature. We report a case of congential bronchial atresia coexistent with intralobar pulmonary sequestation in a 51-year-old woman. Computed tomography showed the branching mass with hyperinflation of adjacent pulmonary parenchyma in the medial segment of the right middle lobe and a large thin-walled cystic mass with air-fluid levels in the medial basal segment of the right lower lobe. Selective inferior phrenic arteriography showed two aberrant arteries supplying the large cystic mass in the right lower lobe. The venous drainage was through the right pulmonary vein.

  11. BICORNUATE UTERUS WITH CERVICAL ATRESIA AND VAGINAL AGENESIS ASSOCIATED WITH OVARIAN ENDOMETRIOSIS - A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Alpana

    2013-06-01

    Full Text Available ABSTRACT: Vaginal agenesis combined with a functional uterus is a rare type of Mullerian duct an omaly. Only 7 – 8% of patients with vaginal agenesis have a functional uterus. Women born with vaginal agenesis, cervical atresia combined with a functioning endometrium typically present with hematometra , disabling pelvic pain and progressively worsening en dometriosis. Almost all need an abdominal hysterectomy for relief. We report a case of severe endometriosis in a 29 years old woman having a bicornuate uterus with cervical atresia and vaginal agenesis.

  12. Pyloric atresia and epidermolysis bullosa letalis: a lethal combination in two premature newborn siblings.

    Science.gov (United States)

    El Shafie, M; Stidham, G L; Klippel, C H; Katzman, G H; Weinfeld, I J

    1979-08-01

    Pyloric atresia and epidermolysis bullosa letalis are rare congenital anomalies. The association of the two diseases in siblings has not been reported previously. This paper describes such as association in two newborn infants of caucasian parents with no family history of similar anomalies. Problems in management included severe fluid and electrolyte losses, systemic infection, and prematurity, which led to the death of the two infants. The question is raised whether the two abnormalities are expressions of closely linked genes. The presence of epidermolysis bullosa should alert the pediatrician to the possiblity of a coexisting pyloric atresia. PMID:490291

  13. Successful pregnancy by IVF in a patient with congenital cervical atresia

    Institute of Scientific and Technical Information of China (English)

    Achour Radhouane; Basly Mohamed; Ben Aissa Imen; Ferjaoui Aymen; NEJI Khaled

    2015-01-01

    Congenital cervical atresia and hypoplasia are rare abnormalities that generally require reconstructive or extirpative procedures to relieve outflow tract obstruction. Infertility is a common sequel, and only four previous pregnancies have been reported. We report a case of successful pregnancy afterin-vitro fertilization in a 32-year-old patient with congenital cervical atresia diagnosed at the age of 28 years. She was referred to our unit and had a succeful pregnancy afterin-vitro fertilization. Caesarean section was perfomed at 38 weeks gestation. A healthy male baby weighing 3 650 g was safely delivered.

  14. Scintigraphic hepatobiliary function studies in newborn infants to diagnose biliary hypoplasia or atresia

    International Nuclear Information System (INIS)

    The results obtained from scintigraphic hepatobiliary function studies, intraoperative cholangiography and histological examinations in a total of 17 infants suspected of having biliary atresia were compared and analysed with reference to the clinical signs and symptoms observed. In most cases, the individual diagnostic procedures led to consistent findings, even though there were some variations in the clinical picture. Patient outcome is largely determined by the site of atresia, due to which fact surgical correction should be carried out as soon as possible, in any case before the 8th week post partum. (TRV)

  15. [Stenting and redilatation of the ductus arteriosus in univentricular heart with pulmonary atresia. A case report].

    Science.gov (United States)

    Hernández-González, Martha; Solorio, Sergio; Martínez-Sánchez, Arturo; Abundes, Arturo; Ledesma, Mariano; Alva, Carlos

    2002-01-01

    Complex congenital heart disease with pulmonary atresia is ductus arteriosus-dependent. Two palliative treatments have been available for years: a systemic pulmonary shunt and prostaglandin E1 infusion. Recently, interventional cardiology has offered a new procedure for these patients: stenting of the patent arterial duct. We report a case with univentricular heart and pulmonary atresia in which percutaneous balloon angioplasty and stenting of the arterial ductus were performed successfully. Nineteen months later the patient is in good clinical conditions with 75% of oxygen saturation. PMID:12148334

  16. Endotoxin and CD14 in the progression of biliary atresia

    Directory of Open Access Journals (Sweden)

    Chen Ching-Mei

    2010-12-01

    Full Text Available Abstract Background Biliary atresia (BA is a typical cholestatic neonatal disease, characterized by obliteration of intra- and/or extra-hepatic bile ducts. However, the mechanisms contributing to the pathogenesis of BA remain uncertain. Because of decreased bile flow, infectious complications and damaging endotoxemia occur frequently in patients with BA. The aim of this study was to investigate endotoxin levels in patients with BA and the relation of these levels with the expression of the endotoxin receptor, CD14. Methods The plasma levels of endotoxin and soluble CD14 were measured with a pyrochrome Limulus amebocyte lysate assay and enzyme-linked immunosorbent assay in patients with early-stage BA when they received the Kasai procedure (KP, in patients who were jaundice-free post-KP and followed-up at the outpatient department, in patients with late-stage BA when they received liver transplantation, and in patients with choledochal cysts. The correlation of CD14 expression with endotoxin levels in rats following common bile duct ligation was investigated. Results The results demonstrated a significantly higher hepatic CD14 mRNA and soluble CD14 plasma levels in patients with early-stage BA relative to those with late-stage BA. However, plasma endotoxin levels were significantly higher in both the early and late stages of BA relative to controls. In rat model, the results demonstrated that both endotoxin and CD14 levels were significantly increased in liver tissues of rats following bile duct ligation. Conclusions The significant increase in plasma endotoxin and soluble CD14 levels during BA implies a possible involvement of endotoxin stimulated CD14 production by hepatocytes in the early stage of BA for removal of endotoxin; whereas, endotoxin signaling likely induced liver injury and impaired soluble CD14 synthesis in the late stages of BA.

  17. Otobasal liquor fistula causing recurrent bacterial meningitis

    International Nuclear Information System (INIS)

    Cerebral subarachnoid space scintigraphy today still is the modality of choice for detection of a liquorrea or a liquor fistula, especially in the case of a recurrent menengitis of unclear origin. This diagnostic method yielded the results required in the case reported for efficient and successful surgical treatment. (orig./CB)

  18. Treatment of Perianal Fistulas in Poland

    Directory of Open Access Journals (Sweden)

    Dziki Łukasz

    2015-12-01

    Full Text Available A perianal fistula is a pathological canal covered by granulation tissue connecting the anal canal and perianal area epidermis. The above-mentioned problem is the reason for the patient to visit the surgeonproctologist. Unfortunately, the disease is characterized by a high recurrence rate, even despite proper management.

  19. CT demonstration of an aortoesophageal fistula.

    Science.gov (United States)

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

    1987-01-01

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

  20. Dural Sinus Malformation with Dural Arteriovenous Fistula

    OpenAIRE

    Yau, C.Kwong; Alvarez, H.; Lasjaunias, P.

    2001-01-01

    A rare case of dural sinus malformation with dural arteriovenous fistula in an infant is presented. Presenting symptom was progressive macrocrania without hydrocephalus. A high flow arteriovenous of the sigmoid sinus associated with jugular bulb diaphragm was demonstrated. Reflux in the intracranial sinus was present. The shunt was successfully occluded by transarterial embolization. The natural history and treatment strategy are discussed.

  1. Atypical manifestation of dural arteriovenous fistula.

    Directory of Open Access Journals (Sweden)

    Tripathi R

    2002-01-01

    Full Text Available A case of secondary dural arteriovenous fistula presenting as infantile stroke, in a fifteen month old boy, is reported. The initial impression on CT scan in this case was misleading, due to the atypical appearance of the pathological periventricular blood vessels, interpreted as periventricular calcification.

  2. Congenital H-type anovestibuler fistula

    Institute of Scientific and Technical Information of China (English)

    Mesut Yazlcl; Barlas Etensel; Harun Gürsoy; Sezen Ozklsaclk

    2003-01-01

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

  3. Coronary Arteriovenous Fistula Causing Hydrops Fetalis

    Directory of Open Access Journals (Sweden)

    Nilüfer Çetiner

    2014-01-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  7. 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.)

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

    Directory of Open Access Journals (Sweden)

    Evangelia Prevyzi

    2013-01-01

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

  9. Comorbidities Do not Influence Primary Fistula Success in Incident Hemodialysis Patients: A Prospective Study

    OpenAIRE

    Wang, Wenjie; Murphy, Brendan; YILMAZ, Serdar; Tonelli, Marcello; MacRae, Jennifer; Manns, Braden J

    2008-01-01

    Background and objectives: Concern about primary fistula failure may contribute to the underuse of arteriovenous fistula. The objective of this study was to investigate the baseline clinical parameters associated with primary fistula success.

  10. Pyloric Atresia Associated with Epidermolysis Bullosa: A Report of 4 Survivals in 5 Cases

    Directory of Open Access Journals (Sweden)

    Alireza Alam-Sahebpoor

    2007-09-01

    Full Text Available Objective: Pyloric atresia (PA is a rare congenital anomaly that constitutes approximately 1% of all intestinal atresias, and its incidence is approximately 1 in 100,000 live births. PA may occur as an isolated condition or associated with other abnormalities, the most common being Junctional epidermolysis bullosa (EB. Evidence suggests that PA-EB is a distinct entity. In this report, we present 5 cases of pyloric atresia associated with Junctional epidermolysis bullosa, 4 of whom survived after surgery. Cases Presentation: Prospective evaluation of 5 patients with pyloric atresia associated with Epidermolysis bullosa undergoing therapeutic surgery. Biopsy of the fresh bulla was compatible with Junctional EB in all 5 patients. All patients underwent laparatomy after stabilization. Four neonates underwent gastroduodenostomy, and one patient had excision of membrane and pyloroplasty. Out of 5 neonates, 4 survive and one died from fulminant septicemia 12 days after operation.Conclusion: Although association of PA with EB has been reported to be fatal, recently there have been encouraging reports of survival among these patients. These 5 patients underwent surgery and survived, and are doing well on follow up.

  11. Sirenomelia and ndash; Mermaid Syndrome with Oesophageal Atresia: A Rare Case Report

    OpenAIRE

    Veena Raja; Vidyavathi Kannar; C. S. Babu Rajendra Prasad

    2015-01-01

    Sirenomelia or Mermaid syndrome is a very rare congenital deformity in which legs are fused together and commonly associated with abnormal kidney development, genital, and rectal abnormalities. In this present case, sirenomelia was associated with oesophageal atresia, which is a rare association and occurs in about 20-35% of cases. [J Interdiscipl Histopathol 2015; 3(3.000): 113-116

  12. UNILATERAL EXTERNAL AUDITORY CANAL ATRESIA WITH CONGENITAL FACIAL NERVE PALSY : A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Venkata Ramana Rao

    2015-07-01

    Full Text Available Congenital facial palsy is generally due to developmental an o m a ly or acquired cause. Unilateral congenital facial palsy due to developmental defect is most often associated with inner ear abnormalities. We report a rare case of unilateral congenital facial palsy with atresia of pinna and external auditory canal and normally developed middle ear and inner ear structures.

  13. UNILATERAL EXTERNAL AUDITORY CANAL ATRESIA WITH CONGENITAL FACIAL NERVE PALSY : A CASE REPORT

    OpenAIRE

    Venkata Ramana Rao; Sharma,; Subba Rao; Pravin

    2015-01-01

    Congenital facial palsy is generally due to developmental an o m a ly or acquired cause. Unilateral congenital facial palsy due to developmental defect is most often associated with inner ear abnormalities. We report a rare case of unilateral congenital facial palsy with atresia of pinna and external auditory canal and normally developed middle ear and inner ear structures.

  14. Hepatic ADC value correlates with cirrhotic severity of patients with biliary atresia

    International Nuclear Information System (INIS)

    Introduction: At least 40% of survivors of biliary atresia have progressive cirrhosis even after undergoing Kasai operation. The values of hepatic apparent diffusion coefficient and apparent-diffusion-coefficient-related indices were applied to biliary atresia patients and correlated with cirrhotic severity scores of model for end-stage liver disease or pediatric end-stage liver disease model, Child-Turcotte, and Child-Pugh systems. Materials and methods: Thirty-three biliary atresia patents (mean = 1140, 61–4314 days of age) received magnetic resonance image examinations due to complications of biliary atresia from April 2008 to August 2009. Two non-breath-hold diffusion weighted imaging sequences were performed with motion-probing gradients in three directions with two b values: 0/100 and 0/500 s/mm2; 1000 ms/61.1 ms, time to repeat/time to echo; number of excitation, 1.0; 8 mm section thickness; 40 cm × 40 cm field of view; 128 × 256 matrix in all biliary atresia patients and 18 control subjects. We used the Spearman rank correlation test to analyze the relationship among the scores of model for end-stage liver disease or pediatric end-stage liver disease model, Child-Turcotte and Child-Pugh scores and right hepatic apparent diffusion coefficients, apparent diffusion coefficient using b factor of 500-albumin product and alanine transaminase/apparent diffusion coefficient with b factor of 500 ratio. Results: The right hepatic apparent diffusion coefficient using b factor of 100, apparent diffusion coefficient with b factor of 500 and product of apparent diffusion coefficient with b factor of 500-albumin level were significantly negatively correlated (p ≤ 0.0125) with model for end-stage liver disease or pediatric end-stage liver disease model, Child-Turcotte, and Child-Pugh scores of biliary atresia patients. The ratio of alanine transaminase level/right hepatic apparent diffusion coefficient with b factor of 500 was also significantly (p ≤ 0

  15. Tentorial artery embolization in tentorial dural arteriovenous fistulas

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-10-15

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

  16. Genitourinary Fistula - An Experience from Tertiary Care Hospital

    Directory of Open Access Journals (Sweden)

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

    2006-07-01

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

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

    International Nuclear Information System (INIS)

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

  18. Treatments to break the dormancy of Cassia fistula L. seeds

    OpenAIRE

    Paulo Alexandre Fernandes Rodrigues de Melo; Edilson Guedes da Costa; Sueli da Silva Santos-Moura; Edna Ursulino Alves; Roberta Sales Guedes

    2013-01-01

    Cassia fistula L. (Fabaceae – Caesalpinioidea) is a forest species that is propagated by seeds. To promote the production of seedlings of C. fistula it is necessary to break the natural dormancy of its seeds, which is caused by the seed tegument that is impermeable to water. The goal of this study was to establish a pre-germination treatment for germinating C. fistula seeds. The seeds were subjected to the following treatments: control – intact seeds (T1); mechanical scarification with sandpa...

  19. [Obstetric vesicovaginal fistula: reporting two cases in France].

    Science.gov (United States)

    Labarrère, A; Gueye, A; Ouaki, F; Pires, C; Pierre, F; Fritel, X

    2011-05-01

    Obstetric vesicovaginal fistula is nowadays rare in developed countries. We are reporting two cases of patients with obstetric vesicovaginal fistula that occurred after operative vaginal deliveries performed in a French hospital. Early postpartum symptoms were vaginal urine leakage and infectious syndrome. The fistula has been cured by vaginal surgery one case and combined (laparotomy and vagina surgery) in the other case. Patients were totally healed a few months following the surgery. PMID:21514873

  20. Pharyngocutaneous fistula onset after total laryngectomy: scintigraphic analysis

    OpenAIRE

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

    2009-01-01

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

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

    OpenAIRE

    Pushappreet Kaur; Jaspinder Kaur

    2014-01-01

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

  2. Spinal Arteriovenous Fistula with Progressive Paraplegia after Spinal Anaesthesia

    OpenAIRE

    Baltsavias, Gerasimos; Argyrakis, Nikolaos; Georgios K Matis; Mpata-Tshibemba, Stephanie

    2014-01-01

    A case of an iatrogenic spinal arteriovenous fistula with progressive paraplegia in a young woman is reported. The fistula was eventually created after repetitive lumbar punctures performed in the process of spinal anaesthesia. Her symptoms were progressed to paraplegia over a period of 2 years. The digital subtraction angiography demonstrated a single-hole fistula, involving the anterior spinal artery and vein. The lesion was occluded by embolization with immediate improvement. The potential...

  3. Spinal arteriovenous fistula with progressive paraplegia after spinal anaesthesia

    OpenAIRE

    Baltsavias, Gerasimos; Argyrakis, Nikolaos; Georgios K Matis; Mpata-Tshibemba, Stephanie

    2014-01-01

    A case of an iatrogenic spinal arteriovenous fistula with progressive paraplegia in a young woman is reported. The fistula was eventually created after repetitive lumbar punctures performed in the process of spinal anaesthesia. Her symptoms were progressed to paraplegia over a period of 2 years. The digital subtraction angiography demonstrated a single-hole fistula, involving the anterior spinal artery and vein. The lesion was occluded by embolization with immediate improvement. The potential...

  4. Arteriovenous Fistula in the Orbit of a Calf

    OpenAIRE

    Lamb, Christopher R.; Naylor, Jonathan M.

    1985-01-01

    An Ayrshire calf with a protruding left eye and a fluctuant swelling dorsal to the orbit was examined. A diagnosis of arteriovenous fistula was made based on the findings of pulsation, a palpable thrill and a machinery-like bruit on auscultation over the swelling. Arteriography failed to outline the full extent of the fistula. The calf was euthanized and the fistula dissected. An enlarged superficial temporal artery communicated with a branch of the maxillary vein by way of a tortuous mass of...

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

    OpenAIRE

    Evangelia Prevyzi

    2013-01-01

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

  6. Cholecystobronchocolic Fistula: A Late Complication of Biliary Sepsis

    OpenAIRE

    Collie, D A; Redhead, D. N.; O. J. Garden

    1994-01-01

    A case of a 48 year old woman presenting with bilioptysis due to a cholecystobronchocolic fistula is reported. Bilioptysis is a rare complication of biliary fistulae, with a high mortality due to chemical pneumonitis. Bronchospasm and rapid respiratory failure may ensue if aggressive management is not adopted. The site of fistulation is established by cholangiography, preferably by the percutaneous transhepatic route. Continued biliary drainage can lead to closure of these fistulae, or allow ...

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

    Science.gov (United States)

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

    2015-10-01

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

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

    Science.gov (United States)

    Rogers, Rebecca G; Jeppson, Peter C

    2016-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Pushappreet Kaur

    2014-12-01

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

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

    Science.gov (United States)

    Allon, Michael; Lok, Charmaine E

    2010-12-01

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

  11. Volume Flow in Arteriovenous Fistulas Using Vector Velocity Ultrasound

    DEFF Research Database (Denmark)

    Hansen, Peter Møller; Olesen, Jacob Bjerring; Pihl, Michael Johannes; Lange, Theis; Heerwagen, Søren; Pedersen, Mads Møller; Rix, Marianne; Lönn, Lars; Jensen, Jørgen Arendt; Nielsen, Michael Bachmann

    2014-01-01

    Volume flow in arteriovenous fistulas for hemodialysis was measured using the angle-independent ultrasound technique Vector Flow Imaging and compared with flow measurements using the ultrasound dilution technique during dialysis. Using an UltraView 800 ultrasound scanner (BK Medical, Herlev......, Denmark) with a linear transducer, 20 arteriovenous fistulas were scanned directly on the most superficial part of the fistula just before dialysis. Vector Flow Imaging volume flow was estimated with two different approaches, using the maximum and the average flow velocities detected in the fistula. Flow...

  12. Detachable balloon embolization of an aneurysmal gastroduodenal arterioportal fistula

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-01-01

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

  13. c-Kit signaling determines neointimal hyperplasia in arteriovenous fistulae

    Science.gov (United States)

    Skartsis, Nikolaos; Martinez, Laisel; Duque, Juan Camilo; Tabbara, Marwan; Velazquez, Omaida C.; Asif, Arif; Andreopoulos, Fotios; Salman, Loay H.

    2014-01-01

    Stenosis of arteriovenous (A-V) fistulae secondary to neointimal hyperplasia (NIH) compromises dialysis delivery, which worsens patients' quality of life and increases medical costs associated with the maintenance of vascular accesses. In the present study, we evaluated the role of the receptor tyrosine kinase c-Kit in A-V fistula neointima formation. Initially, c-Kit was found in the neointima and adventitia of human brachiobasilic fistulae, whereas it was barely detectable in control veins harvested at the time of access creation. Using the rat A-V fistula model to study venous vascular remodeling, we analyzed the spatial and temporal pattern of c-Kit expression in the fistula wall. Interestingly, c-Kit immunoreactivity increased with time after anastomosis, which concurred with the accumulation of cells in the venous intima. In addition, c-Kit expression in A-V fistulae was positively altered by chronic kidney failure conditions. Both blockade of c-Kit with imatinib mesylate (Gleevec) and inhibition of stem cell factor production with a specific short hairpin RNA prevented NIH in the outflow vein of experimental fistulae. In agreement with these data, impaired c-Kit activity compromised the development of NIH in A-V fistulae created in c-KitW/Wv mutant mice. These results suggest that targeting of the c-Kit signaling pathway may be an effective approach to prevent postoperative NIH in A-V fistulae. PMID:25186298

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

    Institute of Scientific and Technical Information of China (English)

    AM El-Tawil

    2011-01-01

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

  15. Countermeasure against postoperative fistulas of head and neck cancer

    International Nuclear Information System (INIS)

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

  16. Clinical study of 18 vesicointestinal fistulas

    International Nuclear Information System (INIS)

    We studied 18 cases of vesicointestinal fistula surgically treated between January 2001 and July 2005. The underlying cause was an inflammatory disease in 12 cases, a carcinoma in 5 and injury (post-radiation therapy) in 1 case. The fistula was visualized by cystography in 2 cases and enterography in 4. Surgical procedures were cystectomy with enterectomy in 2 cases, partial cystectomy with enterectomy in 3, bladder wall overlay-suture with enterectomy in 6 and enterectomy alone in 4. In 3 cases, colostomy without enterectomy was performed for palliative surgery. In all cases the postoperative course was good and surgical treatment was effective. Surgical procedures varied in each case depending on the etiology and the patient's condition. (author)

  17. Role of diaphragm in pancreaticopleural fistula

    Directory of Open Access Journals (Sweden)

    Anestis P Ninos

    2011-01-01

    Full Text Available A pancreatic pleural effusion may result from a pancreatopleural fistula. We herein discuss two interesting issues in a similar case report of a pleural effusion caused after splenectomy, which was recently published in the World Journal of Gastroenterology. Pancreatic exudate passes directly through a natural hiatus in the diaphragm or by direct penetration through the dome of the diaphragm from a neighboring subdiaphragmatic collection. The diaphragmatic lymphatic “stomata” does not contribute to the formation of such a pleural effusion, as it is inaccurately mentioned in that report. A strictly conservative approach is recommended in that article as the management of choice. Although this may be an option in selected frail patients, there has been enough accumulative evidence that a pancreaticopleural fistula may be best managed by early endoscopy in order to avoid complications causing prolonged hospitalization.

  18. An unusual case of pancreatic fistula.

    Science.gov (United States)

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

    2013-01-01

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

  19. Dural fistulas of the cavernous sinus

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-11-01

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

  20. Dural fistulas of the cavernous sinus

    International Nuclear Information System (INIS)

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

  1. 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.

  2. 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.

  3. Arteriovenous fistula detected by perfusion pulmonary scintigraphy

    International Nuclear Information System (INIS)

    A case of arteriovenous fistula in the right pulmonary lobe was diagnosed by perfusion scintigraphy. 100 MBq 99mTc-macroaggregated albumin was injected and scintigraphy was carried out with a gamma camera. In the statistic scintigram a lack of radioactivity whereas in the dynamic measurement increased filling was observed. The kinetic curves of the ROIs offered a direct proof of the arterio-venous shunt. (L.E.)

  4. Traumatic fistula:the case for reparations

    Directory of Open Access Journals (Sweden)

    Arletty Pinel

    2007-01-01

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

  5. An unusual cause of perianal fistula

    OpenAIRE

    Kocierz, L; Leung, E; Thumbe, V

    2011-01-01

    Anal pain is a common presentation in colorectal clinic. Accurate diagnosis often requires examination under anaesthesia as pain prevents careful assessment. This report intends to highlight a rare cause of a superficial perianal fistula caused by an ingested foreign body. A 36-year-old Afro-Caribbean gentleman underwent examination under anaesthesia of rectum. He had a 2-week history of perianal pain and discharge. Intra-operatively, a piece of bone from a pork spare rib was found embedded w...

  6. An unusual case of pancreatic fistula

    OpenAIRE

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

    2013-01-01

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

  7. Successful laparoscopic management for cholecystoenteric fistula

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

  8. Pancreaticoureteral Fistula Following Penetrating Abdominal Trauma

    Directory of Open Access Journals (Sweden)

    Joshua H Wolf

    2007-09-01

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

  9. Endovascular treatment for immature autogenous arteriovenous fistula

    International Nuclear Information System (INIS)

    Aim: To evaluate the anatomical causes of maturation failure and to assess clinical outcomes after the causative lesions of immature arteriovenous fistula (AVF) have been corrected by endovascular treatment. Materials and methods: The medical records and radiological data from 141 patients who underwent endovascular treatment for immature AVF were retrospectively reviewed. Clinical outcomes, such as the success rates and the patency rates following the procedure, were included. The variables, including patients' age, gender, co-morbidities, fistula age, fistula type, numbers of lesions, degree of stenosis, presence of accessory veins, were analysed as the potential predictors of primary and secondary patency. Results: Technical and clinical success rates were 95.7% (135 of 141 AVFs) and 86.5% (122 of 141 AVFs), respectively. The primary and secondary patency rates were 71.9% and 82.8% at 1 year, 60.1% and 82.0% at 2 years, and 54.5% and 82.0% at 3 years, respectively. By multivariate analysis using Cox proportional hazards model, stenosis of >90% was the only independent predictor for both the primary and secondary patency rates [hazard ratio (HR) 5.026, 95% confidence interval (CI) 2.47–10.24, p 90% was an independent predictor for both the primary and secondary patency after the treatment

  10. Definitive exclusion of biliary atresia in infants with cholestatic jaundice: the role of percutaneous cholecysto-cholangiography.

    Science.gov (United States)

    Nwomeh, Benedict C; Caniano, Donna A; Hogan, Mark

    2007-09-01

    Definitive exclusion of biliary atresia in the infant with cholestatic jaundice usually requires operative cholangiography. This approach suffers from the disadvantage that sick infants are subjected to a time-consuming and potentially negative surgical exploration. The purpose of this study was to determine if percutaneous cholecystocholangiography (PCC) prevents unnecessary laparotomy in infants whose cholestasis is caused by diseases other than biliary atresia. This study is a 10 year retrospective review of all infants with persistent direct hyperbilirubinemia and inconclusive biliary nuclear scans who underwent further evaluation for suspected biliary atresia. A gallbladder ultrasound (US) was obtained in all patients. When the gallbladder was visualized, further imaging by PCC was done under intravenous sedation; otherwise, the standard operative cholangiogram (OCG) was performed, with liver biopsy as indicated. The primary outcome was the diagnostic accuracy of PCC, especially with respect to preventing a laparotomy. There were 35 infants with suspected biliary atresia, with a mean age of 8 weeks (range 1-14 weeks). Nine infants whose gallbladder was visualized by ultrasound underwent PCC that definitively excluded biliary atresia. Of this group, the most frequent diagnosis (five patients) was total parenteral nutrition-associated cholestasis. The other 26 infants with absent or decompressed gallbladder had laparotomy and OCG, which identified biliary atresia in 16 patients (61%). Laparotomy was avoided in all 9 patients who underwent PCC, thus reducing the negative laparotomy rate by 47%. There were no complications associated with PCC. Several alternative techniques to operative cholangiogram have been described for the definitive exclusion of biliary atresia, but many of these have distinct drawbacks. Advances in interventional radiology techniques have permitted safe percutaneous contrast evaluation of the biliary tree. Identification of a normal gall

  11. A case of solitary median maxillary central incisor (SMMCI) syndrome with bilateral pyriform aperture stenosis and choanal atresia.

    Science.gov (United States)

    Blackmore, Kate; Wynne, David M

    2010-08-01

    Solitary median maxillary central incisor syndrome is a rare disorder involving midline abnormalities. It may present with life threatening respiratory distress in the neonate secondary to nasal malformations. These include pyriform aperture stenosis and choanal atresia. We present the first reported case of simultaneous choanal atresia and pyriform aperture stenosis in a neonate with solitary median maxillary central incisor syndrome. The clinical presentation and the management of congenital pyriform aperture stenosis are discussed. PMID:20627328

  12. Sox17 haploinsufficiency results in perinatal biliary atresia and hepatitis in C57BL/6 background mice

    OpenAIRE

    Uemura, Mami; OZAWA, Aisa; Nagata, Takumi; Kurasawa, Kaoruko; Tsunekawa, Naoki; Nobuhisa, Ikuo; Taga, Tetsuya; Hara, Kenshiro; Kudo, Akihiko; Kawakami, Hayato; Saijoh, Yukio; Kurohmaru, Masamichi; Kanai-Azuma, Masami; Kanai, Yoshiakira

    2013-01-01

    Congenital biliary atresia is an incurable disease of newborn infants, of unknown genetic causes, that results in congenital deformation of the gallbladder and biliary duct system. Here, we show that during mouse organogenesis, insufficient SOX17 expression in the gallbladder and bile duct epithelia results in congenital biliary atresia and subsequent acute ‘embryonic hepatitis’, leading to perinatal death in ~95% of the Sox17 heterozygote neonates in C57BL/6 (B6) background mice. During gall...

  13. CORRESPONDENCIA

    Directory of Open Access Journals (Sweden)

    Consuelo Restrepo

    2010-06-01

    Full Text Available Letter to the Editor:Given the academic spirit of Colombia Médica, let us make some comments on the article «Unilateral renal agenesis: case review of ambulatory pediatric nephrology clinics in Cali, by Dr. Consuelo Restrepo de Rovetto et al.1As for the assertion «There are no national or local statistics in Colombia to know the frequency, clinical aspects and complications of this anomaly» even when it is true that in our country there is little information on the epidemiological behavior of this type of pathology, we have found in the literature two articles: one published by Zarante et al. in Biomédica in 2010 (published online since 01.09.09, which mentions a prevalence of unilateral renal agenesis of 0.94 per 10,000, in the evaluation of 52,744 births in four Colombian cities2. Another article published by García et al.3 in the same journal in 2003, reported a prevalence of unilateral agenesis or kidney dysplasia of 1.76 per 10,000 births in the evaluation of 5686 births in Bogotá.Additionally, in the results section «Single kidney associated to other pathologies was found in 46.5% cases: occult spina bifida and congenital scoliosis, three cases; anorectal malformations, 3 cases; chromosome syndromes, 2 cases; Klippel-Feil syndrome, two cases; cryptorchidie, 1 case; tricuspid insufficiency, 1 case; pre-auricular appendix in 1 case, and a case of morbid obesity. No patient with myeloid-Vater sequence or meningocele was found», which states that no patients were found with a diagnosis of Vater sequence. We would like to clarify that the term Vater sequence is currently not appropriate and it has been replaced by the term VACTERL association from the acronym vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal malformations, and limb defects4. The term association refers to «the occurrence of multiple idiopathic congenital malformations during blastogenesis»5. Given this definition, and knowing that

  14. Stent placement in arteriovenous fistula : an experimental study

    International Nuclear Information System (INIS)

    To determine the efficacy of metallic stents in the treatment of experimentally created carotid-jugular fistulas. Materials and Methods : Carotid-jugular fistulas were constructed surgically in four mongrel swines. Three Wallstents (Schneider, Bulbanch, Switzerland), 6mm in diameter and 23mm in length, and one Nir stent (Boston Scientific Corporation, Boston, U.S.A.), 3-5mm in diameter and 16mm in length, were placedendovascularly across the fistula holes within the carotid artery. Carotid angiography was performed before,immediately after, and 1-3 months after stent placement. Fistula specimens were obtained after final angiography and gross and microscopic examination was performed. Results : Angiography demonstrated decreased flow through the fistula immediately after stent placement. During follow-up, flow through the fistula decreased progressively but complete closure did not occur. Carotid arteries p in which Wallstents were placed were patent throughout the follow-up period. A carotid artery in which a Nir stent was used showed no decreased flow during follow-up angiography lasting two months. Pathologically, a thin layer of endothelium covered the stent wires; there was a transitional zone between the fibrous connective tissue of organizing thrombus, and endothelial proliferation occurred in the overlying fistula hole. Conclusions : Stent placement effectively reduced flow through the fistulas but during the ensuing three months closure did not occur. Occlusion was then progressive.Pathologically, intimal proliferation arose from the organizing thrombus on the surface of the stent mesh

  15. Embolisation of a bleeding iatrogenic arteriovenous fistula after paracentesis

    OpenAIRE

    Saad, Adam; Willman, Kelly; Maroney, Timothy

    2009-01-01

    A 48-year-old Caucasian male developed an iatrogenic arteriovenous fistula involving a branch of the circumflex iliac artery and an abdominal wall vein after undergoing paracentesis 3 months prior to his presentation. He presented to our emergency room with a large abdominal wall haematoma. The fistula that caused the haematoma was embolised with no further complication.

  16. Left Anterior Descending Artery-Pulmonary Artery Fistula

    Directory of Open Access Journals (Sweden)

    Turan Ege

    2011-12-01

    Full Text Available Despite the fact that coronary arteriovenous fistulas constitute approximately half (48% of coronary artery anomalies, they are rarely seen anomalies. In this report,we aim to present a coronary arteriovenous fistula case detected during a coronary angiography between left anterior descending artery and pulmonary artery.

  17. Pulmonary arteriovenous fistula: detection with magnetic resonance angiography

    International Nuclear Information System (INIS)

    Pulmonary arteriovenous fistula are an uncommon disorder, and are most frequently congenital, usually then associated with hereditary hemorrhagic telangectasia (Rendu-Osler-Weber disease). We present, to our knowledge, the first case of a pulmonary arteriovenous fistula detected by gadolinium-enhanced pulmonary magnetic resonance angiography and confirmed by digital subtraction pulmonary angiography in a patient where the CT scan was unremarkable. (orig.) (orig.)

  18. "Treatable" diffuse pulmonary arteriovenous fistula - An unusual cause

    OpenAIRE

    Nagendra Boopathy Senguttuvan; Jay Kumar; Shyam Sunder Kothari

    2011-01-01

    A 4 year old boy was referred for evaluation of failure to thrive and mild cyanosis. He was found to have a structurally normal heart with evidence of microscopic pulmonary arterio-venous (AV) fistulae. Later, he was diagnosed to have congenital porto-systemic shunt, a very rare cause of pulmonary AV fistula.

  19. Ileocolic Arteriovenous Fistula with Superior Mesenteric Vein Aneurism: Endovascular Treatment

    International Nuclear Information System (INIS)

    We report a case of a venous aneurysm secondary to an acquired ileocolic arteriovenous fistula in a 64-year-old woman with recurrent abdominal pain and history of appendectomy. The aneurysm was diagnosed by ultrasound and computed tomography. Angiography showed an arteriovenous fistula between ileocolic branches of the superior mesenteric artery and vein. This vascular abnormality was successfully treated with coil embolization

  20. Chemoradiotherapy for a patient with a giant esophageal fistula

    Institute of Scientific and Technical Information of China (English)

    Takuma Nomiya; Kazuhide Teruyama; Hitoshi Wada; Kenji Nemoto

    2007-01-01

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

  1. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

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

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

    DEFF Research Database (Denmark)

    Nielsen, T G; Djurhuus, C; Pedersen, Erik Morre; Laustsen, J; Hasenkam, J M; Schroeder, Torben Veith

    1996-01-01

    PURPOSE: The purpose of this study was to assess the impact of arteriovenous fistulas combined with varying degrees of stenosis on distal bypass hemodynamics and Doppler spectral parameters. METHODS: In an in vitro flow model bypass stenoses causing 30%, 55%, and 70% diameter reduction were induced...... the systolic pressure drop from 31% to 48% and had significant impact on all waveform parameters. CONCLUSIONS: Distal arteriovenous fistulas enhance pressure loss across stenoses and affect downstream velocity waveform configuration. The presence of a combined fistula and a stenosis mimics the distal...... 10 cm upstream of a fistula with low outflow resistance. Flow and intraluminal pressure were measured proximal to the stenosis and downstream of the fistula. The waveform parameters peak systolic velocity, end-diastolic velocity, pulsatility index, and pulse rise time were determined from midstream...

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

    Directory of Open Access Journals (Sweden)

    Masato Shino

    2014-01-01

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

  5. Cystic lung changes in a thin section CT in an asymptomatic young adult with unilateral pulmonary vein atresia: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Choul; Yi, Jeong Geun; Park, Jeong Hee [Konkuk Univ. Medical Center, Seoul (Korea, Republic of)

    2012-07-15

    Unilateral pulmonary vein atresia is a rare anomaly, usually associated with symptoms of recurrent hemoptysis and pneumonia in early childhood. Only one report of an asymptomatic adult patient can be found in the literature. We present the case of an asymptomatic patient with unilateral right pulmonary vein atresia in a 20 year old man. Chest radiograph and multidetector computed tomography showed not only pulmonary vein atresia, pulmonary artery hypoplasia, but also cystic lung changes on thin section CT, along with septal and bronchovascular bundle thickening, and ground-glass opacity. Unilateral pulmonary vein atresia could be another disease which can show cystic lung changes on thin section chest CT.

  6. Cystic lung changes in a thin section CT in an asymptomatic young adult with unilateral pulmonary vein atresia: A case report

    International Nuclear Information System (INIS)

    Unilateral pulmonary vein atresia is a rare anomaly, usually associated with symptoms of recurrent hemoptysis and pneumonia in early childhood. Only one report of an asymptomatic adult patient can be found in the literature. We present the case of an asymptomatic patient with unilateral right pulmonary vein atresia in a 20 year old man. Chest radiograph and multidetector computed tomography showed not only pulmonary vein atresia, pulmonary artery hypoplasia, but also cystic lung changes on thin section CT, along with septal and bronchovascular bundle thickening, and ground-glass opacity. Unilateral pulmonary vein atresia could be another disease which can show cystic lung changes on thin section chest CT

  7. Middle Meningeal Arteriovenous Fistula and Its Spontaneous Closure: A Case Report and Review of the Literature

    OpenAIRE

    Chandrashekar, H. S.; K. Nagarajan; Srikanth, S.G.; Jayakumar, P.N.; Vasudev, M.K.; Pandey, Paritosh

    2007-01-01

    Middle meningeal artery pseudo-aneurysms and arteriovenous fistulas are usually post-traumatic, although occasional iatrogenic cases have been reported. The treatment has been obliteration of the fistula by surgical or endovascular means. Spontaneous closure of fistula is uncommon. We report a case of non-traumatic middle meningeal arteriovenous fistula in a patient with alcoholism, which resolved spontaneously without treatment.

  8. Liver scintigraphy in biliary atresia using 99mTc-GSA

    International Nuclear Information System (INIS)

    Liver Scintigraphy using 99mTc-DTPA-galactosyl-human serum albumin is a modern diagnostic tool that can be used to evaluate postoperative liver function in patients with biliary atresia. Calculating the HH15 (Clearance index) and LHL15 (receptor index) indicates the hepatic functional reserve. We evaluated 11 patients with biliary atresia using liver scintigraphy to assess the chronological changes in liver function postoperatively. Results were compared with laboratory data HH15 and LHL15 obtained by liver scintigraphy using 99mTc-GSA improved after portoenterostomy, however, no correlation with laboratory data could be found. Even preoperative results were within the normal range for adults suggesting that the normal range of HH15 and LHL15 in children must differ from the adult range. The present study suggests that 99mTc-GSA scintigraphy will be able to assess the hepatic functional reserve which can not be detected by various other conventional liver function tests. (author)

  9. Left main coronary artery atresia and associated cardiac defects: report on concomitant surgical treatment.

    Science.gov (United States)

    Jatene, Marcelo; Juaneda, Ignacio; Miranda, Rogerio Dos Anjos; Gato, Rafaella; Marcial, Miguel Lorenzo Barbero

    2011-10-01

    A 9-year-old boy with congenital atresia of the left main coronary artery underwent myocardial revascularization. Coarctation of the aorta and ventricular septal defect were diagnosed at the age of 1 year. At age 7 years, the child presented with syncope while exercising. Preoperative evaluation included cardiac catheterization which revealed the unexpected finding of congenital atresia of the left main coronary artery with origin of the circumflex artery from the right coronary artery. Surgical correction included myocardial revascularization by means of left internal mammary artery graft to the anterior descending coronary artery, coarctation resection, and ventricular septal defect repair. The patient recovered uneventfully. We report the details of this extremely rare case with successful concomitant surgical management of the congenital coronary artery anomaly and the associated structural heart disease. PMID:23804483

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

    Directory of Open Access Journals (Sweden)

    Ferdinand eKöckerling

    2015-10-01

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

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

    Science.gov (United States)

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

    2016-08-01

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

  12. What Causes Biliary Atresia? Unique Aspects of the Neonatal Immune System Provide Clues to Disease Pathogenesis

    OpenAIRE

    Mack, Cara L.

    2015-01-01

    Biliary atresia (BA) is the most frequent identifiable cause of neonatal cholestasis and the majority of patients will need liver transplantation for survival. Despite surgical intervention with the Kasai portoenterostomy, significant fibrosis and cirrhosis develops early in life. An increased understanding of what causes this inflammatory fibrosing cholangiopathy will lead to therapies aimed at protecting the intrahepatic biliary system from immune-mediated damage. This review focuses on stu...

  13. A functional study on small intestinal smooth muscles in jejunal atresia

    Directory of Open Access Journals (Sweden)

    Preeti Tyagi

    2016-01-01

    Full Text Available Aim: The present study was aimed to assess the contractile status of neonatal small intestinal smooth muscle of dilated pre-atretic part of intestinal atresia to resolve debatable issues related to mechanisms of persistent dysmotility after surgical repair. Materials and Methods: A total of 34 longitudinally sectioned strips were prepared from pre-atretic dilated part of freshly excised 8 jejunal atresia type III a cases. Spontaneous as well as acetylcholine- and histamine-induced contractions were recorded in vitro by using organ bath preparations. Chemically evoked contractions were further evaluated after application of atropine (muscarinic blocker, pheniramine (H1 blocker, and lignocaine (neuronal blocker to ascertain receptors and neuronal involvement. Histological examinations of strips were made by using Masson trichrome stain to assess the fibrotic changes. Results: All 34 strips, except four showed spontaneous contractions with mean frequency and amplitude of 5.49 ± 0.26/min and 24.41 ± 5.26 g/g wet tissue respectively. The response to ACh was nearly twice as compared to histamine for equimolar concentrations (100 μM. ACh (100 μM induced contractions were attenuated (by 60% by atropine. Histamine (100 μM-induced contractions was blocked by pheniramine (0.32 μM and lignocaine (4 μM by 74% and 78%, respectively. Histopathological examination showed varying degree of fibrotic changes in muscle layers. Conclusions: Pre-atretic dilated part of jejunal atresia retains functional activity but with definitive histopathologic abnormalities. It is suggested that excision of a length of pre-atretic part and early stimulation of peristalsis by locally acting cholinomimetic or H1 agonist may help in reducing postoperative motility problems in atresia patients.

  14. Equol inhibits growth, induces atresia, and inhibits steroidogenesis of mouse antral follicles in vitro.

    Science.gov (United States)

    Mahalingam, Sharada; Gao, Liying; Gonnering, Marni; Helferich, William; Flaws, Jodi A

    2016-03-15

    Equol is a non-steroidal estrogen metabolite produced by microbial conversion of daidzein, a major soy isoflavone, in the gut of some humans and many animal species. Isoflavones and their metabolites can affect endogenous estradiol production, action, and metabolism, potentially influencing ovarian follicle function. However, no studies have examined the effects of equol on intact ovarian antral follicles, which are responsible for sex steroid synthesis and further development into ovulatory follicles. Thus, the present study tested the hypothesis that equol inhibits antral follicle growth, increases follicle atresia, and inhibits steroidogenesis in the adult mouse ovary. To test this hypothesis, antral follicles isolated from adult CD-1 mice were cultured with vehicle control (dimethyl sulfoxide; DMSO) or equol (600 nM, 6 μM, 36 μM, and 100 μM) for 48 and 96 h. Every 24h, follicle diameters were measured to monitor growth. At 48 and 96 h, the culture medium was subjected to measurement of hormone levels, and the cultured follicles were subjected to gene expression analysis. Additionally, follicles were histologically evaluated for signs of atresia after 96 h of culture. The results indicate that equol (100 μM) inhibited follicle growth, altered the mRNA levels of bcl2-associated X protein and B cell leukemia/lymphoma 2, and induced follicle atresia. Further, equol decreased the levels of estradiol, testosterone, androstenedione, and progesterone, and it decreased mRNA levels of cholesterol side-chain cleavage, steroid 17-α-hydroxalase, and aromatase. Collectively, these data indicate that equol inhibits growth, increases atresia, and inhibits steroidogenesis of cultured mouse antral follicles. PMID:26876617

  15. Congenital pouch colon in a girl associated with bilateral atresia of cervix uteri and uterus didelphys

    OpenAIRE

    Rajiv Chadha; Manju Puri; Rahul Saxena; Surendrakumar Agarwala; Archana Puri; Subhasis Roy Choudhury

    2013-01-01

    This report describes a girl with congenital pouch colon (CPC), uterus didelphys with septate vagina, and a cloacal anomaly. The girl underwent cloacal reconstruction at the age of 15 months. Subsequently, at puberty, the child had primary amenorrhea with severe cyclic abdominal pain due to endometriosis of both the uteruses and adnexal cysts with hematometra and hematosalpinx. Laparotomy with removal of both uteri and the left fallopian tube was performed. Both uteri had atresia of the cervi...

  16. Diagnosis and treatment of gastroesophageal reflux in patients with esophageal atresia

    OpenAIRE

    Bergmeijer, Jan Hein

    2002-01-01

    textabstractIn the last two decades, surgical treatment of children born with esophageal atresia has become a standard procedure. Postoperative mortality- now negligible in those born at term without other severe anomalies- mainly relates to patients with associated severe congenital cardiac malformations, cerebral and pulmonary complications, or chromosomal abnormalities incompatible with life. Extreme prematurity may be a causative factor for mortality as well. Mortality in affected prematu...

  17. Sirenomelia and ndash; Mermaid Syndrome with Oesophageal Atresia: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Veena Raja

    2015-09-01

    Full Text Available Sirenomelia or Mermaid syndrome is a very rare congenital deformity in which legs are fused together and commonly associated with abnormal kidney development, genital, and rectal abnormalities. In this present case, sirenomelia was associated with oesophageal atresia, which is a rare association and occurs in about 20-35% of cases. [J Interdiscipl Histopathol 2015; 3(3.000: 113-116

  18. Extrahepatic biliary atresia with choledochal cyst: Prenatal MRI predicted and post natally confirmed: A case report

    OpenAIRE

    Madhavi Nori; J Venkateshwarlu; Vijaysekhar,; Raghavendra Prasad, G.

    2013-01-01

    Extrahepatic biliary atresia (EHBA) is an uncommon cause of neonatal jaundice. Antenatal Magnetic Resonance Imaging (MRI) diagnosis of EHBA has not been published to the best of our knowledge till date. EHBA with cystic component is likely to be mistaken for choledochal cyst. A case that was antenatally predicted and postnatally confirmed by surgery and histopathology is being reported. All imaging signs are analyzed herewith. Imaging helps in the prediction of EHBA and also helps in early po...

  19. Expansion of PROMININ-1-expressing cells in association with fibrosis of biliary atresia

    OpenAIRE

    Mavila, Nirmala; James, David; Shivakumar, Pranavkumar; Nguyen, Marie V.; Utley, Sarah; Mak, Katrina; Wu, Allison; Zhou, Shengmei; Wang, Larry; Vendyres, Christopher; Groff, Megan; Asahina, Kinji; Wang, Kasper S

    2014-01-01

    Biliary atresia (BA), the most common cause of end-stage liver disease and the leading indication for pediatric liver transplantation, is associated with intrahepatic ductular reactions within regions of rapidly expanding periportal biliary fibrosis. While the extent of such biliary fibrosis is a negative predictor of long-term transplant-free survival, the cellular phenotypes involved in the fibrosis are not well established. Using a Rhesus rotavirus (RRV)-induced mouse model of BA, we demon...

  20. Tetralogy of Fallot variant with pulmonary atresia (pseudotruncus arteriosus) in a case of maternal PKU syndrome.

    Science.gov (United States)

    Pavone, P; Praticò, A D; Bianca, I; Raffaele, R; Vecchio, I; Salafia, S; Praticò, E R; Incorpora, G

    2012-10-01

    The authors report on a child with a rare variant of the Tetralogy of Fallot with pulmonary atresia also known as Pseudotruncus arteriosus, who was born by a mother affected by classic phenylketonuria (PKU), diet free of phenylalanine until the age of seven years. According to the authors, this is the first example of such rare variant in an offspring of maternal PKU syndrome. PMID:22992535

  1. New successful one-step surgical repair for apple peel atresia

    OpenAIRE

    Machmouchi M

    2011-01-01

    Mahmoud MachmouchiDepartment of Pediatrics, Royal Commission Hospital, Jubail, Saudi ArabiaAbstract: A new successful surgical approach in two identical twins delivered with intestinal atresia, “apple peel” type is reported. This technique consists of: (1) an end-to-end oblique primary anastomosis with single layer inverted 5/0 Vicryl® sutures (Ethicon, Inc, Somerville, NJ); (2) proximal tube jejunostomy using Foley catheter, size 10 French, inserted through a stab...

  2. Long-Term Prognosis and Factors Affecting Biliary Atresia from Experience over A 25 Year Period

    OpenAIRE

    Hong-Shiee Lai; Wei-Jao Chen; Chiu-Ching Chen; Wen-Tsung Hung; Mei-Hwei Chang

    2006-01-01

    Background: The purpose of this study was to delineate the long-term prognosis and factorswe have noted in our 25 years of experience treating patients sufferingfrom biliary atresia (BA) who have undergone Kasai’s operation.Methods: We studied 141 patients (69 male and 72 female infants) who underwentKasai’s operation at the National Taiwan University Hospital between 1976and 2000. Factors analyzed included age at time of surgery, postoperativebile flow, frequency of cholangitis, prophylactic...

  3. Stoma-Related Variceal Bleeding: An Under-Recognized Complication of Biliary Atresia

    OpenAIRE

    Smith, Sam; Wiener, Eugene S.; Starzl, Thomas E.; Rowe, Marc I.

    1988-01-01

    The medical records of 52 children with biliary atresia treated by portoenterostomy and evaluated for liver transplantation were reviewed to determine the frequency of stoma variceal bleeding and the optimal strategies for prevention and treatment. Eighteen patients had had prior stoma closure, four by preperitoneal closure without takedown from the abdominal wall. Three of the four developed occult variceal bleeding from the stoma closure site. Twenty-two patients had a stoma present at eval...

  4. Points to Be Considered When Applying FibroScan S Probe in Children With Biliary Atresia

    OpenAIRE

    Kim, Seung; Kang, Yunkoo; Lee, Mi Jung; Kim, Myung Joon; Han, Seok Joo; Koh, Hong

    2014-01-01

    ABSTRACT Objectives: With the introduction of smaller probes (S1, S2), the use of transient elastography has been expanded to children. Accordingly, we aimed to address points of consideration in probe choice and interpretation of measured liver stiffness by applying and comparing FibroScan S and M probes in biliary atresia. Methods: Using S1, S2, and M probes, 3 liver stiffness measurements, success rates, and interquartile ranges were obtained from 100 patients. Patients were assigned to 2 ...

  5. Multidetector Computed Tomography Assessment in Biliary Atresia for the Diagnosis of Portosystemic Collaterals before Liver Transplant

    International Nuclear Information System (INIS)

    Introduction: Chronic liver disease increases portal vein pressure and modifies splanchnic circulation. This is particularly significant in infants with biliary atresia. Large collaterals steal portal flow and increase the risk of post transplant portal vein thrombosis. Objective: to describe different types of portosystemic collaterals prior to liver transplantation with low-dose multidetector CT (MDCT) in patients with biliary atresia. Material and methods: 13 patients with severe liver dysfunction due to biliary atresia underwent low-dose 64-MDCT before liver transplantation (effective tube current ranged from 20 to 120 mAs according to weight, with a kilo voltage of 80-120 for all CT). Hepatic arterial and portal venous phases were performed after IV contrast administration [1.5-2 ml/kg]. The mean age of the study group was1 year (range, 4 months to 3.6 years). Two radiologists reviewed the CT images to determine the grade and types of the portosystemic collaterals. Results: A total of 16 CT scans were obtained.the most common portosystemic collaterals found were esophageal (11), gastric submucosal (8), gastric adventitial (7, splenic (7), hemorrhoidal (10), mesenteric [dilated or tortuous branches of the inferior mesenteric vein (8)], retroperitoneal varices [gastro renal shunt (10), splenorenal shunt (4)] and dilated or tortuous left gastric vein (13). Conclusion: MDCT provides important information on venous system patency, presence of varices, and location of venous shunts in pediatric patients with biliary atresia going to liver transplant. in addition, it is critical to detect collaterals that are not evident on ultrasound in order to avoid the steal phenomenon that may lead to portal vein thrombosis and graft failure.

  6. Hybrid Procedure for Pulmonary Atresia with Ventricular Septal Defect in a Low Birth Weight Neonate

    OpenAIRE

    Park, Ji Young; Seo, Dong-Man; Shin, Hong Ju; Kim, Soo-Jin; Son, Jae Sung

    2013-01-01

    Cardiac surgery in neonates with congenital heart disease has progressed dramatically in the past three decades. However, low-birth-weight neonates with congenital heart disease continue to challenge the intellectual and technical skills of healthcare professionals. We present a case of a low-birth-weight neonate with pulmonary atresia and a ventricular septal defect, in whom palliation was achieved with a right ventricular outflow tract stent using a hybrid procedure.

  7. Coronary sinus type atrial septal defect in a child with pulmonary atresia and Ebstein's anomaly.

    OpenAIRE

    Russell, G A; Stovin, P G

    1985-01-01

    At birth an infant was found to have an unusual series of abnormalities with a coronary sinus type atrial septal defect complicating pulmonary atresia with an intact ventricular septum and Ebstein's anomaly. The functionally important anomalies were diagnosed by echocardiography and cardiac catheterisation. The coronary sinus defect and Ebstein's anomaly were detected only at necropsy. Although only a single case, the features of this heart favour Bull's revised classification of pulmonary at...

  8. Radiological evaluation of pulmonary atresia: An analysis of cineangiography in 32 cases

    International Nuclear Information System (INIS)

    Total 32 cases of pulmonary atresia were diagnosed radiographically at Seoul National University Hospital from March, 1979 to August 1982. Some characteristic radiological findings were analyzed in chest PA and cineangiographies. The results were as follows: 1. In the evaluation of chest PA, cardiomegaly was noticed in 16 cases, dextrocardia in 8 cases, elevated cardiac apex in 7 cases and right-sided aortic arch in 6 cases. The pulmonary vascularties were mildly decreased in 20 cases, markedly decreased in 9 cases and decreased with reticular pattern in 3 cases. 2. As final diagnoses after cineangiography, pulmonary atresia was associated with Tetralogy of Fallot variant in 17 cases, transposition of great vessels in 7 cases, single ventricle in 5 cases, tricuspid atresia in 2 cases and intact ventricular septum in 1 case. 3. The classification according to the pattern of pulmonary artery is main pulmonary trunk with PDA(Type Ia) in 10 cases, pulmonary arterial confluence with PDA (Type Ib) in 10 cases, no pulmonary arterial confluence with PDA (Type Ic) in 5 cases, main pulmonary trunk without PDA (Type IIa) in 0 case, pulmonary arterial confluence without PDA (Type IIb) in 5 cases, and no pulmonary arterial confluence without PDA ( Type IIc) in 2 cases. 4. Pulmonary wedge venography was done and successful in 8 cases. Among them, confluence between right and left pulmonary arteries was noticed in 5 cases. 5. Biventricular cineangiograpy and/or pulmonary wedge venography, if necessary, is essential for the accurate diagnosis of pulmonary atresia to demonstrate detailed anatomy of pulmonary artery

  9. Radiological evaluation of pulmonary atresia: An analysis of cineangiography in 32 cases

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dong Ho; Yeon, Kyung Mo; Park, Jae Hyung; Han, Man Chung; Yoon, Yong Soo [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1983-06-15

    Total 32 cases of pulmonary atresia were diagnosed radiographically at Seoul National University Hospital from March, 1979 to August 1982. Some characteristic radiological findings were analyzed in chest PA and cineangiographies. The results were as follows: 1. In the evaluation of chest PA, cardiomegaly was noticed in 16 cases, dextrocardia in 8 cases, elevated cardiac apex in 7 cases and right-sided aortic arch in 6 cases. The pulmonary vascularties were mildly decreased in 20 cases, markedly decreased in 9 cases and decreased with reticular pattern in 3 cases. 2. As final diagnoses after cineangiography, pulmonary atresia was associated with Tetralogy of Fallot variant in 17 cases, transposition of great vessels in 7 cases, single ventricle in 5 cases, tricuspid atresia in 2 cases and intact ventricular septum in 1 case. 3. The classification according to the pattern of pulmonary artery is main pulmonary trunk with PDA(Type Ia) in 10 cases, pulmonary arterial confluence with PDA (Type Ib) in 10 cases, no pulmonary arterial confluence with PDA (Type Ic) in 5 cases, main pulmonary trunk without PDA (Type IIa) in 0 case, pulmonary arterial confluence without PDA (Type IIb) in 5 cases, and no pulmonary arterial confluence without PDA ( Type IIc) in 2 cases. 4. Pulmonary wedge venography was done and successful in 8 cases. Among them, confluence between right and left pulmonary arteries was noticed in 5 cases. 5. Biventricular cineangiograpy and/or pulmonary wedge venography, if necessary, is essential for the accurate diagnosis of pulmonary atresia to demonstrate detailed anatomy of pulmonary artery.

  10. Pattern and survival of biliary atresia patients; Experience in Southern Nigeria

    OpenAIRE

    Philemon E Okoro; Promise Igwe; Opara, Peace I

    2013-01-01

    Background: Biliary atresia (BA) has been a challenge to surgeons worldwide. Beyond the revolutionary surgical technique popularised by Kasai, liver transplantation has added renewed hope in the long-term outcome. In Nigeria, where late presentation is very common, there is need to assess the long-term results of the treatment options available to us. Aim: We aimed to evaluate the presentation and management outcome of BA and the long-term survival of BA patients seen in our practice. Materia...

  11. CLINICAL STUDY OF FISTULA IN ANO

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    Raj

    2015-10-01

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

  12. New successful one-step surgical repair for apple peel atresia

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    Machmouchi M

    2011-11-01

    Full Text Available Mahmoud MachmouchiDepartment of Pediatrics, Royal Commission Hospital, Jubail, Saudi ArabiaAbstract: A new successful surgical approach in two identical twins delivered with intestinal atresia, “apple peel” type is reported. This technique consists of: (1 an end-to-end oblique primary anastomosis with single layer inverted 5/0 Vicryl® sutures (Ethicon, Inc, Somerville, NJ; (2 proximal tube jejunostomy using Foley catheter, size 10 French, inserted through a stab wound in the left upper quadrant and entering the proximal dilated loop at about 10 cm proximal from its blind end (site of anastomosis; and (3 transanastomotic stenting using feeding tube, size 6 French, exteriorized in conjunction with the Foley catheter and reaching the lumen of the distal loop for more than 20 cm. The postoperative course was uneventful and progressive oral feed became ad libitum around day 40 postoperative. This procedure is simple, performed in one stage, and responds to the most obligatory requirements of this congenital malformation.Keywords: proximal jejunal atresia, intestinal atresia, surgical repair, anastomosis

  13. Congenital cholesteatoma of the infratemporal fossa with congenital aural atresia and mastoiditis: a case report

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    Abdel-Aziz Mosaad

    2012-06-01

    Full Text Available Abstract Background Congenital cholesteatoma may be expected in abnormally developed ear, it may cause bony erosion of the middle ear cleft and extend to the infratemporal fossa. We present the first case of congenital cholesteatoma of the infratemporal fossa in a patient with congenital aural atresia that has been complicated with acute mastoiditis. Case presentation A sixteen year old Egyptian male patient presented with congenital cholesteatoma of the infratemporal fossa with congenital aural atresia complicated with acute mastoiditis. Two weeks earlier, the patient suffered pain necessitating hospital admission, magnetic resonance imaging revealed a soft tissue mass in the right infratemporal fossa. On presentation to our institute, Computerized tomography was done as a routine, it proved the diagnosis of mastoiditis, pure tone audiometry showed an air-bone gap of 60 dB. Cortical mastoidectomy was done for treatment of mastoiditis, removal of congenital cholesteatoma was carried out with reconstruction of external auditory canal. Follow-up of the patient for 2 years and 3 months showed a patent, infection free external auditory canal with an air-bone gap has been reduced to 35db. One year after the operation; MRI was done and it showed no residual or recurrent cholesteatoma. Conclusions Congenital cholesteatoma of the infratemporal fossa in cases of congenital aural atresia can be managed safely even if it was associated with mastoiditis. It is an original case report of interest to the speciality of otolaryngology.

  14. An arteriovenous fistula following chalazion excision

    Directory of Open Access Journals (Sweden)

    Dias-Amborcar Yuri

    2007-01-01

    Full Text Available An arteriovenous fistula secondary to a chalazion is a rare occurrence. It may follow spontaneous necrosis or surgical trauma. Digital subtraction angiography and identification of the arterial feeders combined with direct puncture of the nidus and embolization is recommended, as surgical excision becomes much easier and results in a complete excision of the lesion. Conchal cartilage graft is a useful lining material for reconstruction of the tarsal plate due to its natural curvature. It restores lid integrity and ensures a stable and functional eyelid.

  15. Esophageo pleural fistula due to esophageal cancer

    Directory of Open Access Journals (Sweden)

    Ruchi Sachdeva

    2015-01-01

    Full Text Available A 61-year-old male admitted in chest clinic with complaints of left-sided chest pain, sudden onset breathlessness, and cough since last 15 days. Patient was anex-smoker with no past history of tuberculosis. He was diagnosed with esophageal cancer and received radiotherapy 1 year back. On chest X-ray, left-sided hydropneumothorax was found and intercostal drainage insertion was done. A week later patient complained of extrusion of food particles into intercostal drainage bag. On evaluation, esophageopleural (EP fistula was confirmed.

  16. Pulmonary arterio-venous micro fistulae - Diagnostic

    International Nuclear Information System (INIS)

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

  17. Radiologic evaluation of postoperative gastropericardial fistula

    Directory of Open Access Journals (Sweden)

    Jeffrey S. Chen

    2014-01-01

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

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

    International Nuclear Information System (INIS)

    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

  19. Videoradiography of free jejunal grafts for rehabilitation of speech in laryngectomized patients

    International Nuclear Information System (INIS)

    In laryngectomized patients a tracheo-esophageal artificial fistula can be used to achieve air flow from the trachea to the esophagus during speech. A one-way plastic valve is often used for the fistula. A free jejunal graft between the trachea and the esophagus can also be used. To avoid aspiration the transplant is attached to the submental area giving the graft a siphon-like shape. We performed 23 videoradiographic examinations using high-density barium in 14 such patients. The aim was to evaluate the protective function of these grafts against aspiration. Penetration of the bolus and a small amount of residual contrast material in the ascending limb of the graft was a normal finding. If the standard barium bolus reached the descending limb at any time during the examination, this was a sign of aspiration hazard. To avoid aspiration, the vertex of the speech siphon should be higher than the level of the hypopharyngeal anastomosis. (orig.)

  20. Diagnosis of arteriovenous fistulas following a lumbar discectomy

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Byung Suk; Choi, Mi Young; Jean, Se Jeong; Park, Seong Hoon; Kim, Hye Won [Wonkwang University Hospital, Iksan (Korea, Republic of); Kim, Jeong Ho [Gachon University, Gil Medical Center, Gachon (Korea, Republic of)

    2007-07-15

    To evaluate the relevant clinical and radiographical findings for the diagnosis of an arteriovenous fistula after a lumbar discectomy. Five patients with an arteriovenous fistula following a lumbar discectomy were preoperatively diagnosed and treated. We retrospectively evaluated the level of surgery, injured vessels, clinical symptoms, physical findings, and the interval between surgery and treatment. Effective and fast diagnostic methods for determining the presence of a postoperative arteriovenous fistula were evaluated. All of the arteriovenous fistulas resulted from operative injuries of the iliac arteries and veins. They were diagnosed after a mean time of 22 months (range 2 months-4 years) in spite of various symptoms and signs shortly after surgery. The arteriovenous fistulas were confirmed with angiography and were treated by surgery for 3 patients and by insertion of a stent-graft in 2 patients. Postoperative CT angiography showed the complete occlusion of the fistula tract and the normal blood flow. Essential clinical information and radiological examination, especially CT angiography with 3D reconstruction, in necessary to obtain to diagnose an arteriovenous fistula after a lumbar discectomy.

  1. EFFECT OF HEPARIN ON THE PATENCY OF ARTERIOVENOUS FISTULA

    Directory of Open Access Journals (Sweden)

    H Ravari

    2008-11-01

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

  2. Traumatic arteriovenous fistula. Apropos of a case

    Directory of Open Access Journals (Sweden)

    Manuel Otero Reyes

    2011-04-01

    Full Text Available The traumatisms that affect the extremities represent 80% of all the vascular traumatisms approximately. The inadequate handling of these it contributes to fateful consequences as the loss of the life or of the function of the extremity. The vascular lesions for firearm constitute one of the main causes with the appearance of arteriovenous fistula. We present the case of a 36 year old masculine patient with antecedents of having hurt 1 year ago by firearm in the root of the left thigh goes to present increase of volume of the extremity and difficulty to the march with sensation of fatigue and gravity. To the physical exam increase of volume of the limb more marked affection was verified in the root of the thigh, in the area related with the bullet impact thrill is felt and blow holosistólico is auscultated. The echo doppler and the tomography with contrast use evidenced the presence of a arteriovenous fistula. With this diagnosis was carried out surgical exploration and repair by means of veins bond for exclusion and interference of ilio-femoral arterial implant of politetrafluoroethylene (PTFE. The postoperative evolution was satisfactory with regression of all the clinical signs.

  3. Spinal Dural Arteriovenous Fistula: A Review.

    Science.gov (United States)

    Maimon, Shimon; Luckman, Yehudit; Strauss, Ido

    2016-01-01

    Spinal dural arteriovenous fistula (SDAVF) is a rare disease, the etiology of which is not entirely clear. It is the most common vascular malformation of the spinal cord, comprising 60-80 % of the cases. The clinical presentation and imaging findings may be nonspecific and misleading, often mistaking it for other entities like demyelinating or degenerative diseases of the spine.This chapter describes the imaging findings, clinical signs, and symptoms of this disease and also the available treatment options according to the current literature.Angiography is still considered the gold standard for diagnosis; however, MRI/MRA is increasingly used as a screening tool. Modern endovascular techniques are becoming increasingly more effective in treating SDAVF offering a less invasive treatment option; however, they still lag behind surgical success rates which approach 100 %. The outcome of both treatment options is similar if complete obliteration of the fistula is obtained and depends mainly on the severity of neurological dysfunction before treatment.Heightened awareness by radiologists and clinicians to this rare entity is essential to make a timely diagnosis of this treatable disease. A multidisciplinary treatment approach is required in order to make appropriate treatment decisions. PMID:26508408

  4. Stable gastric pentadecapeptide BPC 157 heals rat colovesical fistula.

    Science.gov (United States)

    Grgic, Tihomir; Grgic, Dora; Drmic, Domagoj; Sever, Anita Zenko; Petrovic, Igor; Sucic, Mario; Kokot, Antonio; Klicek, Robert; Sever, Marko; Seiwerth, Sven; Sikiric, Predrag

    2016-06-01

    To establish the effects of BPC 157 on the healing of rat colovesical fistulas, Wistar Albino male rats were randomly assigned to different groups. BPC 157, a stable gastric pentadecapeptide, has been used in clinical applications-specifically, in ulcerative colitis-and was successful in treating both external and internal fistulas. BPC 157 was provided daily, perorally, in drinking water (10µg/kg, 12ml/rat/day) until sacrifice or, alternatively, 10µg/kg or 10ng/kg intraperitoneally, with the first application at 30min after surgery and the last at 24h before sacrifice. Controls simultaneously received an equivolume of saline (5.0ml/kg ip) or water only (12ml/rat/day). Assessment (i.e., colon and vesical defects, fistula leaking, fecaluria and defecation through the fistula, adhesions and intestinal obstruction as healing processes) took place on days 7, 14 and 28. Control colovesical fistulas regularly exhibited poor healing, with both of the defects persisting; continuous fistula leakage; fecaluria and defecation through the fistula; advanced adhesion formation; and intestinal obstruction. By contrast, BPC 157 given perorally or intraperitoneally and in µg- and ng-regimens rapidly improved the whole presentation, with both colon and vesical defects simultaneously ameliorated and eventually healed. The maximal instilled volume was continuously raised until it reached the values of healthy rats, there were no signs of fecaluria and no defecation through the fistula, there was counteraction of advanced adhesion formation or there was an intestinal obstruction. In conclusion, BPC 157 effects appear to be suited to inducing full healing of colocutaneous fistulas in rats. PMID:26875638

  5. Rerouting of high / recurrent anal fistula without seton

    International Nuclear Information System (INIS)

    Objective: To evaluate a new treatment option in cases of high or complex anal fistulas where either the internal opening could not be outlined or there is recurrence after surgery. Study Design: Quasi Experimental study. Place and Duration of study: This study was carried out in Pakistan Naval Ship Hafeez from Jun 2008 to Aug 2011. Patients and Methods: Thirty seven patients were selected for a rerouting procedure in PNS Hafeez. The selection criteria included patients with a high or a complex fistula who had previous surgery but had recurrence of their condition. Complex fistulas, tuberculous fistulas, fistulas with two or more external openings and patients with a recurrent fistula who subsequently were found to have a low fistula were excluded from the study.The lower part of the tract was dissected, rerouted and brought out through the anal canal. The excess tract was excised and the cut end was sutured with the anal canal mucosa, thus converting an external fistula into an internal one, where the secretions from it can be retained by the external anal sphincter, thus preventing constant soiling. Results: Average age was 37 years. Thirty (81%) patients were males. Follow up period was 6 months. Tuberculosis and malignancies were ruled out. The over all success rate was 86.5%. Conclusion: Rerouting of high or recurrent anal fistulas, though not the ideal procedure, can be a useful option in cases where either the internal opening cannot be found or there has been a failure of conventional procedures. It does not eradicate the problem, but prevents constant uncontrolled discharge, which is the main concern of the patient. (author)

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

    Science.gov (United States)

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

    2016-01-01

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

  7. Evolution of Computed Tomography Findings in Secondary Aortoenteric Fistula

    International Nuclear Information System (INIS)

    Aortoenteric fistula is a rare but significant clinical entity associated with high morbidity and mortality if remain untreated. Clinical presentation and imaging findings may be subtle and prompt diagnosis can be difficult. Herein, we present a patient who initially presented with abdominal pain and computed tomography showed an aortic aneurysm compressing duodenum without any air bubbles. One month later, the patient presented with gastrointestinal bleeding and computed tomography revealed air bubbles within aneurysm. With a diagnosis of aortoenteric fistula, endovascular aneurysm repair was carried out. This case uniquely presented the computed tomography findings in progression of an aneurysm to an aortoenteric fistula

  8. Enterovesical fistula caused by a bladder squamous cell carcinoma

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

  9. Key to successful vesico vaginal fistula repair, an experience of urogenital fistula surgeries and outcome at gynaecological surgical camp 2005

    International Nuclear Information System (INIS)

    Vesico-vaginal fistula is not life threatening medical problem, but the woman face demoralization, social boycott and even divorce and separation. The aetiology of the condition has been changed over the years and in developed countries obstetrical fistula are rare and they are usually result of gynaecological surgeries or radiotherapy. Urogenital fistula surgery doesn't require special or advance technology but needs experienced urogynaecologist with trained team and post operative care which can restore health, hope and sense of dignity to women. This prospective study was carried out to analyze the success rate in patients attending the referral hospital and sent from free gynaecological surgery camps held at interior of Sindh, and included preoperative evaluation for route of surgery, operative techniques and postoperative care. Total 70 patients were admitted from the patients attending the camp. Out of these, 29 patients had uro-genital fistula. Surgical repair of the fistula was done through vaginal route on 27 patients while 2 required abdominal approach. Out of 29 surgical repairs performed, 27 proved successful. Difficult and complicated fistulae need experienced surgeon. Establishment of separate fistula surgery unit along with appropriate care and expertise accounts for the desired results. (author)

  10. Acute iliofemoral venous thrombosis in patients with atresia of the inferior vena cava can be treated successfully with catheter-directed thrombolysis

    DEFF Research Database (Denmark)

    Broholm, Rikke; Jørgensen, Maja; Just, Sven; Jensen, Leif P; Bækgaard, Niels

    2011-01-01

    To assess the effectiveness and clinical outcomes of catheter-directed thrombolysis in patients with atresia of the inferior vena cava (IVC) and acute iliofemoral deep vein thrombosis (DVT).......To assess the effectiveness and clinical outcomes of catheter-directed thrombolysis in patients with atresia of the inferior vena cava (IVC) and acute iliofemoral deep vein thrombosis (DVT)....

  11. Congenital ileal atresia presenting as a single cyst-like dilated bowel on prenatal sonography at late third trimester: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Ji, Eun Kyung; Cho, Young A; Kwon, Tae Hee [CHA General Hospital, Pochon CHA University College of Medicine, Pochon (Korea, Republic of)

    2003-12-15

    Small bowel obstruction is suspected when distension of bowel loops are seen on prenatal sonography. However, ileal atresia could show atypical feature that is absent of bowel dilatation. We present a case of ileal atresia that appeared as a single cyst-like dilatation of small bowel on late third trimester prenatal sonography.

  12. Congenital ileal atresia presenting as a single cyst-like dilated bowel on prenatal sonography at late third trimester: A case report

    International Nuclear Information System (INIS)

    Small bowel obstruction is suspected when distension of bowel loops are seen on prenatal sonography. However, ileal atresia could show atypical feature that is absent of bowel dilatation. We present a case of ileal atresia that appeared as a single cyst-like dilatation of small bowel on late third trimester prenatal sonography.

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

    Directory of Open Access Journals (Sweden)

    Suresh Jungari

    2015-02-01

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

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

    Science.gov (United States)

    Massinde, An; Kihunrwa, A

    2013-07-01

    Foreign body is a rare cause of vesico-vaginal fistula most often reported in developed countries. In developing countries obstructed labor is the commonest cause of fistula. A nulliparous 19-year-old female presented with a 3-week history of a foreign body in the vagina causing urinary incontinence and offensive vaginal discharge. Her guardian allegedly inserted the foreign body after she refused a pre-arranged marriage. A plastic container was removed from the vagina under general anesthesia. A large vesico-vaginal fistula was discovered, which was successfully surgically repaired. We recommend urgent removal of the foreign body, preferably under general anesthesia. However, if the history or physical examination reveals prolonged exposure, repair of the fistula should be delayed to allow for adequate debridement in order to prevent any life-threatening complications. PMID:24116334

  15. Fecopneumothorax and colopleural fistula – uncommon complications of Crohn's disease

    Directory of Open Access Journals (Sweden)

    Popoviæ M

    2006-06-01

    Full Text Available Abstract Background Colopleural fistula and fecopneumothorax are very rare complications of Crohn's disease. Fistula formation is frequent in Crohn's disease and occurs in approximately 33% of patients. On the other hand, fistulous communication between the pleural cavity and adjacent organs below the diaphragm is extremely rare. Case presentation We describe the case of 27 year-old female with colopleural fistula as a complication of Crohn's disease. The diagnosis was established with clinical exam, barium enema, chest X-ray, abdominal and chest CT exam. The treatment was surgical. Conclusion Colopleural fistula and fecopneumothorax are rare but life treating complications of Crohn's disease. Surgical treatment is mandatory as soon as the diagnosis is established.

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

    OpenAIRE

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

    1994-01-01

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

  17. Thrombosis of aggressive dural arteriovenous fistula after incomplete embolization

    Energy Technology Data Exchange (ETDEWEB)

    Fok, K.F. [Dept. of Neurosurgery, Tuen Mun Hospital, Tuen Mun (Hong Kong); Agid, R.; Souza, M.P.S.; terBrugge, K.G. [Div. of Neuroradiology, Dept. of Medical Imaging, Toronto Western Hospital, Toronto, ON (Canada)

    2004-12-01

    We report the cases of three patients diagnosed with dural arteriovenous fistula (DAVF) and cortical venous reflux (CVR). All were treated by transarterial endovascular embolization. Residual shunting and cortical venous drainage continued to be present at the end of the treatment procedure, despite the fact that during endovascular embolization glue penetration into the proximal venous component of the fistula had been achieved. Subsequently, follow-up angiography showed total obliteration of the fistulas and absent associated CVR. The fistulas were no longer opacified, and no additional treatment was performed. We demonstrate that residual aggressive DAVF may progress to total thrombosis if strategic deposition of the glue into the venous side has been achieved. Early follow-up angiogram is recommended prior to a planned complementary surgical approach. (orig.)

  18. Thrombosis of aggressive dural arteriovenous fistula after incomplete embolization

    International Nuclear Information System (INIS)

    We report the cases of three patients diagnosed with dural arteriovenous fistula (DAVF) and cortical venous reflux (CVR). All were treated by transarterial endovascular embolization. Residual shunting and cortical venous drainage continued to be present at the end of the treatment procedure, despite the fact that during endovascular embolization glue penetration into the proximal venous component of the fistula had been achieved. Subsequently, follow-up angiography showed total obliteration of the fistulas and absent associated CVR. The fistulas were no longer opacified, and no additional treatment was performed. We demonstrate that residual aggressive DAVF may progress to total thrombosis if strategic deposition of the glue into the venous side has been achieved. Early follow-up angiogram is recommended prior to a planned complementary surgical approach. (orig.)

  19. Intracranial dural arteriovenous fistula with spinal medullary venous drainage

    International Nuclear Information System (INIS)

    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.)

  20. 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.

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  2. Role of fistulography in evaluating pancreatic fistula after pancreaticoduodenectomy

    NARCIS (Netherlands)

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

    2012-01-01

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

  3. Meconial peritonitis in a rare association of partial ileal apple-peel atresia with small abdominal wall defect

    Directory of Open Access Journals (Sweden)

    V. Insinga

    2014-06-01

    Full Text Available Intestinal atresia type III B (apple peel and gastroschisis are both congenital malformations who require early surgical correction in neonatal age. Their association is very rare. We present the case of a full term infant with partial apple peel ileal atresia and a small defect of the anterior abdominal wall, complicated by in utero intestinal perforation and subsequent meconial peritonitis. We observed a partial atresia of small intestine, with involvement of terminal ileus savings of jejunum and a large part of the proximal ileum, small anterior abdominal wall defect with herniation of few bowel loops, intestinal malrotation. Paralytic ileus and infections are the main causes of morbidity and mortality at neonatal age. In our case, in spite of the mild phenotype, prognosis has been complicated by the onset of functional bowel obstruction, caused by chemical peritonitis resulting from contact with either amniotic fluid and meconium.

  4. Estudo angiográfico da circulação pulmonar na tetralogia de Fallot com atresia pulmonar Angiographic study of pulmonary circulation in tetralogy of Fallot with pulmonary atresia

    Directory of Open Access Journals (Sweden)

    Marco Aurélio Santos

    2005-02-01

    Full Text Available OBJETIVO: Identificar os tipos de suprimento sangüíneo vascular pulmonar na tetralogia de Fallot com atresia pulmonar por meio de estudo hemodinâmico. MÉTODOS: Foram submetidos a estudo cineangiocardiográfico 56 pacientes portadores de tetralogia de Fallot com atresia pulmonar com idade de 20 dias a 4 anos e efetuadas injeções de contraste nas seguintes estruturas vasculares: 1 veia pulmonar encunhada, 2 colaterais aortopulmonares, 3 aorta torácica e 4 ductus arteriosus e/ou shunt sistêmico pulmonar. RESULTADOS: Dos 56 pacientes, 15 tinham o suprimento sangüíneo pulmonar através de colaterais aortopulmonares, em 36 o suprimento sangüíneo pulmonar era feito isoladamente pelo ductus arteriosus e em 5 pelo ductus arteriosus e colaterais aortopulmonares. Conforme a presença ou ausência de estruturas vasculares que compõem a circulação pulmonar na tetralogia de Fallot com atresia pulmonar e do tipo de perfusão vascular pulmonar, os doentes foram classificados em 6 tipos. CONCLUSÃO: Em função da grande complexidade e extrema variabilidade do suprimento sangüíneo pulmonar na tetralogia de Fallot com atresia pulmonar torna-se possível, com este tipo de abordagem, a obtenção de informações, suficientemente necessárias, para o correto manuseio clínico-cirúrgico.OBJECTIVE: To identify the types of pulmonary vascular blood supply in tetralogy of Fallot with pulmonary atresia by use of hemodynamic study. METHODS: Fifty-six patients with tetralogy of Fallot and pulmonary atresia, and ages ranging from 20 days to 4 years, underwent cineangiocardiographic study with contrast medium injections in the following vascular structures: 1 wedged pulmonary vein; 2 aortopulmonary collaterals; 3 thoracic aorta; and 4 ductus arteriosus or systemic-pulmonary shunt. RESULTS: In the 56 patients studied, pulmonary blood was supplied as follows: in 15, by aortopulmonary collaterals; in 36, only by the ductus arteriosus; and in 5, by the ductus

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

    Science.gov (United States)

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

    2016-06-01

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

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

    OpenAIRE

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

    2015-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

  8. Doppler findings in a rare Coronary Artery Fistula

    OpenAIRE

    Jorns Carl; Jung Christian; Huhta James

    2007-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1981-08-01

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

  10. Urethral fistula following circumcision: salvaged by buccal mucosa graft urethroplasty

    OpenAIRE

    Sinha, Rahul Janak; Dalela, Divakar; S N Sankhwar; Singh, Vishwajeet

    2009-01-01

    Fistula following circumcision and at times accompanied by disfigurement of the glans penis is a common problem in our country, where a large number of circumcision is performed by untrained professionals. These complications may have profound negative psychological impact on the growing child. Herein, we report the successful closure of such fistula using buccal mucosa, which occurred following circumcision (for phimosis) in a 15 year old boy. This resulted in the disfigurement of the glans ...

  11. Absence and reliance : Liberian women's experience of vaginal fistula

    OpenAIRE

    Söderbäck, Maja; Wilhelmsson, Emma; Häggström-Nordin, Elisabet

    2012-01-01

    Childbirth entails considerable risk in developing countries. A prolonged labour process can cause the woman sustained injuries and lead to the death of the unborn child. Many women in Africa suffer from vaginal fistulas, causing a constant leakage of urine and/or faeces. The aim of this study was to explore and describe women's experiences of living with fistulas and how the condition affects their daily life. An ethnographic-inspired design involving observation, group- and individual conve...

  12. Closure of a nonhealing gastrocutaneous fistula using an endoscopic clip.

    Science.gov (United States)

    Siddiqui, Ali A; Kowalski, Thomas; Cohen, Sidney

    2007-01-01

    Gastrocutaneous fistula after gastrostomy tube removal may persist for a prolonged period. We present a case of a 58-year-old woman with a GCF that had persisted for 5 months following the removal of an endoscopically-placed gastrostomy tube (PEG). Conservative therapy with anti-acid medications and administering motility agents was unsuccessful. For the closure of the GCF, the endoscopic metal clips were used to close the fistula. PMID:17269533

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

    OpenAIRE

    Badrasawi, Manal; Shahar, Suzana; Sagap, Ismail

    2015-01-01

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

  14. 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....

  15. Portobiliary fistula: successful transcatheter treatment with embolisation coils

    OpenAIRE

    Chanyaputhipong, Jendana; Lo, Richard Hoau Gong; Tan, Bien Soo; Chow, Pierce Kah Hoe

    2014-01-01

    Although portobiliary fistula is a recognised complication of percutaneous transhepatic biliary drainage, it is extremely uncommon and can result in haemobilia. Herein, we present a case of complicated transhepatic biliary drainage catheter insertion in a patient with underlying hepatitis B liver cirrhosis, which resulted in a portobiliary fistula. The patient had a preoperative transhepatic biliary drainage procedure done prior to a Whipple’s operation for a large, obstructive, gastrointesti...

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

    Directory of Open Access Journals (Sweden)

    N. Danila

    2005-07-01

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

  17. A Young Boy with Coronary Cameral Fistula

    Directory of Open Access Journals (Sweden)

    Mohammad Arifur Rahman

    2015-09-01

    Full Text Available Abstract: Coronary-Cameral Fistula (CCF is an anomalous connection between a coronary artery and cardiac chamber. Most CCFs are discovered incidentally during angiographic evaluation for coronary vascular disorder. Here, we report a 16-year-old boy with exertional breathlessness for 3 years. There was a continuous murmur at the right para sternal border in the 4th and 5th intercostal space. Echocardiography showed Right Ventricular Hypertrophy (RVH with strain pattern. Besides, transthoracic echocardiography demonstrated a normally functioning left ventricle, but dilated right atrium and ventricle. The right ventricle also showed hypertrophy and trabeculation. Coronary angiography demonstrated a direct connection between the right ventricular cavity and the right epicardial coronary artery. However, the left coronary arterial system was normal. The patient was treated by ligation of the fistulous connection by off-pump surgery.

  18. Multiple Intracranial Arteriovenous Fistulas in Cowden Syndrome.

    Science.gov (United States)

    Prats-Sánchez, Luis A; Hervás-García, Jose V; Becerra, Juan L; Lozano, Manuel; Castaño, Carlos; Munuera, Josep; Escudero, Domingo; García-Esperón, Carlos

    2016-06-01

    Cowden syndrome is a rare autosomal dominant disease. It is characterized by multiple noncancerous tumorlike growths called hamartomas, which typically are found in the skin, oral mucosa, thyroid, breast, and gastrointestinal tract. It carries with it a potential risk of malignant transformation, especially of the breast and thyroid. In 80% of the cases, the human tumor suppressor gene, phosphatase and tensin homolog (PTEN), is mutated in the germ line. We report a patient with Cowden syndrome who presented with generalized seizure and left anterior temporal hemorrhage and a nontraumatic subarachnoid hemorrhage due to multiple intracranial arteriovenous fistulas (AVFs). We discuss previous reports about vascular malformations in patients with Cowden syndrome and PTEN mutations. Importantly, we hypothesize that the production of multiple AVFs in our patient was associated with PTEN mutation. PMID:27105569

  19. Recurrent perimedullary arteriovenous fistula at thoracic level

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

  20. Delayed Nephropleural Fistula After Percutaneous Nephrolithotomy.

    Science.gov (United States)

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

    2016-01-01

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

  1. Oronasal fistula in cleft palate surgery

    Directory of Open Access Journals (Sweden)

    Sadhu Partha

    2009-10-01

    Full Text Available Oronasal fistula (ONF is the commonest complication associated with cleft palate surgery. The main symptoms associated with ONF are nasal regurgitation of food matter and hypernasality of voice. Repair of cleft palate under tension is considered to be the main reason of ONF though vascular accidents and infection can also be the cause. Most of the ONFs are situated in the hard palate or at the junction of hard and soft palate. Repair of ONF depends on its site, size and mode of presentation. A whole spectrum of surgical procedures starting from small local flaps to microvascular tissue transfers have been employed for closure of ONF. Recurrence rate of ONF is 25% on an average after the first attempt of repair.

  2. Inoperable aggressive mesenteric fibromatosis with ureteric fistula

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    Unosawa, Satoshi; Kimura, Haruka; Niino, Tetsuya

    2013-01-01

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

  4. Carotid Cavernous Fistula Associated with Persistent Trigeminal Artery

    Science.gov (United States)

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

    1998-01-01

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

  5. Palliative Endoscopic Therapy for Cancer Patients with Esophageal Fistula

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

  6. Combined endovascular and surgical treatment in vertebral arteriovenous fistula

    International Nuclear Information System (INIS)

    A 7-year-old girl with a right-sided congenital arteriovenous fistula in the neck was admitted with signs of cardial incompensation. Her fistula was fed from the right vertebral artery in antegrade as well as retrograde directions. A steal from the intracranial arteries was established. In addition, smaller feeding arteries from the neck were found. She was operated on with ligation of the right vertebral artery proximal to the fistula but the attempted ligation of the artery cranially to the fistula was unsuccessful. She was therefore embolized by the formation of a plug of platinum fiber coils in the upper right vertebral artery. Catheterization was performed from the left vertebral artery via the basilar artery. Persisting minor feeders to the fistula from cervical arteries were embolized in a second session. Finally, surgical extirpation of the fistula was performed together with the operative ligation of a crossover feeding artery from the left vertebral artery. Her heart size, heart rate and blood pressure were successively normalized. (orig.)

  7. Elevated Shear Stress in Arteriovenous Fistulae: Is There Mechanical Homeostasis?

    Science.gov (United States)

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

    2011-11-01

    Arteriovenous fistulae are created surgically to provide access for dialysis in patients with renal failure. The current hypothesis is that the rapid remodeling occurring after the fistula creation is in part a process to restore the mechanical stresses to some preferred level (i.e. mechanical homeostasis). Given that nearly 50% of fistulae require an intervention after one year, understanding the altered hemodynamic stress is important in improving clinical outcomes. We perform numerical simulations of four patient-specific models of functioning fistulae reconstructed from 3D Doppler ultrasound scans. Our results show that the vessels are subjected to `normal' shear stresses away from the anastomosis; about 1 Pa in the veins and about 2.5 Pa in the arteries. However, simulations show that part of the anastomoses are consistently subjected to very high shear stress (>10Pa) over the cardiac cycle. These elevated values shear stresses are caused by the transitional flows at the anastomoses including flow separation and quasiperiodic vortex shedding. This suggests that the remodeling process lowers shear stress in the fistula but that it is limited as evidenced by the elevated shear at the anastomoses. This constant insult on the arterialized venous wall may explain the process of late fistula failure in which the dialysis access become occluded after years of use. Supported by an R21 Grant from NIDDK (DK081823).

  8. Frequency of oronasal fistulae in complete cleft palate repair

    International Nuclear Information System (INIS)

    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)

  9. Primary aortoduodenal fistula after radiotherapy. Report of a case

    Energy Technology Data Exchange (ETDEWEB)

    Oshima, Takeshi; Inoue, Hitoshi; Oshima, Akira; Minami, Tomohito; Matsumine, Takao [Tokyo Metropolitan Fuchu Hospital (Japan)

    1999-10-01

    Aortoduodenal fistula is a rare and life-threatening cause of gastrointestinal hemorrhage. The patient was a 44-year-old woman who repeated intermittent hematemesis and melena after hysterectomy, para-aortic lymph node dissection, and subsequent radiotherapy. Angiography revealed no bleeding point. Upper gastrointestinal endoscopy showed an ulcer at the third portion of the duodenum. Emergency laparotomy revealed an aortoduodenal fistula which was inferred to be caused by radiotherapy because no recurrence of malignancy was detected. After the fistula was closed, the patient repeated hematemesis and anal bleeding. She died of acute hemorrhagic shock, in spite of three operations including axillo-femoral bypass. We propose that radiation might have played a role in the pathogenesis of the aortoduodenal fistula in our case. The new case of primary aortoduodenal fistula following radiotherapy is added to four cases previously reported in the literature. Six cases in which the lesion of the duodenum could be demonstrated by endoscopy, have been reported in Japan. Aortoduodenal fistula should be considered as a probable diagnosis in patients presenting massive gastrointestinal hemorrhage after radiotherapy. Rapid surgical treatments are needed, and operative procedures to be considered include resection of the aorta with aortic stump closure and axillo-femoral bypass. (author)

  10. Temporal and topographic changes in DNA synthesis after induced follicular atresia

    International Nuclear Information System (INIS)

    Hamsters were hypophysectomized on the morning of estrus (Day 1) and injected immediately with 30 IU pregnant mare's serum (PMS). This was followed on Day 4 by the injection of an antiserum to PMS (PMS-AS) that initiated follicular atresia (Time zero). From 0 to 72 h after PMS-AS, the animals were injected with [3H]thymidine and killed 4 h later. One ovary was saved for autoradiography and histology; from the other ovary, 5-10 large antral follicles were dissected and pooled, and incorporation into DNA was determined by scintillation counting. DNA synthesis dropped sharply between 12 and 18 h, coinciding with a fall in labeling index of the cumulus oophorus and thecal endothelial cells and a sharp fall in thecal vascularity. In contrast, for the mural granulosa cells bordering on the antral cavity, labeling index dropped sharply between 8 and 12 h when thecal vascularity was still high. The earliest sign of atresia was evident by 4 h in cumulus cells when, paradoxically, DNA synthesis was still high. It took 3 days for atresia of the antral follicles to progress to advanced stages, as evidenced by pseudo-pronuclei in the free floating ovum, further erosion of the mural granulosa, and minimal DNA/follicle. However, the theca still retained its histological integrity and contained no pyknotic cells. Although by 48 h the granulosal compartment was in disarray (DNA/follicle significantly different from earlier values), the egg was still viable, as judged by maximal fluorescence after the addition of fluoroscein diacetate

  11. Pulmonary ventilation and perfusion abnormalities and ventilation perfusion imbalance in children with pulmonary atresia or extreme tetralogy of Fallot

    International Nuclear Information System (INIS)

    Xenon-133 lung ventilation and perfusion scans were done preoperatively after cardiac catheterization and cineangiocardiography in 19 children; 6 had pulmonary atresia with an intact ventricular septum and hypoplastic right ventricle, 4 pulmonary atresia with associated complex univentricular heart, and 9 extreme Tetralogy of Fallot. The four patients with discrepancies in the sizes of the left and right pulmonary arteries on angiography had marked asymmetry of pulmonary perfusion and ventilation-perfusion imbalance on scintigraphy. Similar degrees of asymmetry and imbalance were present in 6 of the 15 children with equal-size pulmonary vessels. Asymmetry of pulmonary perfusion and ventilation-perfusion imbalance were associated with a poor prognosis

  12. Successful Treatment of Multiple Jejuno-Ileal Atresia by Four Primary Anastomosis and Trans Anastomotic Silastic Stents

    Directory of Open Access Journals (Sweden)

    N Hyseni

    2009-07-01

    Full Text Available A case of multiple intestinal atresia is described. Dilatation of the bowel was observed at 19 weeks’gestation during routine ultrasound scan. Regular scans were performed throughout the pregnancy and asimple bowel obstruction was suspected. The baby was delivered at 40 weeks’ gestation in good condition.The infant had feeding intolerance caused by small bowel obstruction but abdominal distension developedduring the first day. At laparotomy, multiple intestinal atresia were found. The interpretation of successfultraetmeent of multiple jejuno-ileal atersia and transanastomotic silastic stents are discussed.

  13. Pulmonary ventilation and perfusion abnormalities and ventilation perfusion imbalance in children with pulmonary atresia or extreme tetralogy of Fallot

    Energy Technology Data Exchange (ETDEWEB)

    Dowdle, S.C.; Human, D.G.; Mann, M.D. (Univ. of Cape Town (South Africa))

    1990-08-01

    Xenon-133 lung ventilation and perfusion scans were done preoperatively after cardiac catheterization and cineangiocardiography in 19 children; 6 had pulmonary atresia with an intact ventricular septum and hypoplastic right ventricle, 4 pulmonary atresia with associated complex univentricular heart, and 9 extreme Tetralogy of Fallot. The four patients with discrepancies in the sizes of the left and right pulmonary arteries on angiography had marked asymmetry of pulmonary perfusion and ventilation-perfusion imbalance on scintigraphy. Similar degrees of asymmetry and imbalance were present in 6 of the 15 children with equal-size pulmonary vessels. Asymmetry of pulmonary perfusion and ventilation-perfusion imbalance were associated with a poor prognosis.

  14. Congenital pouch colon in a girl associated with bilateral atresia of cervix uteri and uterus didelphys

    Directory of Open Access Journals (Sweden)

    Rajiv Chadha

    2013-01-01

    Full Text Available This report describes a girl with congenital pouch colon (CPC, uterus didelphys with septate vagina, and a cloacal anomaly. The girl underwent cloacal reconstruction at the age of 15 months. Subsequently, at puberty, the child had primary amenorrhea with severe cyclic abdominal pain due to endometriosis of both the uteruses and adnexal cysts with hematometra and hematosalpinx. Laparotomy with removal of both uteri and the left fallopian tube was performed. Both uteri had atresia of the cervix uteri. This report emphasizes the need for comprehensive evaluation and a long-term management strategy for associated gynecologic anomalies in girls with CPC, especially with regard to patency of the outflow tract.

  15. Pulmonary atresia with intact ventricular septum and hypoplastic right ventricle in an Arabian foal.

    Science.gov (United States)

    Krüger, M U; Wünschmann, A; Ward, C; Stauthammer, C D

    2016-09-01

    Pulmonary atresia with intact ventricular septum, rudimentary tricuspid valve, hypoplastic right ventricle, and right-to-left atrial shunting were identified in a four-day-old, male Arabian foal with clinical signs of cyanotic heart disease. Pulmonary blood flow was apparently derived from a ductus arteriosus. Echocardiographic evaluation revealed the majority of cardiac abnormalities and also findings compatible with right-sided congestive heart failure. Congenital cardiac defects have a high incidence in this breed, and this is the first description of this combination of congenital cardiac defects. PMID:27283083

  16. Distribution of Interstitial Cells of Cajal in the Esophagus of Fetal Rats with Esophageal Atresia

    OpenAIRE

    Caner Isbir

    2016-01-01

    Aim: Scarcity of the interstitial cells of Cajal (ICC) is related to motility disorders. In the study, we aimed to evaluate the number and density of ICCs in the fetal rat esophagus in the adriamycin - esophageal atresia (EA) model. Material and Method: Rat fetuses were divided into three groups as a control, adriamycin group without EA and adriamycin group with EA. Four doses of adriamycin, 2 mg/kg each, were injected intraperitoneally to the adriamycin group rats between on 6 and 9 days of ...

  17. Extrahepatic biliary atresia with choledochal cyst: Prenatal MRI predicted and post natally confirmed: A case report

    Directory of Open Access Journals (Sweden)

    Madhavi Nori

    2013-01-01

    Full Text Available Extrahepatic biliary atresia (EHBA is an uncommon cause of neonatal jaundice. Antenatal Magnetic Resonance Imaging (MRI diagnosis of EHBA has not been published to the best of our knowledge till date. EHBA with cystic component is likely to be mistaken for choledochal cyst. A case that was antenatally predicted and postnatally confirmed by surgery and histopathology is being reported. All imaging signs are analyzed herewith. Imaging helps in the prediction of EHBA and also helps in early postnatal surgical referral which in turn improves the results of Kasai′s portoenterostomy.

  18. Extrahepatic biliary atresia with choledochal cyst: Prenatal MRI predicted and post natally confirmed: A case report.

    Science.gov (United States)

    Nori, Madhavi; Venkateshwarlu, J; Vijaysekhar; Prasad, G Raghavendra

    2013-07-01

    Extrahepatic biliary atresia (EHBA) is an uncommon cause of neonatal jaundice. Antenatal Magnetic Resonance Imaging (MRI) diagnosis of EHBA has not been published to the best of our knowledge till date. EHBA with cystic component is likely to be mistaken for choledochal cyst. A case that was antenatally predicted and postnatally confirmed by surgery and histopathology is being reported. All imaging signs are analyzed herewith. Imaging helps in the prediction of EHBA and also helps in early postnatal surgical referral which in turn improves the results of Kasai's portoenterostomy. PMID:24347854

  19. Case report: Isolated unilateral pulmonary vein atresia diagnosed on 128-slice multidetector CT

    Directory of Open Access Journals (Sweden)

    Rashmi Dixit

    2011-01-01

    Full Text Available Unilateral pulmonary venous atresia is an uncommon entity that is generally believed to be congenital. Most patients present in infancy or childhood with recurrent chest infections or hemoptysis. Pulmonary angiography is usually used for definitive diagnosis. However, the current multislice CT scanners may obviate the need for pulmonary angiography. We report two cases diagnosed using 128-slice CT angiography. On the CT angiography images both these cases demonstrated absent pulmonary veins on the affected side, with a small pulmonary artery and prominent bronchial or other systemic arterial supply.

  20. Jejunoileal Atresia: Factors Affecting the Outcome and Long-term Sequelae

    OpenAIRE

    Calisti, Alessandro; Olivieri, Claudio; Coletta, Riccardo; Briganti, Vito; Oriolo, Lucia; Giannino, Giuseppina

    2012-01-01

    Context: Jejunoileal atresia (JIA) is a common abnormality. The outcome is conditioned by several variables. Nutritional problems, and long-term sequelae are described among those who survive. Aim: To correlate the type of JIA and its management to the outcome and long-term quality of life. Settings and Design: Forty-three cases over a 17-year period (1992–2009). Perinatal data, management, and outcome were extracted from the clinical notes. The cases that had survived were contacted to get i...

  1. Congenital pouch colon in a girl associated with bilateral atresia of cervix uteri and uterus didelphys.

    Science.gov (United States)

    Chadha, Rajiv; Puri, Manju; Saxena, Rahul; Agarwala, Surendrakumar; Puri, Archana; Choudhury, Subhasis Roy

    2013-04-01

    This report describes a girl with congenital pouch colon (CPC), uterus didelphys with septate vagina, and a cloacal anomaly. The girl underwent cloacal reconstruction at the age of 15 months. Subsequently, at puberty, the child had primary amenorrhea with severe cyclic abdominal pain due to endometriosis of both the uteruses and adnexal cysts with hematometra and hematosalpinx. Laparotomy with removal of both uteri and the left fallopian tube was performed. Both uteri had atresia of the cervix uteri. This report emphasizes the need for comprehensive evaluation and a long-term management strategy for associated gynecologic anomalies in girls with CPC, especially with regard to patency of the outflow tract. PMID:23798813

  2. Laryngo-tracheo-oesophageal clefts

    Directory of Open Access Journals (Sweden)

    Leboulanger Nicolas

    2011-12-01

    Full Text Available Abstract A laryngo-tracheo-esophageal cleft (LC is a congenital malformation characterized by an abnormal, posterior, sagittal communication between the larynx and the pharynx, possibly extending downward between the trachea and the esophagus. The estimated annual incidence of LC is 1/10,000 to 1/20,000 live births, accounting for 0.2% to 1.5% of congenital malformations of the larynx. These incidence rates may however be underestimated due to difficulty in diagnosing minor forms and a high mortality rate in severe forms. A slightly higher incidence has been reported in boys than in girls. No specific geographic distribution has been found. Depending on the severity of the malformation, patients may present with stridor, hoarse cry, swallowing difficulties, aspirations, cough, dyspnea and cyanosis through to early respiratory distress. Five types of laryngo-tracheo-esophageal cleft have been described based on the downward extension of the cleft, which typically correlates with the severity of symptoms: Type 0 laryngo-tracheo-esophageal cleft to Type 4 laryngo-tracheo-esophageal cleft. LC is often associated with other congenital abnormalities/anomalies (16% to 68%, mainly involving the gastro-intestinal tract, which include laryngomalacia, tracheo-bronchial dyskinesia, tracheo-bronchomalacia (mostly in types 3 and 4, and gastro-esophageal reflux disease (GERD. The syndromes most frequently associated with an LC are Opitz/BBB syndrome, Pallister Hall syndrome, VACTERL/VATER association, and CHARGE syndrome. Laryngeal clefts result from failure of fusion of the posterior cricoid lamina and abnormal development of the tracheo-esophageal septum. The causes of the embryological developmental anomalies leading to LC are not known but are thought to be multifactorial. LC appears to be mostly sporadic although some familial cases with suspected autosomal dominant transmission have been reported. The age of diagnosis depends mainly on the severity of

  3. Associação de agenesia sacrococcígea e atresia anal em gato sem raça definida Sacrococcygeal agenesis association and anal atresia in mixed breed cats

    Directory of Open Access Journals (Sweden)

    Felipe Purcell de Araújo

    2009-09-01

    Full Text Available O presente trabalho teve como objetivo descrever o caso de um felino, que desde o nascimento apresentou atresia anal, ausência de cauda e malformação dos membros pélvicos. Ao exame radiográfico, pôde-se observar presença de agenesia da sétima vértebra lombar, sacro e vértebras coccígeas, espinha bífida, meningocele, hiperflexão dos joelhos e desvio valgo dos tarsos, diagnosticando-se agenesia sacrococcígea associada à atresia anal.This paper has the objective to report a case of a cat that since birth had anal atresia, absence of tail and malformation of the pelvic member. The radiographic examination revealed agenesis of the seventh lumbar vertebra, sacral and coccygeal vertebrae, spina bifida, meningocele, hyperflexion of the knees and tarsal valgus deviation, diagnosing sacrococcygeal agenesis associated with anal atresia.

  4. A case of gastrocolic fistula secondary to adenocarcinoma of the colon

    Directory of Open Access Journals (Sweden)

    BiaoHuan Zhou

    2015-01-01

    Conclusion: It is rare for gastrocolic fistula case to be caused by colon adenocarcinoma, and has been rarely reported inside China. The best therapy of gastrocolic fistula remains radical en-bloc surgery.

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

    International Nuclear Information System (INIS)

    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

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

    Institute of Scientific and Technical Information of China (English)

    王慧晓; 白如林; 黄承光; 卢亦成; 张光霁

    2004-01-01

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

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

    Science.gov (United States)

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

    2009-10-01

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

  8. Atresia anal en perros y gatos: conceptos actuales a partir de tres casos clínicos Anal atresia in dogs and cats: the scope from three clinical cases

    Directory of Open Access Journals (Sweden)

    EM García-González

    2012-01-01

    Full Text Available La atresia anal se define como la falta de comunicación del recto y el perineo a través del ano, siendo esta la malformación anorrectal reportada con mayor frecuencia en el perro y el gato. Está asociada a alteraciones en la diferenciación de la cloaca en el embrión en desarrollo; sin embargo los mecanismos fisiopatológicos involucrados hasta el momento no han sido completamente esclarecidos. En el presente documento se expone la experiencia en el diagnóstico y manejo de tres pacientes (dos perros y un gato con atresia anal, presentamos los resultados del análisis de la frecuencia de esta patología en nuestro centro hospitalario, realizamos una revisión detallada de las teorías de los mecanismos fisiopatológicos involucrados en el desarrollo embrionario y con base en estos criterios, sugerimos la clasificación del tipo de atresia anal más apropiada partiendo del análisis de las propuestas existentes y su relación con los conceptos actuales de la anatomía embriológica.Anal atresia is defined as the lack of a complete communication between rectum and the anus, it is the most common anorectal malformation and has been observed mainly in dogs. It has been associated to alterations of anogenital differentiation of the cloaca in the embryo, however, the exact mechanisms remain unclear. Different criteria have been proposed in the literature to classify anal atresia. This study shows the diagnosis, treatment and outcome of three cases (two dogs and one cat with anal atresia. The frequency of this malformation in our hospital is reported as well as a discussion of the theories of the processes involved in the development of anal atresia, and a revised classification for this pathology according to embryo anatomy and development is proposed.

  9. Treatment of colon conduit redundancy in a child with esophageal atresia.

    Science.gov (United States)

    Glasser, James G; Reddy, P Prithvi; Adkins, E Stanton

    2006-03-01

    We recently revised a redundant colon conduit in a boy who was born with isolated esophageal atresia. In view of the paucity of reports dealing with correction of this common complication of esophageal replacement, it seemed appropriate to report our experience. Because of effective medical therapy of acid peptic disease, patients who formerly required conduit replacement may now be candidates for revision; however, the medical literature does not specify when conduit revision, as opposed to conduit replacement, is indicated; also, no guidance is provided regarding what constitutes effective operative revision. Innovative techniques that stretch and elongate the atretic esophagus will likely lessen the use of conduits in esophageal atresia; nevertheless, colon conduits are useful in many other clinical situations and will remain an essential part of the armamentarium of pediatric, general, and thoracic surgeons. This report highlights the DeMeester and Tannuri technique, whereby a colon conduit is prepared like a Roux limb. The mesentery is divided only once; the conduit's blood supply is not severed from the distal mesocolon. This innovation improves a conduit's blood supply and lessens its attendant complications. Lastly, we describe a muscle splitting, posterolateral thoracotomy technique that is simpler than the alternatives and is useful in a variety of clinical situations. PMID:16553129

  10. Respiratory Distress Secondary to Rhabdomyosarcoma of the Tongue and Co-existent Choanal Atresia.

    Science.gov (United States)

    Chatopadhayay, Rahul; Tiwari, Preeti; Gangopadhyay, A N; Pandey, Vaibhav

    2016-07-01

    Whilst rhabdomyosarcoma (RMS) is the third most common solid tumour in children, congenital RMS of the tongue is extremely rare and usually present as painless progressive mass since birth (Dagher and Helman in Oncologist 4:34-44, 1999; Childs and Goudy in Int J Pediatr Otorhinolaryngol 5:126-128, 2010). In neonates, presentation with respiratory distress is unexpected as neonates are preferential nasal breathers and restricted oral breathing due to tumour usually poses no problem. We herein report a case of rhabdomyosarcoma of the tongue with co-existent unilateral choanal atresia, presenting with respiratory distress. The baby developed upper respiratory tract infection following which developed severe respiratory distress. Airway symptoms were precipitated as there was combined obstruction of both the nostrils due to infection or adenoid enlargement and unilateral chonal atresia. Treatment of respiratory distress in the presence of RMS and bilateral nasal pathology must first prioritise the security of the airway, before taking a multi-factorial approach to the therapy of the lingual mass (Childs and Goudy in Int J Pediatr Otorhinolaryngol 5:126-128, 2010). This case illustrates the importance of vigilance with respect to co-existent nasal pathology, in order to avoid the occurrence of complete airway obstruction. We therefore feel that any diagnosis of lingual RMS should warrant a formal examination of both nasal cavities. PMID:27408448

  11. Tumour necrosis factor-alpha gene polymorphisms in Iranian patients with biliary atresia

    Directory of Open Access Journals (Sweden)

    Nikou Fotouhi

    2014-01-01

    Full Text Available Background: Biliary atresia (BA is a progressive inflammatory destructive process of the bile ducts. This study evaluated the relationship between single-nucleotide polymorphisms in the promoter region of tumour necrosis factor-alpha (TNF-α gene and bilaiary atresia. Materials and Methods: Genomic deoxyribonucleic acid from 16 patients with established diagnosis of BA and 36 patients with INC was obtained. The genotypes of TNF-α-1031 (T/C and TNF-α-308 (G/A were determined using the restriction fragment length polymorphism-polymerase chain reaction and the results were analysis with proper statistic software. Results: The frequencies of T/T, T/C in TNF-α-1031 and G/G, G/A in TNF-α-308 were as same as control group. Moreover, we have same deduction for allele frequency and haplotypes analysis (T allele: 84.37%; G allele: 87.5% in BA patients (T allele: 80.56%; G allele: 86.11% in controls. In all cases variants of polymorphism did not affect the severity or incidence of BA disease. Conclusion: although no significant associations were found between BA and control groups, it seems meaningful that since the nature of BA is multi factorial. Next step will be considering a new target such as downstream modulation of the TNF-α pathway or other cytokines and chemokines which act directly/indirectly.

  12. Karyotype analysis of a male exhibiting Meckel's diverticulum and aural atresia

    Energy Technology Data Exchange (ETDEWEB)

    Frizzell, B.; Hicks, M.F. (David Lipscomb Univ., Nashville, TN (United States))

    Patau's Syndrome is caused by inheritance of an extra chromosome 13. It is characterized primarily by severe mental retardation, cleft palate, and retarded growth. Most fetuses expressing Patau's Syndrome spontaneously abort, and those that are born usually die before one year. Both Meckel's diverticulum and aural atresia are defects found in patients with Patau's at levels higher than those in the general population. An otherwise asymptomatic male expressing only Meckel's diverticulum and aural atresia has a female sibling whose son expressed Patau's syndrome. Twenty percent of patients with Patau's show a translocation of part of chromosome 13 to another D chromosome. If a translocation were the cause of the expression of Patau's in this family, it is possible that the normal male inherited a balanced translocation and the Patau's male received an unbalanced translocation. A karyotype analysis of the non-Patau's male was done to determine if such a translocation were present.

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

    Directory of Open Access Journals (Sweden)

    Ashrarur Rahman Mitul

    2012-07-01

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

  14. 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.

  15. Characteristics of obstetric fistulas and the need for a prognostic classification system

    OpenAIRE

    Karateke, Ates; Cam, Cetin; Ozdemir, Arman; Guney, Buhara; Vatansever, Dogan; Celik, Cem

    2010-01-01

    Introduction To evaluate the need for a prognostic classification system for obstetric fistula (OF) with the data obtained by a voluntarily action for OF repair in a regional hospital and Niger, Africa. Material and methods Obstetric fistula (OF) characteristics of 51 women with vesicovaginal fistula in a fistula campaign in Maradi Regional Hospital, Niger were evaluated. Initial basic gynecological examination, methylene blue (MBT) test and direct cystoscopy were used to describe the charact...

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

    OpenAIRE

    Suresh Jungari; Bal Govind Chauhan

    2015-01-01

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

  17. Color Doppler findings of post-biopsy arteriovenous fistula in renal transplant

    OpenAIRE

    Shaheen, F.; Hakeem, A.; Singh, M.; Gojwari, T; Shafi, H.; Wani, M.; Rasool, S

    2008-01-01

    Post biopsy arterio-venous fistula in renal transplant range in incidence from 15-16%. Spontaneous resolution of 75% A-V fistulas is seen within four weeks. We report a patient with post biopsy arterio-venous fistula who had developed unexplained hypertension with no definite feature of rejection on biopsy. Doppler application revealed an arterio-venous fistula which showed spontaneous resolution in six weeks.

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

    OpenAIRE

    Amin Rahpeyma; Saeedeh Khajehahmadi

    2015-01-01

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

  19. 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...

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

    OpenAIRE

    Mustafa Rasid Toksoz; Ramazan Kocaaslan; Furkan Erol Karabekmez

    2014-01-01

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

  1. 131I rose bengal hepatography and sequential liver scintigraphy in the differential diagnosis between congenital biliary atresia and infantile hepatitis

    International Nuclear Information System (INIS)

    For the purpose of the differentiation between congenital biliary atresia and infantile hepatitis, 30 hepatographies and 140 sequential liver scintigraphies with 131I rose bengal were performed. In 140 cases of sequential liver scintigraphies (72 with congenital biliary atresia and 68 with infantile hepatitis) scintigraphies were usually obtained at 30 minutes, 5 hours and 48 hours after the injection of 131I rose bengal, and the criteria used for the diagnosis of congenital biliary atresia were 1) visualization of the kidney, 2) no detectable radioactivity in the intestine, 3) prolonged retention of the 131I rose bengal on the liver scintigram. Several sup(99m)Tc labeled hepatobiliary agents, for example sup(99m)Tc FPI, sup(99m)Tc HIDA and sup(99m)Tc EHIDA, were tried to use for the infants with jaundice to compare with 131I rose bengal. As the result, it is conceivable that the sequential liver scintigraphies with 131I rose bengal were the most suitable method for the diagnosis of congenital biliary atresia, and the criteria described above were available for the decision of indication for surgery. (author)

  2. Rectal atresia and anal stenosis: the difference in the operative technique for these two distinct congenital anorectal malformations.

    Science.gov (United States)

    Lane, V A; Wood, R J; Reck, C; Skerritt, C; Levitt, M A

    2016-04-01

    Rectal atresia and anal stenosis are rare forms of anorectal malformations. The aim of the definitive surgical repair in such cases is to preserve the anal canal, the dentate line, and the sphincter complex. We present a case of rectal atresia and anal stenosis to demonstrate the differences in the operative repair. The techniques described leave the anterior wall of the very distal anal canal untouched in both rectal stenosis and anal atresia; however, the dissection of the rectum differs. The atretic rectum in rectal atresia is mobilized and sutured to the anal canal circumferentially. In anal stenosis, the posterior rectum is mobilized in the form of rectal advancement, and the posterior 180° is anastomosed directly to the skin (as in a standard PSARP) with preservation of the anal canal as the anterior 180° of the final anoplasty. These patients have an excellent prognosis for bowel control and fecal continence, and therefore, complete mobilization and resection of the anal canal must be avoided. PMID:26902368

  3. Atresia duodenal asociada a invaginación intestinal secundaria a divertículo de meckel en un lactante de tres meses

    OpenAIRE

    Rubén Martín Alvarez-Solís; Fredy Chablé-Montero; Marcela Vargas-Vallejo; David Bulnes Mendizábal; Armando Quero-Hernández; José Cabrera-Aguirre

    2006-01-01

    La asociación entre atresia duodenal e invaginación intestinal no se ha reportado en la literatura. Presentamos las características clínicas y quirúrgicas de un paciente masculino de tres meses de edad que presenta atresia duodenal asociada a invaginación intestinal secundaria a un divertículo de Meckel perforado e invertido. Dentro de las causas de vómitos en lactantes se incluyen las atresias intestinales. Aunque es raro se han reportado casos en otras edades pediátricas. La invaginación in...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Sang Don Lee

    2011-01-01

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

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

    OpenAIRE

    Sang Don Lee; Tae Nam Kim; Hong Koo Ha

    2011-01-01

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

  7. Extracranial vertebral arteriovenous fistula presenting as an osteolytic lesion of the axis. Case report.

    OpenAIRE

    Shin, S. H.; Chung, C.K.; Kim, H. J.; Han, M.H.; Han, D. H.

    1996-01-01

    Arteriovenous fistulas of the extracranial vertebral artery are rare. The authors report a case of a spontaneous arteriovenous fistula of the extracranial vertebral artery presenting as an osteolytic lesion at the body of the axis. The patient presented with headache and posterior neck pain. The fistula was obliterated by an endovascular trapping.

  8. Successful operation on a coronary arteriovenous fistula in a 74 year old woman.

    OpenAIRE

    Brack, M. J.; Hubner, P J; Firmin, R K

    1991-01-01

    Coronary arteriovenous fistulas are rare and are usually diagnosed in children or young adults. Most are believed to be congenital. A right coronary arteriovenous fistula was first diagnosed in a patient of 74. Despite her age the fistula was successfully operated on and her symptoms were relieved.

  9. Diagnosis and morphological classification of pulmonary arteriovenous fistula by sup(99m)Tc MAA

    International Nuclear Information System (INIS)

    Pulmonary A-V fistula was diagnosed and classified morphologically based on the pattern of time-activity curves by sup(99m)Tc MAA. If the diameter of the fistula is large, macro-albumin easily reveals a shunt. If the fistula has the form of an ''aneurysm,'' the degree of shunt is generally slight. (author)

  10. Congenital Circumflex Coronary Arteriovenous Fistula with Aneurysmal Termination in the Pulmonary Artery

    OpenAIRE

    Darwazah, Ahmad K.; Hussein, Izzedein H.; Hawari, Mohammad H.

    2005-01-01

    Coronary arteriovenous fistula is a rare congenital anomaly that is seen in 0.1% to 0.2% of coronary angiograms. Aneurysmal formation in the fistula is even rarer. We report a case of congenital circumflex arteriovenous fistula with aneurysmal formation just near its termination in the pulmonary artery, associated with atherosclerotic left anterior descending coronary artery. The anomaly was successfully repaired.

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

    International Nuclear Information System (INIS)

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

  12. Spontaneous vertebro-vertebral arterio-venous fistula associated with fibro-muscular dysplasia

    International Nuclear Information System (INIS)

    Extracranial vertebral arteriovenous fistulae of non traumatic origin are extremly rare. The authors report two cases of spontaneous vertebro-vertebral arteriovenous fistulae associated with fibromuscular dysplasia. They discuss the relation-ship between arteriovenous fistulae and fibro-muscular dysplasia, and the specific problems of treatment in these two cases. (orig.)

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

    OpenAIRE

    Rizal Rivandi

    2015-01-01

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  15. Spontaneous extrusion of staghorn renal calculus with nephrocutaneous fistula in a child.

    Science.gov (United States)

    Purkait, Bimalesh; Sinha, Rahul Janak; Bansal, Ankur; Singh, Vishwajeet

    2016-01-01

    Renal stone disease may present as nephrocutaneous fistula. Spontaneous extrusion of renal stone with nephrocutaneous fistula is rare. Most of the cases have been reported in adults. We present a case of nephrocutaneous fistula with spontaneous extrusion of staghorn renal calculus in a paediatric patient. PMID:27068729

  16. Radial Artery Approach to Salvage Nonmaturing Radiocephalic Arteriovenous Fistulas

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-08-01

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

  17. High-resolution MRI for Primary anal fistulas

    International Nuclear Information System (INIS)

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

  18. Risk factors for leukopenia in patients with gastrointestinal fistula

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

  19. 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.

  20. Coronary-cameral fistulas: indications and methods for closure.

    Science.gov (United States)

    Carminati, Mario; Giugno, Luca; Chessa, Massimo; Butera, Gianfranco; Piazza, Luciane; Bussadori, Claudio

    2016-05-17

    Coronary-cameral fistulas (CCF) are anomalous connections between one or more coronary arteries and a cardiac chamber, most commonly the right ventricle or right atrium. The major indications for closure are: significant left to right shunt, myocardial ischaemia, prevention of endoarteritis or rupture. Nowadays, the first option for treatment is transcatheter closure. According to the morphology of the fistulas the most appropriate occluder device should be selected: coils (e.g., Gianturco coils, controlled-release coils, PFM coils), vascular plugs or a patent ductus arteriosus (PDA) device or muscular ventricular septal defect (VSD) device. The way to deploy the occluders could be direct arterial or venous through an arteriovenous loop, according to the anatomy of the fistulas assessed by multiple angiograms in different projections. A test occlusion of the fistula with balloon catheter and simultaneous coronary angiogram is recommended for choosing the proper device type and size and the best position for deployment to achieve complete occlusion of the fistula without compromising the flow in coronary side branches. PMID:27174108

  1. Imaging studies of pyriform sinus fistula

    International Nuclear Information System (INIS)

    Pyriform sinus fistula (PSF) refers to a persistent embryologic third or fourth pharyngeal pouch, which typically presents as a congenital sinus tract that originates from the pyriform sinus. The sinus tract is often diagnosed by a barium study or direct endoscopic inspection. Utilization of advanced imaging studies, including ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI), may aid in the diagnosis of this disease entity. To review the imaging findings of PSF and demonstrate the value of various cross-sectional imaging (US, CT, and MRI) in the diagnosis of PSF. PSF in five children was verified surgically. Preoperative barium esophagography, US, CT, and MRI were performed selectively in these patients. The clinical and imaging findings are reviewed retrospectively. Barium studies demonstrated the sinus tract in all five patients. US, CT, and MRI demonstrated an associated inflammatory process. By utilizing the trumpet maneuver, the presence of sinus tract was evident in two patients during US. The sinus tract is also demonstrated by CT in another patient. Although barium esophagography is advantageous in demonstration of the sinus tract in PSF, US and CT are also capable of showing the sinus tract. The extent of inflammatory process related to PSF is better delineated by US, CT, and MRI. (orig.)

  2. Bacteremia due to Acinetobacter ursingii in infants: Reports of two cases

    Science.gov (United States)

    Yakut, Nurhayat; Kepenekli, Eda Kadayifci; Karaaslan, Ayse; Atici, Serkan; Akkoc, Gulsen; Demir, Sevliya Ocal; Soysal, Ahmet; Bakir, Mustafa

    2016-01-01

    Acinetobacter ursingii is an aerobic, gram-negative, opportunistic microorganism which is rarely isolated among Acinetobacter species. We present two immunocompetent infants who developed bacteremia due to A. ursingii. The first patient is a two -month- old boy who had been hospitalized in pediatric surgery unit for suspected tracheo-esophageal fistula because of recurrent aspiration pneumonia unresponsive to antibiotic therapy. The second patient is a fourteen -month- old boy with prolonged vomiting and diarrhea. A. ursingii was isolated from their blood cultures. They were successfully treated with ampicillin-sulbactam. Although A. ursingii has recently been isolated from a clinical specimen; reports of infection with A. ursingii in children are rare. A. ursingii should be kept in mind as an opportunistic microorganism in children. PMID:27347282

  3. Hybrid treatment of arteriovenous fistula between popliteal vessels

    Directory of Open Access Journals (Sweden)

    Adenauer Marinho de Oliveira Góes Junior

    2014-12-01

    Full Text Available The authors describe treatment of a patient who presented an arteriovenous fistula between the popliteal vessels more than 20 years after a gunshot wound. The patient underwent endovascular treatment using Viabahn (Gore® stent grafts, but, because of the large disparity in popliteal artery diameters proximal and distal of the fistula, the endovascular treatment was unsuccessful. The superficial femoral artery was then banded around the stent graft that was deployed previously. This improvised strategy allowed an open surgical approach to be performed far from the fistula site, reducing the risks of operating in a region with anatomic distortions and significant enlargement of the surrounding venous structures, which would certainly have increased the likelihood of iatrogenic injuries.

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

    Science.gov (United States)

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

    2016-05-01

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

  5. MR angiography of hemodialysis access fistula. Evaluation before PTA procedure

    International Nuclear Information System (INIS)

    We evaluated the feasibility of MR angiography for hemodialysis fistula. Eleven patients with suspected stenosis or occlusion of an autogenous hemodialysis fistula in the forearm underwent MRA. MRA was obtained using both the 3D-PC method and 3D gadolinium contrast-enhanced (CE) method with a knee coil. The two methods were compared with DSA in seven patients. CE-MRA clearly demonstrated the entire dialysis fistula. However, signals of the stenotic area are effaced in PC-MRA. The diameter of the vessels evaluated in the CE-MRA was well correlated with angiography. CE-MRA demonstrated smaller collateral vessels more clearly than PC-MRA. CE-MRA provided useful information before the PTA procedure. (author)

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

    Science.gov (United States)

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

    1984-04-01

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

  7. Aphallia with urethrorectal fistula, bladder and urethral calculi

    Directory of Open Access Journals (Sweden)

    M Movarrekh

    2006-04-01

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

  8. Sigmoid perforation post laser ablation of fistula in ano

    Directory of Open Access Journals (Sweden)

    Raj Gautam

    2015-06-01

    Full Text Available Laser ablation of fistula tract is a safe, effective, sphincter-preserving therapy that can be successfully performed by surgeons. Various studies and papers have been published advocating the use of lasers. However clinical experience and technical expertise is necessary for the use of lasers. Here we present a case of a 45 year old male presenting with acute abdomen following laser ablation of fistula in ano. The patients X-Ray abdomen showed free gas under the diaphragm and was explored. The exploration revealed a pyoperitoneum and a sigmoid perforation for which closure of perforation and a diverting colostomy was done. The patient was further operated for fistula excision and Seton suturing and is planned for colostomy closure. [Int J Res Med Sci 2015; 3(6.000: 1551-1553

  9. Creation of an Arterio-Venous Fistula Between the Brachial Artery and Basilic Vein with a Saphenous Vein Graft Interposition

    Directory of Open Access Journals (Sweden)

    Hakan KARA

    2015-09-01

    Full Text Available Arteriovenous fistulas for hemodialysis are usually open in the upper extremity. For patients with thrombosed arteriovenous fistulas in this area, alternative fistula access routes are needed. AVF creation with a saphenous vein graft is an alternative hemodialysis access method in the patient who has lost the chance of fistula creation with his native vessels.The aim of this case report is to discuss AV fistula management with a saphenous vein graft between the brachial artery and basilic vein in a hemodialysisdependent patient. In this patient previous fistulas were thrombosed and the native vessels in the upper extremity vessels were not suitable for a new AV fistula creation.

  10. Embolization of a High-Output Postnephrectomy Aortocaval Fistula with Gianturco Coils and Cyanoacrylate

    International Nuclear Information System (INIS)

    The authors describe the endovascular treatment of a high-output, large-caliber, postnephrectomy aortocaval fistula using a mixture of cyanoacrylate and lipiodol combined with Gianturco coil embolization. Thirty-nine coils were used to decrease the flow through the fistula so that a fast-polymerizing glue mixture could be injected into the fistula. During rapid polymerization, the N-butyl-2-cyanoacrylate (NBCA) mixture was trapped within the coils, providing an easily controllable glue cast in the fistula, thereby preventing inadvertent embolization into the lungs. This approach can be of considerable benefit for the endovascular treatment of central high-output fistulas

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

    Directory of Open Access Journals (Sweden)

    Yang Xinjian

    2007-01-01

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

  12. 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

    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...... 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...... intraoperative ligation of arteriovenous fistulas based on continuous wave Doppler....

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

    OpenAIRE

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

    2007-01-01

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

  14. Breast fistula repair after autologous fat graft: a case report

    OpenAIRE

    Luca Maione; Giorgio Pajardi; Valeriano Vinci; Davide Forcellini; Fabio Caviggioli; Francesco Maria Klinger; Marco Klinger

    2011-01-01

    We report the case of a 55-year-old female patient who attended our clinic for the presence of a scar retraction in the upper pole of the left breast as a complication of breast augmentation. In the scar area, we observed an orifice that probing revealed to be a fistula. The patient was referred to surgical intervention under general anesthesia to obtain scar contracture release using autologous fat graft; one month after autologous fat injection, following healing of the fistula, the patient...

  15. Traumatic arteriovenous fistula of the superficial temporal artery

    Directory of Open Access Journals (Sweden)

    Otacílio de Camargo Júnior

    2014-03-01

    Full Text Available Arteriovenous fistulae of the superficial temporal artery are rare, and their principal cause is traumas. Complications include pulsatile mass, headache, hemorrhage and deformities that compromise esthetics. Treatment can be performed using conventional surgery or endovascular methods. The authors describe a case of a 44-year-old male patient who developed a large pulsating mass, extending from the preauricular region to the right parietotemporal and frontal regions after a motorcycle accident. The treatment chosen was complete surgical removal of the pulsatile mass and ligature of the vessels feeding the fistula.

  16. A Cause of Mortal Massive Upper Gastrointestinal Bleeding: Aortoesophageal Fistula

    Science.gov (United States)

    Akin, Mete; Yalcinkaya, Tolga; Alkan, Erhan; Arslan, Gokhan; Tuna, Yasar; Yildirim, Bulent

    2016-01-01

    Introduction: Aortoesophageal fistula is an uncommon but mortal cause of massive upper gastrointestinal bleeding. The most common causes are thoracic aortic aneurisym, foreign body reaction, malignancy and postoperative complication. It can be seen in different pattern on upper gastrointestinal endoscopy. There are surgical, endoscopic and interventional radiological treatment options, however, definitive treatment is surgical intervention. Diagnosis and treatment desicion should be made quickly because of rapid and mortal course. Case report: In this article, a case of aortoesophageal fistula was presented that resulted in mortality as a result of massive bleeding. PMID:26980940

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

    Science.gov (United States)

    Kramer, Scott; Tzimas, Demetrios; Saitta, Patrick

    2016-01-01

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    -diamine-tetraacetic acid (EDTA), the synthetic broad-spectrum inhibitor, GM6001, the angiotensin-converting enzyme (ACE) inhibitor, ramiprilate, and the tetracycline, doxycycline. In Crohn's disease fistulas, about 50% of the total protease activity was attributable to MMP activity. The average total MMP activity was...... activity by 72%, which is comparable to the effect of GM6001 (87%). Moreover, MMP-9 activity was completely blunted by ramiprilate. Doxycycline had no effect on MMP activity. Increased functional MMP activity, notably MMP-3 and -9, is present in Crohn's fistulas and may be inhibited by ramiprilate, a...

  19. Traumatic esophageopleural fistula due to fish bone injury

    Directory of Open Access Journals (Sweden)

    Ajay Kumar Verma

    2015-01-01

    Full Text Available Oesophageopleural fistula (EPF is an abnormal communication in between the oesophagous and pleural space such that the contents of oesophagous are drained into the pleural space surrounding the lungs. We describe a case of a middle-aged female who presented with right sided pyothorax secretions of which consisted of food particles. Chest computed tomography and barium swallow confirmed the diagnosis of oesophageopleural fistula, cause of which was found to be an accidental fish bone injury. Conservative management was done by chest tube drainage along with ryles tube feeding. Patient expired following severe sepsis.

  20. Interventional treatment of intracranial arteriovenous fistula in infants

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy and safety of embolization therapy with NBCA for intracranial arteriovenous fistula (AVF) in infants. Methods: Four patients with cerebral arteriovenous fistula were reported, including 3 males and 1 female with nonspecific symptoms and signs, and the diagnosis was made by DSA. Three of them were treated by embolization therapy with NBCA. Results: Three of the cases were treated by NBCA, neither death nor complication occurred. Conclusion: Intracranial AVF is rare in childhood. Endovascular treatment with NBCA is effective and safe, but the long-term effect has to be confirmed by follow-up study. (authors)