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Sample records for carotid-cavernous sinus fistula

  1. Carotid-cavernous fistula after functional endoscopic sinus surgery.

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    Karaman, Emin; Isildak, Huseyin; Haciyev, Yusuf; Kaytaz, Asim; Enver, Ozgun

    2009-03-01

    Carotid-cavernous fistulas (CCFs) are anomalous communications between the carotid arterial system and the venous cavernous sinus. They can arise because of spontaneous or trauma causes. Most caroticocavernous fistulas are of spontaneous origin and unknown etiology. Spontaneous CCF may also be associated with cavernous sinus pathology such as arteriosclerotic changes of the arterial wall, fibromuscular dysplasia, or Ehler-Danlos syndrome. Traumatic CCFs may occur after either blunt or penetrating head trauma. Their clinical presentation is related to their size and to the type of venous drainage, which can lead to a variety of symptoms, such as visual loss, proptosis, bruit, chemosis, cranial nerve impairment, intracranial hemorrhage (rare), and so on. Treatment by endovascular transarterial embolization with electrolytically detachable coils is a very effective method for CCF with good outcomes. Carotid-cavernous fistulas have been rarely reported after craniofacial surgery and are uncommon pathologies in otolaryngology practice. In this study, we report a 40-year-old woman with CCF secondary to blunt trauma of functional endoscopic sinus surgery.

  2. Color Doppler Imaging in the Diagnosis and Follow-up of Carotid Cavernous Sinus Fistulas

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    This report describes color doppler imaging (CDI) in theevaluation and follow-up of nine patients with carotid cavernous sinusfistulas.The orbits and carotid arteries were examined with CDI.In allcases,the diagnosis was confirmed by angiography.CDI clearlydemonstrated the dilated superior ophthalmic veins (SOVs) with retrogradeflow and low resistance arterial doppler waveform in all nine patients (10eyes).After the study of quantitative hemodynamics,we found that directcarotid cavernous sinus fistulas s...

  3. Transvenous injection of Onyx for casting of the cavernous sinus for the treatment of a carotid-cavernous fistula.

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    Arat, Anil; Cekirge, Saruhan; Saatci, Isil; Ozgen, Burce

    2004-12-01

    A complex case of carotid-cavernous fistula was treated transvenously by injection of ethyl vinyl alcohol co-polymer into the cavernous sinus after an unsuccessful embolization attempt with detachable coils and liquid adhesive agents. There were no complications. At 3 months the patient's symptoms had resolved completely, and a control angiogram revealed persistent occlusion. The physical properties of ethyl vinyl alcohol polymer justify further investigation of this agent for the treatment of carotid-cavernous fistula.

  4. Transvenous embolization of a dural carotid-cavernous sinus fistula via the inferior ophthalmic vein.

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    Michels, Kevin S; Ng, John D; Falardeau, Julie; Roberts, Warren G; Petersen, Bryan; Nesbit, Gary M; Barnwell, Stanley L

    2007-01-01

    A 76-year-old woman presented with an acute onset of right periocular pain, diplopia, ocular injection, progressive proptosis, and periocular swelling. She had an unremarkable past medical history, and the erythrocyte sedimentation rate and complete blood count were normal. A carotid-cavernous sinus fistula was suspected, and an MRI demonstrated enlargement of the superior ophthalmic vein posterior to the globe and enlargement of the inferior ophthalmic vein throughout its entire course. Cerebral arteriography demonstrated a dural cavernous sinus fistula. The inferior ophthalmic vein was accessed via the inferonasal orbital space and was catheterized for delivery of multiple platinum coils to the cavernous sinus fistula. Follow-up venograms demonstrated occlusion of the fistula. At 2-month follow-up, there was a residual sixth nerve palsy and resolution of symptoms, including proptosis and periocular swelling.

  5. [Neuro-ophthalmology and interventional neuro-radiology--co-treatment for carotid cavernous sinus fistula].

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    Platner, Eva; Bakon, Mati; Huna-Baron, Ruth

    2013-02-01

    Carotid-cavernous fistulas (CCFs) are abnormal arteriovenous communications in the cavernous sinus. In many cases of CCF's the primary signs are ocular manifestations, which include: pulsatile proptosis, orbital bruit, chemosis and conjunctival injection, elevated intraocular pressure, venous stasis retinopathy, and cranial nerve pareses. Patients in whom the fistula causes arterial drainage into the cerebral veins and sinuses are at risk for intracranial hemorrhage. The most common treatment for CCF's is endovascular occlusion of the lesion. The goal of this procedure is to occlude the fistula but preserve the patency of the internal carotid artery. The CCF itself, as well as its treatment, can be sight- and even life-threatening. We describe 3 case reports of patients with CCF, in order to demonstrate the cooperation between the neuro-opthalmologist and the invasive neuro-radiologist, in the follow-up of the patient and in the treatment timing decision.

  6. Carotid cavernous fistula: Ophthalmological implications

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    Chaudhry Imtiaz

    2009-01-01

    Full Text Available Carotid cavernous fistula (CCF is an abnormal communication between the cavernous sinus and the carotid arterial system. A CCF can be due to a direct connection between the cavernous segment of the internal carotid artery and the cavernous sinus, or a communication between the cavernous sinus, and one or more meningeal branches of the internal carotid artery, external carotid artery or both. These fistulas may be divided into spontaneous or traumatic in relation to cause and direct or dural in relation to angiographic findings. The dural fistulas usually have low rates of arterial blood flow and may be difficult to diagnose without angiography. Patients with CCF may initially present to an ophthalmologist with decreased vision, conjunctival chemosis, external ophthalmoplegia and proptosis. Patients with CCF may have predisposing causes, which need to be elicited. Radiological features may be helpful in confirming the diagnosis and determining possible intervention. Patients with any associated visual impairment or ocular conditions, such as glaucoma, need to be identified and treated. Based on patient′s signs and symptoms, timely intervention is mandatory to prevent morbidity or mortality. The conventional treatments include carotid ligation and embolization, with minimal significant morbidity or mortality. Ophthalmologist may be the first physician to encounter a patient with clinical manifestations of CCF, and this review article should help in understanding the clinical features of CCF, current diagnostic approach, usefulness of the available imaging modalities, possible modes of treatment and expected outcome.

  7. The association of carotid cavernous fistula with Graves′ ophthalmopathy

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    Ozlem Celik

    2013-01-01

    Full Text Available Graves′ ophthalmopathy (GO is one of the frequent manifestations of the disorder which is an inflammatory process due to fibroblast infiltration, fibroblast proliferation and accumulation of glycosaminoglycans. Eye irritation, dryness, excessive tearing, visual blurring, diplopia, pain, visual loss, retroorbital discomfort are the symptoms and they can mimic carotid cavernous fistulas. Carotid cavernous fistulas are abnormal communications between the carotid arterial system and the cavernous sinus. The clinical manifestations of GO can mimic the signs of carotid cavernous fistulas. Carotid cavernous fistulas should be considered in the differential diagnosis of the GO patients especially who are not responding to the standard treatment and when there is a unilateral or asymmetric eye involvement. Here we report the second case report with concurrent occurrence of GO and carotid cavernous fistula in the literature.

  8. Transvenous treatment of a complex cavernous sinus dural arteriovenous fistula secondary to balloon embolization of a traumatic carotid-cavernous fistula

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

    2006-01-01

    @@ AIthough recurrent traumatic carotid-cavernous fistula (CCF) and its treatment have been reported sporadically,1 a complex cavernous sinus dural arteriovenous fistula (DAVF) secondary to balloon embolization of a direct traumatic CCF is rare. In 2005, we treated such a case via transvenous approach using coils and N-buty-2-cyanoacrylate (NBCA). The causes of recurrent cavernous sinus DAVF and its endovascular approach are discussed.

  9. Noncavernous arteriovenous shunts mimicking carotid cavernous fistulae

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    Kobkitsuksakul, Chai; Jiarakongmun, Pakorn; Chanthanaphak, Ekachat; Singhara Na Ayudya, Sirintara (Pongpech)

    2016-01-01

    PURPOSE The classic symptoms and signs of carotid cavernous sinus fistula or cavernous sinus dural arteriovenous fistula (AVF) consist of eye redness, exophthalmos, and gaze abnormality. The angiography findings typically consist of arteriovenous shunt at cavernous sinus with ophthalmic venous drainage with or without cortical venous reflux. In rare circumstances, the shunts are localized outside the cavernous sinus, but mimic symptoms and radiography of the cavernous shunt. We would like to present the other locations of the arteriovenous shunt, which mimic the clinical presentation of carotid cavernous fistulae, and analyze venous drainages. METHODS We retrospectively examined the records of 350 patients who were given provisional diagnoses of carotid cavernous sinus fistulae or cavernous sinus dural AVF in the division of Interventional Neuroradiology, Ramathibodi Hospital, Bangkok between 2008 and 2014. Any patient with cavernous arteriovenous shunt was excluded. RESULTS Of those 350 patients, 10 patients (2.85%) were identified as having noncavernous sinus AVF. The angiographic diagnoses consisted of three anterior condylar (hypoglossal) dural AVF, two traumatic middle meningeal AVF, one lesser sphenoid wing dural AVF, one vertebro-vertebral fistula (VVF), one intraorbital AVF, one direct dural artery to cortical vein dural AVF, and one transverse-sigmoid dural AVF. Six cases (60%) were found to have venous efferent obstruction. CONCLUSION Arteriovenous shunts mimicking the cavernous AVF are rare, with a prevalence of only 2.85% in this series. The clinical presentation mainly depends on venous outflow. The venous outlet of the arteriovenous shunts is influenced by venous afferent-efferent patterns according to the venous anatomy of the central nervous system and the skull base, as well as by architectural disturbance, specifically, obstruction of the venous outflow. PMID:27767958

  10. Spontaneous Resolution of Direct Carotid Cavernous Fistula

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    Ishaq, Mazhar; Arain, Muhammad Aamir; Ahmed, Saadullah; Niazi, Muhammad Khizar; Khan, Muhammad Dawood; Iqbal, Zamir

    2010-01-01

    Proptosis due to carotid cavernous fistula is rare sequelae of head injury. We report a case of post-traumatic, direct high flow carotid cavernous fistula that resolved spontaneously 06 weeks after carotid angiography. It however, resulted in loss of vision due to delay in early treatment. In the ca

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

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    Giotakis, A.; Kral, F.; Riechelmann, H.; Freund, M.

    2015-01-01

    We report a case of a 90-year-old patient with intractable posterior epistaxis presenting as the only symptom of a nontraumatic low-flow carotid-cavernous sinus fistula. Purpose of this case report is to introduce low-flow carotid-cavernous sinus fistula in the differential diagnosis of intractable posterior epistaxis. We provide a literature review for the sequence of actions for the confrontation of posterior epistaxis. We also emphasize the significance of the radiological diagnostic and therapeutic procedures in the management of posterior epistaxis due to pathology of the cavernous sinus. The gold-standard diagnostic procedure of carotid-cavernous sinus fistula is digital subtraction angiography (DSA). DSA with coils is also the state-of-the-art therapy. By failure of DSA, neurosurgery or stereotactic radiosurgery (SRS) may be used as alternatives. SRS may also be used as enhancement procedure of the DSA. Considering the prognosis of a successfully closed carotid-cavernous sinus fistula, recanalization occurs only in a minority of patients. Close follow-up is advised. PMID:26839726

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

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    A. Giotakis

    2015-01-01

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

  13. Direct orbital puncture of the cavernous sinus for the treatment of a carotid-cavernous dural AV fistula with a concomitant venous/lymphatic malformation.

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    Coumou, Adriaan D; van den Berg, René; Bot, Joost C; Beetsma, Daan B; Saeed, Peerooz

    2014-02-01

    A 37- year old male with a long history of a left orbital venous/lympathic malformation presented with ocular injection, increased proptosis and reduced left vision. Angiography demonstrated a carotid cavernous dural AV fistula combined with a concomitant venous/lymphatic malformation. After attempts at transvenous embolization, a direct uncomplicated transorbital puncture of the cavernous sinus via a lateral orbitotomy was performed with complete resolution of ocular symptoms.

  14. Spontaneous carotid cavernous sinus fistulas: Correlation between clinical findings and venous drainage; Fistole carotido-cavernose spontanee: Correlazione tra quadri clinici e drenaggio venoso

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    Calzolari, Ferdinando [Arcispedale S. Anna, Ferrara (Italy). Servizio di Neuroradilogia; Ravalli, Luca [Ferrara, Univ. (Italy). Clinica Oculistica

    1997-04-01

    They reviewed retrospectively 6 cases of spontaneous carotid cavernous fistulas to discuss the differences in clinical findings depending on venous patterns. Orbit US was performed in all patients but one and all patients were examined with CT and intraarterial digital subtraction angiography (DSA). CT was performed to demonstrate possible lesions of the orbit apex or skull base and showed dilation of the superior ophthalmic vein in 4 patients, bilateral in only one case. Moreover, CT detected enlargement of the cavernous sinuses in 4 cases (3 unilateral, one bilateral). Dynamic CT, performed in 2 patients, showed early opacification of both cavernous sinuses. DSA was carried out on the basis of clinical data and US and CT findings. It diagnosed carotid cavernous fistulas in all cases. The fistulas were bilateral in 3 subjects. In all the patients with exophthalmos, conjunctival chemosis and dilated episcleral veins, the superior ophthalmic vein was the main venous drainage from the cavernous sinus. Only 4 of these patients had abduction nerve palsy: bruit was present in 2 cases only. The ocular signs were contralateral to the fistula in one patient. In the patient presenting III, IV and VI nerve palsy, the venous drainage was direct from the cavernous sinus to pericarotid plexus, plexus and inferior petrosal sinus; in this case there were no ocular signs. The clinical findings of spontaneous cavernous fistulas are caused by the arterial supply and by the venous drainage of the fistula: for the early diagnosis and treatment is important to know that some patients do not exhibit the classic triad of symptoms, characterized by pulsating bruit and conjunctival chemosis. Their experience has confirmed that spontaneous carotid cavernous fistulas may be characterized by atypical clinical findings, such as ocular signs contralateral to the fistula side or palsies of cranial nerves only.

  15. 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).

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

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

    2016-01-01

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

  17. Endovascular management of carotid-cavernous fistulas

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    GAO Bu-lang; LI Ming-hua; LI Yong-dong; FANG Chun; WANG Jue; DU Zhuo-ying

    2007-01-01

    Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas (CCF) and their complications such as pseudoaneurysms. Methods: Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coil embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stent management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% (4/22). A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% (8/22). Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.

  18. Abducens Nerve Palsy and Ipsilateral Horner Syndrome in a Patient With Carotid-Cavernous Fistula.

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    Kal, Ali; Ercan, Zeynep E; Duman, Enes; Arpaci, Enver

    2015-10-01

    The combination of abducens nerve palsy and ipsilateral Horner syndrome was first described by Parkinson and considered as a localizing sign of posterior cavernous sinus lesions. The authors present a case with right abducens nerve palsy with ipsilateral Horner syndrome in a patient with carotid-cavernous fistula because of head trauma. The patient was referred to the ophthalmology clinic with diplopia complaint after suffering a head trauma during a motorcycle accident. Cerebral angiography showed low-flow carotid-cavernous fistula.

  19. Endovascular treatment with transvenous approach for embolization of carotid cavernous fistula

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    Benny Young

    2014-10-01

    Full Text Available The aim of endovascular treatment in carotid cavernous fistula is to close the tear side at cavernous sinus part. It can be dealt either by transvenous or transarterial approach. The option is influenced by type of fistula and angioarchitectural findings. We described two different transvenous routes emphasizing on anatomical consideration and its technical aspect.

  20. Post-traumatic carotid cavernous fistula of late manifestation report

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    Joanna Roskal-Wałek

    2015-01-01

    Full Text Available Carotid cavernous fistula (CCF is an abnormal connection between the carotid artery and the cavernous sinus. Carotid cavernous fistula of traumatic aetiology occurs more commonly. The characteristic triad of symptoms covers the following: pulsating exophthalmos, a humming sound within the skull, and dilation and tortuosity of conjunctival and episcleral veins. The diagnosis of CCF may constitute a diagnostic problem in the situation when the symptoms occur several weeks after injury, it may overlap with other post-traumatic changes, and the dominant symptom may be cranial nerve palsy. The lack of a correct diagnosis and adequate causative therapy creates the risk of not only loss of vision, but also of life. We present a case of a patient who developed fistula symptoms a few weeks after an injury. The diagnosis of post-traumatic CCF was confirmed by imaging examinations. The application of transluminal embolisation led to the resolution of the majority of symptoms.

  1. Endovascular treatment of traumatic carotid cavernous fistula with trapping technique

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    Benny Young

    2013-08-01

    Full Text Available Conventional endovascular treatment for carotid cavernous fistula (CCF involves a direct delivery of either coils, detachable balloon or both to the fistula with end point of CCF resolution and carotid artery preservation. But in few cases with severe laceration of carotid artery, the feasible endovascular technique applicable is by blocking the filling of fistula from cerebral circulation. This method known as trapping technique which implicates carotid artery occlusion, was performed in our present case with good result. (Med J Indones. 2013;22:178-82. doi: 10.13181/mji.v22i3.588Keywords: Carotid cavernous fistula (CCF, carotid occlusion, trapping technique

  2. Acute abducens nerve palsy as a presenting feature in carotid-cavernous fistula in a 6-year-old girl [

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    Pawar, Neelam

    2013-04-01

    Full Text Available [english] Carotid-cavernous fistulas (CCF are abnormal communications between the internal carotid artery and the cavernous sinus. Traumatic carotid-cavernous fistulae are rare potential complications of craniofacial trauma. Typical findings of CCF are proptosis, chemosis, headache, oculomotor or abducens nerve palsy, trigeminal pain and pulsating bruit over the temporal skull and the bulb.CCF are reported very rarely in childhood. This report describes the clinical and radiological findings of a pediatric patient presented with CCF.

  3. Spontaneous occlusion of traumatic carotid-cavernous fistula - the effect of angiography

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    Stampfel, G.

    1984-08-01

    In two patients with a traumatic carotid-cavernous fistula, permanent occlusion of the lesion was observed following cerebral angiography and confirmed by further angiography. A delay is therefore recommended between performing angiography and carrying out further treatment, which may carry some risk. Possibly the use of ionic contrast media, which irritate the vessels, compression of the carotid artery, which reduces flow through the fistula, and general anaesthesia, which may drop the blood pressure, initiate thrombosis in the cavernous sinus. 3 figs.

  4. Direct carotid cavernous fistula after submucous resection of the nasal septum.

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    Bizri, A R; al-Ajam, M; Zaytoun, G; al-Kutoubi, A

    2000-01-01

    A carotid cavernous fistula (CCF) is an abnormal arteriovenous anastomosis between the carotid artery and the cavernous sinus. Etiologies of this condition reported in the literature so far include facial trauma, rupture of an intracavernous aneurysm of the carotid artery, Ehler-Danlos syndrome and fibromuscular dysplasia of the cerebral arteries. Such fistulae were reported as complications of rhinoplasty, transsphenoidal surgery, embolization of cavernous sinus meningioma, and rhinocerebral mucormycosis. CCF may also occur spontaneously in children or as a congenital malformation. However, to our knowledge, submucous resection of the nasal septum has not been reported before to cause direct carotid-cavernous fistula. CT and angiographic findings are presented and a review of the literature for reported causes of CCF is made as well as a brief discussion of the possible pathophysiology.

  5. Covered Stent Implantation for the Treatment of Direct Carotid-Cavernous Fistula and Its Mid-Term Follow-up

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    Briganti, F.; Tortora, F.; Marseglia, M.; Napoli, M.; Cirillo, L.

    2009-01-01

    Summary Carotid-cavernous fistulas are abnormal arteriovenous communications either directly between the internal carotid artery and the cavernous sinus or between the dural branches of the internal and external carotid arteries. These fistulas predominantly present with ocular manifestations and they are treated mainly by endovascular techniques in most cases. A detailed review of the literature allowed us to make a complete analysis of the information available on the topic. We describe a case of a direct carotid-cavernous fistula occluded by endovascular implantation of a covered stent, showing the persistence of results after three years. PMID:20465897

  6. [Traumatic arteriovenous pial fistula masquerading as a carotid-cavernous fistula: an uncommon disorder with an unusual presentation].

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    Santos-Franco, Jorge Arturo; Lee, Angel; Nava-Salgado, Giovanna; Zenteno, Marco; Gómez-Villegas, Thamar; Dávila-Romero, Julio César

    2012-01-01

    Traumatic intracranial pial arteriovenous fistulae are infrequent lesions. Their cardinal signs have been related to mass effect and hemorrhage, but their clinical manifestations due to venous retrograde flow into ophthalmic veins has never been described. This phenomenon is usually seen in dural arteriovenous fistula draining to the cavernous sinus or carotid-cavernous sinus fistula.A traumatic intracranial pial arteriovenous fistula arising from the supraclinoid internal carotid artery in a young patient was revealed by aggressive behavior and ophthalmologic manifestations. The endovascular management included the use of coils, stent, and ethylene-vinyl alcohol with transient balloon occlusion of the parent vessel.

  7. Epileptic Seizures Induced by a Spontaneous Carotid Cavernous Fistula

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    Yildirim, Erkan

    2016-01-01

    A 79-year-old woman was admitted to our emergency department with complaints of fainting and loss of consciousness three times during the past month. She was diagnosed with epilepsy and started to be treated with antiepileptic drug. Physical examination showed, in the left eye, chemosis, limited eye movements in all directions, and minimal exophthalmos as unexisting symptoms on admission developed on the sixth day. Orbital magnetic resonance imaging (MRI) and digital subtraction angiography (DSA) imaging revealed a carotid cavernous fistula (CCF). Epileptic attacks and ophthalmic findings previously present but diagnosed during our examinations were determined to ameliorate completely after performing the coil embolization. Based on literature, we present the first case with nontraumatic CCF manifesting with epileptic seizures and intermittent eye symptoms in the present report. PMID:28077946

  8. Diagnosis and treatment of traumatic carotid cavernous fistula

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    杨东虹; 何奇元; 邹咏文; 许民辉

    2002-01-01

    Objective: To discuss the diagnosis and managementof traumatic carotid cavernous fistula (TCCF).Methods: In all 15 patients with TCCF confirmed byangiography, 8 patients got early diagnosis and cure. WithSeldinger technique adpoted in the puncture of femoralartery, Magic 3 F-1.8 F BD catheters combining withballoon were used to embolize the fistula or the internalcarotid artery.Results: Early diagnosis and cure were achieved in 8patients within one week and no sequelae occurred. Sevenpatients with delayed diagnosis who were cured beyond oneweek had some sequelae such as hypopsia in 5 cases,incomplete oculomotor paralyses in 3 and incompleteabducent paralyses in 2. Among all the 15 cases, theinternal carotid artery was preserved in 12 cases acountingfor 80%. Occluding the fistula with sacrifice of the internalcarotid artery was performed in 3 cases and no repatency of the fistula occurred by following up beyond three months.Conclusions: The preferred therapy for TCCF is toocclude the fistula using detachable balloon. The diagnosisand treatment for TCCF can significantly reduce occurrencerate of the complications and sequelae.

  9. Arteriovenous Malformation in Temporal Lobe Presenting as Contralateral Ocular Symptoms Mimicking Carotid-Cavernous Fistula

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    Fadzillah Mohd-Tahir

    2013-01-01

    Full Text Available Aim. To report a rare case of arteriovenous malformation in temporal lobe presenting as contralateral orbital symptoms mimicking carotid-cavernous fistula. Method. Interventional case report. Results. A 31-year-old Malay gentleman presented with 2-month history of painful progressive exophthalmos of his left eye associated with recurrent headache, diplopia, and reduced vision. Ocular examination revealed congestive nonpulsating 7 mm exophthalmos of the left eye with no restriction of movements in all direction. There was diplopia in left lateral gaze. Left IOP was elevated at 29 mmHg. Left eye retinal vessels were slightly dilated and tortuous. CT scan was performed and showed right temporal arteriovenous malformation with a nidus of 3.8 cm × 2.5 cm with right middle cerebral artery as feeding artery. There was dilated left superior ophthalmic vein of 0.9 mm in diameter with enlarged left cavernous sinus. MRA and carotid angiogram confirmed right temporal arteriovenous malformation with no carotid-cavernous fistula. Most of the intracranial drainage was via left cavernous sinus. His signs and symptoms dramatically improved following successful embolisation, completely resolved after one year. Conclusion. Intracranial arteriovenous malformation is rarely presented with primary ocular presentation. Early intervention would salvage the eyes and prevent patients from more disaster morbidity or fatality commonly due to intracranial haemorrhage.

  10. Evaluation of cerebral oximetry during endovascular treatment of carotid-cavernous fistula

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    Dujovny, Manuel; Misra, Mukesh; Alp, M. Serdar; Debrun, Gerard; Charbel, F. T.; Aletich, Victor; Ausman, James I.

    1997-08-01

    Endovascular treatment of carotid cavernous fistula is done routinely in our institution. We have been monitoring these patients with transcranial cerebral oximetry. The transcranial cerebral oximeter is a reliable, low-cost, non-invasive device that provides real-time evaluation of regional brain oxygen saturation during and after endovascular treatment of cerebrovascular diseases. We used the INVOS 3100A (Somanetics, Troy, MI) in our study. We discuss seven patients with carotid-cavernous fistulas treated by endovascular balloon occlusion, each monitored continuously before, during, and after the procedure with transcranial cerebral oximetry. The cerebral oxygen saturation depicted was directly related to the side of the venous drainage of the fistula, with the brain oxygen saturation 15 - 20% higher on the side of the venous drainage. Following endovascular occlusion of the fistula, oxygen saturation gradually became equal on both sides. In our patients treated for carotid-cavernous fistula, we evaluated the sensitivity and usefulness of cerebral oximetry as an important non-invasive monitoring tool for the endovascular treatment of carotid-cavernous fistula.

  11. Carotid-cavernous fistula caused by laceration of persistent fetal trigeminal artery treated with single catheter coil embolization

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    Benjamin L Brown

    2012-01-01

    Full Text Available We present the endovascular treatment of traumatic carotid-cavernous fistula from persistent fetal trigeminal artery (PFTA laceration. To date, there are six such cases of traumatic PFTA-cavernous fistulas reported in the literature. These injuries can pose a unique challenge in that rupture of a PFTA in its course through the cavernous sinus may produce a fistula feeding from both anterior and posterior circulations. Previously, these have been treated with dual catheter coil embolization from the carotid and basilar systems. We utilize a single catheter technique accessing the cavernous sinus through the origin of the PFTA on the internal carotid. Both anterior and posterior fistula components may be embolized through this single access. This represents a simple yet safe treatment option.

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

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    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.

  13. Treatment of recurrent traumatic carotid cavernous fistula via endovascular embo lism technique

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Endovascular embolism technique has been demonstrated to be the best initial option for treatment of carotid cavernous fistula (CCF). Several large series re ports have shown that most CCFs can be successfully occluded via transarterial or transvenous endovascular approach.1-6 This paper reports a case of C CF recurred after endovascular occlusion of internal carotid artery (ICA) proxim al to the fistula. A new technique has been described for transarterial emboliza tion with tungsten microcoils via surgical exposure to ICA, which has not been r eported previously in the literatures.

  14. Direct traumatic carotid cavernous fistula: angiographic classification and treatment strategies. Study of 172 cases.

    Science.gov (United States)

    Chi, Cuong Tran; Nguyen, Dang; Duc, Vo Tan; Chau, Huynh Hong; Son, Vo Tan

    2014-01-01

    We report our experience in treatment of traumatic direct carotid cavernous fistula (CCF) via endovascular intervention. We hereof recommend an additional classification system for type A CCF and suggest respective treatment strategies. Only type A CCF patients (Barrow's classification) would be recruited for the study. Based on the angiographic characteristics of the CCF, we classified type A CCF into three subtypes including small size, medium size and large size fistula depending on whether there was presence of the anterior carotid artery (ACA) and/or middle carotid artery (MCA). Angiograms with opacification of both ACA and MCA were categorized as small size fistula. Angiograms with opacification of either ACA or MCA were categorized as medium size fistula and those without opacification of neither ACA nor MCA were classified as large size fiatula. After the confirm angiogram, endovascular embolization would be performed impromptu using detachable balloon, coils or both. All cases were followed up for complication and effect after the embolization. A total of 172 direct traumatic CCF patients were enrolled. The small size fistula was accountant for 12.8% (22 cases), medium size 35.5% (61 cases) and large size fistula accountant for 51.7% (89 cases). The successful rate of fistula occlusion under endovascular embolization was 94% with preservation of the carotid artery in 70%. For the treatment of each subtype, a total of 21/22 cases of the small size fistulas were successfully treated using coils alone. The other single case of small fistula was defaulted. Most of the medium and large size fistulas were cured using detachable balloons. When the fistula sealing could not be obtained using detachable balloon, coils were added to affirm the embolization of the cavernous sinus via venous access. There were about 2.9% of patient experienced direct carotid artery puncture and 0.6% puncture after carotid artery cut-down exposure. About 30% of cases experienced

  15. Neuroradiological diagnosis and interventional therapy of carotid cavernous fistulas; Neuroradiologische Diagnostik und interventionelle Therapie bei Carotis-cavernosus-Fisteln

    Energy Technology Data Exchange (ETDEWEB)

    Struffert, T.; Engelhorn, T.; Doelken, M.; Doerfler, A. [Universitaetsklinikum Erlangen, Abteilung fuer Neuroradiologie, Erlangen (Germany); Holbach, L. [Universitaetsklinikum Erlangen, Augenklinik, Erlangen (Germany)

    2008-12-15

    Carotid cavernous fistulas are pathologic connections between the internal and/or external carotid artery and the cavernous sinus. According to Barrow one can distinguish between direct (high flow) and indirect (low flow) fistulas, whereby direct fistulas are often traumatic while indirect fistulas more frequently occur spontaneously in postmenopausal women. Diagnosis can easily be established using MRI and angiography, which allow exact visualization of the anatomy of fistulas to plan the interventional neurological therapy that in recent years has replaced surgical therapy. This article provides an overview on imaging findings, diagnosis using MRI and angiography as well as interventional treatment strategies. (orig.) [German] Bei Carotis-cavernosus-Fisteln handelt es sich um pathologische Verbindungen zwischen der A. carotis interna und/oder externa und dem Sinus cavernosus. Nach Barrow kann zwischen direkten und indirekten Fisteln unterschieden werden. Direkte Fisteln sind oftmals traumatische Fisteln und zeigen ein hohes Shuntvolumen (''high flow''), waehrend indirekte Fisteln ein geringeres Shuntvolumen (''low flow'') zeigen und gehaeuft bei postmenopausalen Patientinnen spontan auftreten. Die neuroradiologische Diagnostik mit MRT und Angiographie erlaubt die Darstellung der genauen Gefaessarchitektur der Fistel und ist damit Grundlage der interventionellen neuroradiologischen Therapie, die in den letzten Jahren die chirurgische Therapie praktisch abgeloest hat. In diesem Beitrag werden die klinischen Befunde, die Diagnostik mittels MRT und Angiographie sowie interventionelle Strategien vorgestellt. (orig.)

  16. Transorbital Approach for Endovascular Occlusion of Carotid-Cavernous Fistulas: Technical Note and Review of the Literature

    Science.gov (United States)

    Chen, Ching-Jen; Caruso, James P; Ding, Dale; Schmitt, Paul J; Buell, Thomas J; Raper, Daniel M; Evans, Avery; Newman, Steven A; Jensen, Mary E

    2017-01-01

    Carotid-cavernous fistulas (CCFs) pose an anatomically and physiologically challenging problem for clinicians. The most common method of treatment for these lesions is transvenous endovascular embolization via the inferior petrosal sinus or the facial vein. When transvenous access is not possible, an alternate approach must be devised. We describe a case example with bilateral Barrow Type B CCFs, which were inaccessible using the traditional transvenous approach. Hence, a direct transorbital approach, performed under fluoroscopic guidance, was employed to successfully obliterate the CCF. At five months follow-up, the patient was recovering without complications. This case delineates the technical aspects of transorbital CCF embolization and demonstrates that this approach is a viable alternative to conventional transvenous methods for appropriately selected CCF cases. We supplement our case example and technical note with a literature review of this approach. PMID:28191380

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

    Directory of Open Access Journals (Sweden)

    Andres Asser

    2014-12-01

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

  18. Prognostic analysis and complications of traumatic carotid cavernous fistulas after treatment with detachable balloon and/or coil embolization

    Institute of Scientific and Technical Information of China (English)

    杨振九; 李宏伟; 吴良贵; 郑俊宁; 张佳栋; 史锡文; 楚功仁

    2004-01-01

    Objective:To explore the causes of the formation of traumatic carotid-cavernous fistulas and the therapeutic effect of detachable balloon and/or coil embolization and the prevention of its complications.Methods: From October, 1992 to March, 2002, 17patients with traumatic carotid-cavernous fistulas were treated with detachable balloon and/or coil embolization in our hospital. The clinical data and imaging features of CT, MR and selective angiogram of these patients were analyzed.Results: One week after treatment with embolization, the clinical symptoms of the 17 patients were remitted, and optic cacophony, nystagmus, exophthalmos and dropsy of conjunctiva disappeared. Two patientsmanifested surgical complications, one patient died. Sixteen patients survived. They were all followed up for more than 2 years, which showed one patient had handicap in movement, and in one patient the signs and symptoms of traumatic carotid-cavernous fistulas reoccurred 2 months after treatment.Conclusions: The detachable balloon and/or coil embolization is safe and reliable. It is a good method to treat traumatic carotid-cavernous fistulas.

  19. Spontaneous Carotid-Cavernous Fistula in the Type IV Ehlers-Danlos Syndrome.

    Science.gov (United States)

    Kim, Jeong Gyun; Cho, Won-Sang; Kang, Hyun-Seung; Kim, Jeong Eun

    2014-02-01

    Ehlers-Danlos syndrome (EDS) is a rare inherited connective disease. Among several subgroups, type IV EDS is frequently associated with spontaneous catastrophic bleeding from a vascular fragility. We report on a case of carotid-cavernous fistula (CCF) in a patient with type IV EDS. A 46-year-old female presented with an ophthalmoplegia and chemosis in the right eye. Subsequently, seizure and cerebral infarction with micro-bleeds occurred. CCF was completely occluded with transvenous coil embolization without complications. Thereafter, the patient was completely recovered. Transvenous coil embolization can be a good treatment of choice for spontaneous CCF with type IV EDS. However, every caution should be kept during invasive procedure.

  20. Direct-puncture approach to the extraconal portion of the superior ophthalmic vein for carotid cavernous fistulae

    Energy Technology Data Exchange (ETDEWEB)

    Kurata, A.; Suzuki, S.; Iwamoto, K.; Miyazaki, T.; Inukai, M.; Abe, K.; Niki, J.; Yamada, M.; Fujii, K. [Kitasato University School of Medicine, Department of Neurosurgery, Kanagawa (Japan); Kan, S. [Kitasato University School of Medicine, Department of Radiology, Kanagawa (Japan)

    2009-11-15

    The transvenous approach via the superior ophthalmic vein (SOV) is an available approach for carotid cavernous fistula (CCF), especially in the event that there is no other suitable approach route to the fistula. Surgical exposure of the peripheral roots of the SOV is commonly used; however, often, the SOV is often not accessible because of anatomical problems and/or complications. In this paper, we present and discuss our original direct-puncture approach to the extraconal portion of the SOV. An attempt on three patients with traumatic CCF failed with the transarterial approach and the conventional venous approach via the inferior petrosal sinus; therefore, the patients were treated with the direct-puncture approach to the extraconal portion of the SOV using two-dimensional digital subtraction angiography with local anesthesia. All cases that had tortuous and partially stenotic division of the SOV were treated successfully with this approach and without complications. This approach will become an alternate approach, especially when the peripheral roots of the SOV are focally narrowed and tortuous, making it impossible to insert a catheter. (orig.)

  1. Complex carotid cavernous sinus fistulas Barrow type D: endovascular treatment via the ophthalmic vein, imaging control with standardized MRI, long-term results; Interdisziplinaere Embolisation spontaner Karotis-Cavernosus-Fisteln Typ D nach Barrow ueber die Vena ophthalmica: klinische Langzeitergebnisse und kernspintomografische Befunde

    Energy Technology Data Exchange (ETDEWEB)

    Struffert, T.; Grunwald, I.Q.; Reith, W. [Abteilung fuer Diagnostische und Interventionelle Neuroradiologie, Universitaetsklinikum des Saarlandes (Germany); Muecke, I. [Klinik fuer Augenheilkunde, Universitaetsklinikum des Saarlandes (Germany)

    2007-04-15

    Purpose: Since feeding arteries from both the internal and external carotid artery are common, cavernous fistulas of Barrow type D are difficult to treat. Embolization using the transarterial approach is considered to be the standard therapy. However, it is often impossible to embolize feeders from the internal carotid artery. The transorbital approach after anterior orbitotomy through the ophthalmic vein is an alternative in this complex situation. The following reports our experience with three female patients who underwent transvenous embolization. Procedural success was documented using standardized MRI and clinical reevaluation. Materials and Methods: Three female patients between 57 and 78 years of age were diagnosed with carotid cavernous fistulas by conventional angiogram. All patients were suffering from exophthalmus and visual impairment. Two patients showed secondary glaucoma and diplopia. In one patient we performed a technically successful transarterial embolization using particles, but no relevant improvement of the patient's condition was seen. Transfemoral transvenous access via the sinus petrosus was not possible in any patient. All patients were then embolized via the ophthalmic vein using GDC detachable coils. All patients were clinically reevaluated by an ophthalmologist. Also a standardized MRI was performed for documentation. Follow-up was performed for the first patient for 32 months, for the second patient for 34 months and for the third patient for 50 months. Results: Transvenous embolization was technically successful in all three cases. Clinical symptoms disappeared rapidly. Postprocedural MRI showed a symmetric diameter of the ophthalmic vein. Venous congestion of the orbit caused by fatty tissue edema regressed completely. Contrast-enhanced magnetic resonance angiography showed normal arterial vessels without evidence of fistula. (orig.)

  2. [Treatment of carotid-cavernous fistula using a detachable balloon catheter--a case report and review].

    Science.gov (United States)

    Chono, Y; Abe, H; Sasaki, H; Abe, S; Takei, H; Koiwa, M; Saito, H

    1983-01-01

    A case of post-traumatic carotid cavernous fistula, successfully treated by a detachable balloon catheter, is reported. A 55-year-old housewife was admitted to the author's department on 25th August, 1980. Three months prior to admission, she complained of right tinnitus following a traffic accident and then developed right chemosis and exophthalmus. A selective right internal carotid angiography revealed rapid filling of the carotid cavernous fistula. Under general anesthesia, the patient was treated by the maneuver after Debrun. Since it appeared necessary to employ the second balloon, the first one was released gently being inflated only with the contrast medium. During the procedure, the neck of the balloon was incidentally snapped upward and, then, the fistula was eventually occluded preserving the carotid flow as was verified by a control angiography. The bruit was abolished immediately after the procedure and all ocular symptoms disappeared during the following a few weeks. A skull film showed a deflation of the balloon at 4 weeks postoperatively, but clinical and angiographic follow-up examinations at 9 months thereafter revealed no signs or symptoms of recurrence. This Debrun's procedure is being widely accepted for a carotid cavernous fistula as a relatively simpler, safer, and more effective one comparing with the conventional methods. Our experiment on dogs, however, indicated that rupture of the balloon is not always avoidable even with a smaller volume than its maximum capacity and some resistance was felt during introduction of the co-axial catheter. Thus, it appeared mandatory to improve and quality control the balloon and the catheter. In the case presented here, a follow-up angiography showed no recurrence of the fistula except for an asymptomatic pseud-aneurysmal pouch, even though the balloon was inflated only with the contrast medium and was deflated within 4 weeks. These findings suggest possibility of successful, and long-lasting outcome

  3. [Successful treatment using detachable coils for traumatic carotid cavernous fistula as a complication of transsphenoidal surgery for a pituitary adenoma: a case report].

    Science.gov (United States)

    Kobayashi, N; Abe, T; Furuya, H; Dohi, K; Shimazu, M; Sasaki, K; Izumiyama, H; Matsumoto, K; Ohki, S; Nemoto, S

    2000-02-01

    We report a case of a patient with traumatic carotid cavernous fistula (CCF) caused by transnasal-transsphenoidal surgery, who was successfully treated using detachable coils. A 47-year-old man was admitted to our hospital because of severe headache. He was confirmed to have a nonfunctioning pituitary adenoma with presellar-type sphenoid sinus. Cerebral angiography initially disclosed no vascular lesions. A transnasal-transsphenoidal adenomectomy was performed. When the anterior wall of the sphenoid sinus was dissected with a chisel, the chisel deeply stuck into the posterolateral part of the sinus. Profuse arterial bleeding was observed through the sphenoid sinus. The bleeding was stopped easily by compression and packing with bone wax. The operation was continued, the sellar floor was opened widely and the tumor was removed subtotally. The medial wall of the cavernous sinus was intact. Histological examination revealed a pituitary adenoma. Immediately after surgery, the patient noticed a bruit. He developed chemosis and abducent palsy on the right side. Cerebral angiography displayed a high-flow CCF, which was attributed to the carotid artery injury caused by the transnasal-transsphenoidal surgery. The CCF disappeared after two-staged embolization using detachable coils, 1st transvenous and 2nd transarterial. Ten months later, cerebral angiography showed persistent occlusion of the fistula, and the patient experienced no tumor recurrence. It is suggested that drilling is a safer procedure than using a chisel for dissection of a sphenoid sinus with incomplete pneumatization. Endovascular treatment using detachable coils proved useful to manage the CCF, an unusual complication of transsphenoidal surgery.

  4. Urgent treatment of severe symptomatic direct carotid cavernous fistula caused by ruptured cavernous internal carotid artery aneurysm using high-flow bypass, proximal ligation, and direct distal clipping: Technical case report

    Directory of Open Access Journals (Sweden)

    Hirotaka Hasegawa

    2014-01-01

    Full Text Available Background: Direct carotid cavernous fistula (CCF secondary to ruptured carotid cavernous aneurysms (CCAs is rare, but patients with this condition who develop acutely worsening and severe neuro-ophthalmic symptoms require urgent treatment. Endovascular methods are the first-line option, but this modality may not be available on an urgent basis. Case Description: In this article, we report a 45-year-old female with severe direct CCF due to rupture of the CCA. She presented with intractable headache and acute worsening of double vision and visual acuity. Emergent radiographic study revealed high-flow fistula tracked from the CCA toward the contralateral cavernous sinus and drained into the engorged left superior orbital vein. To prevent permanent devastating neuro-ophthalmic damages, urgent high-flow bypass with placement of a radial artery graft was performed followed by right cervical internal carotid artery (ICA ligation and the clipping of the ICA at the C3 portion, proximal to the ophthalmic artery. In the immediate postoperative period, her symptoms resolved and angiography confirmed patency of the high-flow bypass and complete occlusion of the CCF. Conclusion: With due consideration of strategy and techniques to secure safety, open surgical intervention with trapping and bypass is a good treatment option for direct severe CCF when the endovascular method is not available, not possible, or is unsuccessful.

  5. Traumatic aneurysm of the supraclinoid internal carotid artery and an associated carotid-cavernous fistula: vascular reconstruction performed using intravascular implantation of stents and coils. Case report.

    Science.gov (United States)

    Lee, Chang-Young; Yim, Man-Bin; Kim, Il-Man; Son, Eun-Ik; Kim, Dong-Won

    2004-01-01

    This report documents the treatment of a traumatic aneurysm of the supraclinoid internal carotid artery (ICA) that was associated with a carotid-cavernous fistula (CCF), which appeared following closed head trauma. This life-threatening lesion, which is very rare, required aggressive management achieved using intravascular stents and coils. A 19-year-old man presented with severe traumatic intracerebral and subarachnoid hematoma after he had suffered a severe closed head injury in a motor vehicle accident. Cerebral angiography performed 11 days after the injury demonstrated a traumatic aneurysm and severe narrowing of the right supraclinoid ICA, which was consistent with a dissection-induced stenosis associated with a direct CCF. Both lesions were successfully obliterated with preservation of the parent artery by using stents in conjunction with coils. Follow-up angiography obtained 7 months postoperatively revealed persistent obliteration of the aneurysm and CCF as well as patency of the parent artery. The patient remained asymptomatic during the clinical follow-up period of 14 months. Endovascular treatment involving the use of a stent combined with coils appears to be a feasible, minimally invasive option for treatment of this hard-to-treat lesion.

  6. 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)

  7. Selection of the methods used in MR angiography with arteriovenous malformation, carotid cavernous fistula, moyamoya disease, and cerebral aneurysms; A comparison of 3-D phase-contrast MRA with 3-D time-of-flight MRA

    Energy Technology Data Exchange (ETDEWEB)

    Ikawa, Fusao; Uozumi, Tohru; Kuwabara, Satoshi (Hiroshima Univ. (Japan). School of Medicine) (and others)

    1993-02-01

    The methods used in MR angiography (MRA) can be roughly divided into two groups: time-of-flight methods (TOF methods) which make use of the influx effect of the flow, and the phase-contrast method of Dumoulin, Souza, and their collaborators (PC method), which utilizes phase differences induced by the flow. In this study, the selection of the MRA method was determined by a comparison of the three-dimensional (3-D) PC and the 3-D TOF method in normal and clinical cases. The tool used was SIGNA Advantage (1.5T) made by GE. The 3-D PC method was applied under a pulse sequence generated by gradient-recalled acquisition in the steady state (GRASS); the pulse sequence used for the 3-D TOF method was spoiled GRASS (SPGR) in a total of 28 cases. The following conclusions were reached: the TOF method should be used when aneurysms, arteriovenous malformations (AVM), and moyamoya disease have been diagnosed, and the PC method should be used when AVM and carotid cavernous fistulae (CCF) are to be evaluated in the flow and when CCFs have been diagnosed. (author).

  8. 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.

  9. An orbital fistula complicating anaerobic frontal sinusitis and osteomyelitis

    NARCIS (Netherlands)

    H.J. Simonsz (Huib); H.J.F. Peeters; G.M. Bleeker

    1982-01-01

    textabstractA patient is described with an orbital fistula complicating frontal sinusitis and osteomyelitis of the frontal bone. The fistula was excised, but a fortnight later an acute exacerbation occurred. From the discharging pus a Staphylococcus aureus was cultured and from mucosa obtained durin

  10. Minimally invasive surgery for pyriform sinus fistula by transoral videolaryngoscopic surgery.

    Science.gov (United States)

    Kamide, Daisuke; Tomifuji, Masayuki; Maeda, Mayuka; Utsunomiya, Kazuho; Yamashita, Taku; Araki, Koji; Shiotani, Akihiro

    2015-01-01

    Pyriform sinus fistula is a rare branchial anomaly that manifests as recurrent cervical infection resulting from contamination of the fistula internal orifice in the pyriform sinus. Although open neck surgery to resect the fistula has been recommended as a definitive treatment, identifying the fistula within the scar is difficult and occasionally results in recurrence. Here, we describe a novel transoral surgical technique for pyriform sinus fistula using transoral videolaryngoscopic surgery (TOVS) as a definitive treatment to resect and close the fistula without skin incision. Needle cautery enables fine excision and delicate dissection of the fistula tract. TOVS is a safe, easy, and reliable treatment and is a suitable first line treatment.

  11. Ectopic Molar with Maxillary Sinus Drainage Obstruction and Oroantral Fistula

    Directory of Open Access Journals (Sweden)

    Shahin Abdollahifakhim

    2013-06-01

    Full Text Available Introduction: Ectopic tooth eruption may result owing to one of 3 processes: developmentalDisturbance, iatrogenic activity, or pathologic process, such as a tumor or a cyst. In rare cases, occlusion of the sinus ostia may predispose a patient to develop a maxillary sinus mucocele. When the maxillary sinus is invaded, symptoms usually occur late in the process.   Case report: A 17 years old boy referred to department of Otolaryngology, Head and Neck Surgery of university of medical sciences, Tabriz_Iran in 2010 with chronic recurrent mucoprulent discharge from retromollar trigone , posterior to right superior alveolar ridge. CT scan revealed a dense mass resembling tooth, obstructing sinus ostium with homogenous opacity with ring enhancement, occupying whole sinus and expanding all walls. A Caldwell Luke approach in combination with endoscopy was selected.   Discussions: In the present patient, removal of ectopic tooth resolved the symptoms completely, the fistula obstructed and discharges discontinued. An ectopic tooth is a rare entity obstructing sinus ostium. The etiology of ectopic eruption has not yet been completely clarified, but many theories have been suggested,including trauma, infection, developmental anomalies and pathologic conditions, such as dentigerous cysts. In summary, although the ectopic teeth is rare but it would be assumed in presence of unilateral symptoms of sinonasal cavity. Therefore in peristant unilateral sinonasal symptoms we should complete examining of this site to rule out rare causes of these symptoms.

  12. Transorbital superior ophthalmic vein sacrifice to preserve vision in ocular hypertension from aseptic cavernous sinus thrombosis.

    Science.gov (United States)

    Ladner, Travis R; Davis, Brandon J; He, Lucy; Mawn, Louise A; Mocco, J

    2015-12-01

    Aseptic cavernous sinus thrombosis (CST) is rare and may clinically masquerade as a carotid cavernous fistula. Conventional management includes oral anticoagulation, but cases of ocular hypertension affecting vision may require more aggressive intervention. We report a case of a woman with spontaneous bilaterally occluded cavernous sinuses with elevated intraocular pressure (IOP), which resolved immediately following unilateral superior ophthalmic vein (SOV) sacrifice. She was subsequently placed on oral anticoagulants. By 4 months postoperatively her IOP was normalized and her vision had improved. Repeat angiography demonstrated stable venous filling, with some mild improvement of flow through the cavernous sinus. Coil-mediated sacrifice of the SOV might be an effective means to relieve ocular hypertension and preserve vision in the setting of aseptic CST.

  13. The role of proper treatment of maxillary sinusitis in the healing of persistent oroantral fistula

    Directory of Open Access Journals (Sweden)

    David B. Kamadjaja

    2008-09-01

    Full Text Available Background: Oroantral communication (OAC is one of the possible complications after extraction of the upper teeth. If not identified and treated properly, a large OAC may develop into oroantral fistula (OAF which means that there is a permanent epithelium-lined communication between antrum and oral cavity. Such fistulas may cause ingress of microorganism from oral cavity into the antrum leading to maxillary sinusitis. Oroantral fistula usually persists if the infection in the maxillary antrum is not eliminated. Therefore, treatment of oroantral fistula should include management of maxillary sinusitis in which surgical closure of oroantral fistula should be done only when the sinusitis has been cured. Purpose: This case report emphasizes on the importance of proper management of maxillary sinusitis in the healing of oroantral fistula. Case: A case of an oroantral fistula following removal of upper left third molar is presented. As the maxillary sinusitis was not identified pre-operatively, two surgical procedures to close the fistula had ended up in dehiscence. Case management: The diagnosis of maxillary sinusitis was finally made and the sinusitis subsequently treated with combination of trans-alveolar sinus wash out, insertion of an acrylic splint, and two series of nasal and sinus physiotherapy procedures. The size of the defect decreased gradually during the treatment of the sinusitis and finally closed up without any further surgical intervention. Conclusion: This case report points out that it is important to detect intraoperatively an antral perforation after any surgery of the maxillary teeth and to close any oroantral communication as early as possible and that it is important to treat properly any pre-existing maxillary sinusitis before any surgical method is done to close the fistula.

  14. Recovery of opthalmoplegia associated with cavernous sinus dural arteriovenous fistulas after transvenous cavernous sinus packing

    Energy Technology Data Exchange (ETDEWEB)

    Lv Xianli; Jiang Chuhan; Li Youxiang; Yang Xinjian [Beijing Neurosurgical institute, Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan Xili, Chongwen, Beijing (China); Wu Zhongxue, E-mail: ttyyzjb@sina.co [Beijing Neurosurgical institute, Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan Xili, Chongwen, Beijing (China)

    2010-08-15

    Background: We report the recovery of ophthalmoplegia in 11 patients with cavernous sinus dural arteriovenous fistula (CSDAVF) after sinus packing at follow-up. Methods: Of 18 patients with CSDAVF treated with transvenous cavernous sinus packing between August 2002 and December 2007 at Beijing Tiantan Hospital, there were 9 patients with initial CNIII or CNVI dysfunction and 2 patients with CNVI dysfunction immediately after cavernous sinus packing selected and reevaluated. Results: Of 11 patients with CNIII or CNVI palsy, recovery was complete in 10. In 1 patient, complete CNVI palsy was unchanged because the CSDAVF was not cured. There were 6 men and 5 women with a mean age of 52.9 years. In 5 patients, CNVI palsy was associated with chemosis, proptosis and pulsatile tinnitus. Timing of treatment after onset of symptoms was from 4 to 35 days in 9 patients. All CSDAVFs were Barrow type D. Mean follow-up after treatment was 17.7 months (range, 2-54 months). Conclusion: CSDAVF-induced CNIII or CNVI palsies can be cured after cavernous sinus packing transvenously in most patients.

  15. Dural cavernous sinus fistulas. Diagnostic and endovascular therapy

    Energy Technology Data Exchange (ETDEWEB)

    Benndorf, Goetz [Baylor College of Medicine, Houston, TX (United States). Dept. of Radiology; Ben Taub General Hospital, Houston, TX (United States). Interventional Neuroradiology

    2010-07-01

    Dural cavernous sinus fistulas (DCSFs) represent a benign vascular disease, consisting in an arteriovenous shunt at the cavernous sinus. In the absence of spontaneous resolution, the fistula may lead to eye redness, swelling, proptosis, chemosis, ophthalmoplegia and visual loss. Although modern imaging techniques have improved the diagnostic, patients with low-flow DCSFs are still misdiagnosed. These patients can get erroneously treated for infections and inflammation for months or years and are at risk of visual loss. Early and proper diagnosis helps to avoid deleterious clinical course of the disease. This volume provides a complete guide to clinical and radiological diagnosis as well as to therapeutic management of DCSF with emphasis on modern minimal invasive treatment options. It commences with an informative description of relevant anatomy. After sections on the classification, etiology and pathogenesis of DCSF, the clinical symptomatology of the disease is described in detail. The role of modern non-invasive imaging tools is then addressed with the use of computed tomography, magnetic resonance imaging and ultrasound. Intra-arterial digital subtraction angiography (DSA), although invasive, remains the gold standard and is mandatory for clinical decision-making and strategy in endovascular treatment. Hence, a throughout consideration is given to both, 2D-DSA and 3D rotational angiography, including recent technological advancements such as Dual Volume (DV) imaging and angiographic computed tomography (ACT). After a short section on arteriovenous hemodynamics, the therapeutic management of DCSFs is described in detail. In particular, various transvenous techniques, required for successful endovascular occlusion of DCSF, are discussed in depth. This well-illustrated volume will be invaluable to all who may encounter DCSF in their clinical practice. (orig.)

  16. Endovascular management of dural fistulas into the cavernous sinus. A systematic review

    Directory of Open Access Journals (Sweden)

    Moscote-Salazar Luis Rafael

    2014-06-01

    Full Text Available Background: Dural fistula to the cavernous sinus (DFCS is an infrequent pathology that consists in the anomalous communication between the meningeal branches of the internal carotid artery (ICA and/or the external carotid artery (ECA and the cavernous sinus. Aim: To perform a systematic review to evaluate clinical and imaging findings in DFCS, and current indications for treatment.

  17. Acute suppurative thyroiditis in children secondary to pyriform sinus fistula.

    Science.gov (United States)

    Sai Prasad, T R; Chong, Chia Li; Mani, Anna; Chui, Chan Hon; Tan, Carolyn Eng Looi; Tee, Wen Sim Nancy; Jacobsen, Anette Sundfor

    2007-08-01

    Acute suppurative thyroiditis (AST), a potential complication of pyriform sinus fistula (PSF), is a rare clinical condition as the thyroid gland is remarkably resistant to infections. Lack of awareness of the entity contributes to the rarity and frustrating recurrences. We performed a retrospective review of all cases of AST due to PSF treated at our institution over a 10-year period. The clinical data, investigations, operative findings and procedures, microbial culture reports and follow-up were recorded and analyzed. Between January 1997 and September 2006, 12 cases (8 males and 4 females) of AST due to PSF were treated. Nine patients (75%) underwent successful complete excision, seven of whom had initial incision and drainage procedures. In three patients (25%) with recurrence, one underwent complete excision at a later procedure, one patient had multiple recurrences with six incision and drainage procedures and two failed attempts of excision of PSF before final successful complete excision. The third patient is awaiting re-excision of the PSF tract. All patients, except the one awaiting re-excision, are well with no further recurrences during the follow-up period that ranged from 18 to 96 months (median, 46.5 months). AST due to PSF is a challenging entity in terms of diagnosis and management as recurrences are common despite meticulous dissection. High index of suspicion and radiological investigations such as barium studies and computed tomography scan aid in the delineation and excision of the fistulous tract.

  18. Acute suppurative thyroiditis secondary to piriform sinus fistula: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Diez, O.; Anorbe, E.; Aisa, P.; Saez De Ormijana, J.; Aguirre, X.; Paraiso, M. [Department of Radiology, Hospital Santiago Apostol, C/Olaguibel 29, E01004 Vitoria-Gasteiz (Spain)

    1998-11-01

    We present a typical case of acute suppurative thyroiditis (AST), associated with a piriform sinus fistula. We illustrate the case with an ultrasound picture of a hypoechogenic perithyroid mass and a CT scan using intravenous iodine contrast showing a perithyroid hypodense mass with peripheral enhancement, the mass also having intrathyroid involvement. When clinical and radiological findings suggest the presence of AST, it is necessary to rule out the presence of a piriform sinus fistula by means of a radiological study with barium contrast. Piriform sinus fistula is a rare abnormality derived from the branchial arch which is directly related to recurrent episodes of AST; surgical excision is hence, necessary to avoid such episodes. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

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

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Ziyin; Wang, Chaohua; Zhang, Changwei; Xie, Xiaodong [Dept. of Neurosurgery, West China Hospital of Sichuan University, Chengdu (China); Wang, Kun; Tang, Jianjian [Dept. of Neurosurgery, Affiliated Hospital of Hainan Medical College, Haikou (China)

    2013-06-15

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

  20. Preoperative identification of the internal opening with the modified Killian's method in a case of pyriform sinus fistula.

    Science.gov (United States)

    Kano, Makoto; Murono, Shigeyuki; Yamamoto, Tamaki; Yoshizaki, Tomokazu

    2016-01-01

    Pyriform sinus fistula is a rare branchial pouch anomaly, which causes recurrent neck abscess. Although complete excision of the fistula tract is considered as a definitive treatment for pyriform sinus fistula, it has been suggested that chemocauterization with trichloroacetic acid (TCA) of the internal opening is a reasonable treatment. For this purpose identifying the existence of an internal opening is important. Here, we describe the Modified Killian's method, a recently proposed simple endoscopic technique to observe a wider area of the hypopharyngeal space, and show that it is helpful to identify the internal opening of the pyriform sinus fistula. The Modified Killian's method is a suitable examination for pyriform sinus fistula prior to TCA chemocauterization.

  1. Therapeutic embolization of cavernous sinus dural arteriovenous fistulas via transvenous approach

    Institute of Scientific and Technical Information of China (English)

    侯凯; 罗祺; 陈强; 王宏磊; 罗毅男; 王长坤

    2003-01-01

    Objective To describe the transvenous catheterization technique for the treatment of cavernous sinus dural arteriovenous fistulas (CSdAVFs), including its indications, complications and efficacy.Methods Eight patients with symptomatic CSdAVFs were treated by endovascular embolization with platinum coils, via the inferior petrosal sinus (IPS) in 6 patients, and via the Sylvian vein after surgical exposure in other 2 patients.Results Complete angiographic resolution of the fistula was obtained in six patients immediately after the procedures, and a complete resolution of symptoms and signs was achieved in all patients. The residual fistulas in two patients disappeared completely in the follow-up angiography.Conclusion Transvenous embolization is a useful and safe approach in the management of CSdAVFs.

  2. A dural arteriovenous fistula in cavernous sinus developed from viral meningitis.

    Science.gov (United States)

    Hai, Jian; Zhang, Lin; Wan, Jue-Feng; Su, Shao-Hua; Wang, Fei; Zhang, Gui-Yun

    2011-06-01

    Although hormonal influences, inflammation, trauma, sinus thrombosis, venous hypertension, and congenital origin have been proposed as sources of dural arteriovenous fistulas (DAVFs) in cavernous and sigmoid sinuses, the etiology of these lesions remains controversial. We present a case with a cavernous sinus DAVF developed from viral meningitis which has not been previously described. A 24-year-old male was admitted to our institute because of periorbital pain, decreased vision, pulsatile tinnitus, chemosis, and exophthalmos on the right side after he had suffered viral meningitis four months before. Cerebral angiography demonstrated a cavernous sinus DAVF, which was successfully obliterated with several platinum coils using a transvenous approach. The viral meningitis most likely caused the inflammation, that may be responsible for the occurrence of the cavernous sinus DAVF. Prompt treatment for inflammation may help to prevent the development of DAVFs.

  3. [The impact of endovascular intervention on visual functions in patients with traumatic carotid-cavernous anastomosis].

    Science.gov (United States)

    Ryzhova, I P

    1997-01-01

    In 217 patients with traumatic carotid-cavernous anastomosis (TCCA) the visual functions investigation before and after endovascular intervention conduction for the anastomosis exclusion was done. Cessation of the noise in the head synchronous with a pulse, decrease of disappearance of an exophthalmus of an eye or superior optical vein pulsation, of congestional appearance in the orbit, were the signs of the complete anastomosis exclusion. Rehabilitation or increase of visual acuity, improvement of an eye fundus ophthalmological picture, vascular index normalization were noted during deep ophthalmological investigation. Decrease of the blind spot parameters was an objective index of the visual functions rehabilitation, witnessing the disappearance of optical nerve disc (OND) oedema, contrast frequential characteristics normalization, critical frequency of light flashings radiance (CFLFR) rise, decrease of a papillary cycle time (PCT). Studying of the parameters mentioned have special significance for the estimation of postoperative conservative therapy efficiency.

  4. Endovascular treatment of dural fistulas with the venous outflow of laterocavernous sinus

    Energy Technology Data Exchange (ETDEWEB)

    Lv Xianli; Jiang Chuhan; Li Youxiang; Lv Ming [Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, No. 6, Tiantan Xili, Chongwen, Beijing, 100050 (China); Wu Zhongxue, E-mail: ttyyzjb@sina.co [Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, No. 6, Tiantan Xili, Chongwen, Beijing, 100050 (China)

    2010-08-15

    Objective: To report our findings concerning the laterocavernous sinus (LCS) drainage of dural fistulas, focusing our attention on the important implications in treatment of the LCS, which is one of the principal drainage pathways of the superficial middle cerebral vein (SMCV). Methods: Consecutive 32 patients with dural fistulas treated endovascularly between 2005 and 2008 were reviewed. Seven patients had angiographic features such as dural fistulas draining with SMCV via LCS. Clinical records for these 7 patients were focused to determine their presenting symptoms, angiographic features, endovascular treatments, and clinical outcomes. Results: Over 3 years, 7 patients had 7 dural fistulas drained with SMCV via LCS were treated. Six-vessel angiography confirmed the presence of the dural fistulas. All fistulas were Cognard Type III featured by leptomeningeal veins drainage. One fistula involving the lesser sphenoid wing and 6 fistulas involving CS were supplied by external carotid artery branches with or without dural branches of the internal carotid artery. LCS was identified as a contiguous to SMCV drainage in these cases. One patient was treated with transvenous coil embolization alone, two with transvenous a combination of Onyx and coil embolization, and 4 with transarterial embolization. An angiographic obliteration and clinical cure was achieved in all patients. Complication was local hair loss due to X-ray radiation in one patient. Conclusion: It is very important to diagnose the presence of LCS in dural fistulas during the diagnostic angiography. It is believed that the knowledge of LCS might be relevant for the understanding and treatment of dural fistulas involving the LCS.

  5. [Childhood transverse sinus dural arteriovenous fistula treated with endovascular and direct surgery: a case report].

    Science.gov (United States)

    Niizuma, Kuniyasu; Sakata, Hiroyuki; Koyama, Shinya; Kon, Hiroyuki; Chonan, Masashi; Sasaki, Tatsuya; Nishijima, Michiharu; Ezura, Masayuki; Tominaga, Teiji

    2012-11-01

    Infantile dural arteriovenous fistula is a rare cerebrovascular malformation carrying a poor prognosis with an anatomic cure of only 9%. Endovascular embolization is mainly selected to treat this entity, aiming to obtain normal development of the patients. We present a case of a 20-month-old girl with epilepsy. Digital subtraction angiography revealed a dural arteriovenous fistula involving the right transverse sinus. The arteriovenous fistula was fed by multiple dural branches from the middle meningeal, occipital, meningohypophyseal, and anteroinferior cerebellar arteries. The right transverse sinus was transvenously embolized with platinum coils. Although the shunt flow remained, the patient was liberated from epilepsy. Nine months later, the patient suffered from a recurrence of epilepsy. Digital subtraction angiography demonstrated some increase in shunt flow. Right middle meningeal, occipital, posterior deep temporal, and tentorial arteries were transarterially embolized using N-butyl cyanoacrylate, followed by complete surgical resection of the right transverse sinus. The shunt flow disappeared after surgery, and her epilepsy improved significantly. Our experience suggests that the combination of endovascular and surgical treatment is effective for recurrent infantile dural arteriovenous fistula.

  6. Submucosal Abscess of the Esophagus Caused by Piriform Sinus Fistula Treated with Transoral Video Laryngoscopic Surgery.

    Science.gov (United States)

    Koyama, Satoshi; Fujiwara, Kazunori; Morisaki, Tsuyoshi; Fukuhara, Takahiro; Kawamoto, Katsuyuki; Kitano, Hiroya; Takeuchi, Hiromi

    2016-01-01

    Piriform sinus fistula (PSF) is a rare branchial anomaly that causes repetitive acute suppurative thyroiditis or deep neck abscess. The definitive treatment of PSF is open neck surgery. However, such surgery has a cosmetic problem and a high risk of recurrence. Furthermore, identifying the fistula is difficult due to previous repetitive infections. We report a case of esophageal submucosal abscess caused by PSF treated with endoscopic mucosal incision. The patient underwent transoral video laryngoscopic surgery (TOVS), and endoscopy as well as fluoroscopy revealed complete closure of PSF without any complication. TOVS is a novel surgical technique for the definitive treatment of PSF with esophageal submucosal abscess.

  7. Endovascular management of dural arteriovenous fistulas of the transverse and sigmoid sinus in 150 patients

    Energy Technology Data Exchange (ETDEWEB)

    Kirsch, M. [Ernst-Moritz-Arndt-Universitaet Greifswald, Institut fuer Diagnostische Radiologie und Neuroradiologie, Greifswald (Germany); Liebig, T. [TU Muenchen, Institut fuer Neuroradiologie, Klinikum Rechts der Isar, Munich (Germany); Kuehne, D. [Klinik fuer Radiologie und Neuroradiologie, Alfried-Krupp-Krankenhaus, Essen (Germany); Henkes, H. [Katharinenhospital-Klinikum Stuttgart, Klinik fuer Neuroradiologie, Stuttgart (Germany)

    2009-07-15

    This study aimed to evaluate the safety and efficiency of the endovascular treatment of transverse-sigmoid sinus dural arteriovenous fistulas (TS{sub d}AVF). A total of 150 consecutive patients and 348 procedures were evaluated. Pulsatile tinnitus (81%), headache (15%), and intracranial hemorrhage (10%) were the most frequent manifestations of the TS{sub d}AVFs. More than half of the affected sinuses were partially or completely thrombosed. Access-wise treatment was performed transarterial (n = 33), transvenous (n = 21), or a combination thereof (n = 96). A mean of 2.4 procedures per patient was required. Immediate postprocedural occlusion rate after transarterial embolization was 30% only. Transvenous treatment alone resulted in an early occlusion rate of 81%, with delayed complete obliteration of half of the remaining fistulas. After combined transarterial/transvenous treatment, the angiographic cure rate was 54%. At follow-up, 88% of patients with residual shunt after the treatment showed complete occlusion. The cumulative complication rate was 9% (n = 13), with minor adverse events in ten patients (7%) and major complications in three patients (2%). Transvenous coil occlusion of the sinus segment with the adjacent dAVF site, eventually combined with transarterial occlusion of supplying arteries, is a very effective and well-tolerated treatment method. In selected patients, variations of these methods (e.g., sinus stenting, compartmental sinus occlusion) can be useful. (orig.)

  8. Long term follow-up of 43 pure dural arteriovenous fistulae (AVF) of the lateral sinus

    Energy Technology Data Exchange (ETDEWEB)

    Fermand, M.; Reizine, D.; Melki, J.P.; Riche, M.C.; Merland, J.J.

    1987-07-01

    Fourty-three patients with arterio-venous fistulae of the dura of the transverse sinus with a complaint of tinnitus are reviewed, with a follow-up of 12 months to 11 years. 34 patients were embolized, 2 treated surgically, and 7 were untreated. Embolization appears to have been beneficial. The benign nature of this abnormality must be emphasized, and serious psychological study of the patient must be made before deciding on therapy.

  9. Odontogenic sinusitis, oro-antral fistula and surgical repair by Bichat's fat pad: Literature review.

    Science.gov (United States)

    Bravo Cordero, Gustavo; Minzer Ferrer, Simona; Fernández, Lara

    2016-01-01

    Odontogenic sinusitis accounts for 10-12% of maxillary sinusitis. It occurs due to an interruption of the mucoperiosteum in response to a series of conditions, most frequently the extraction of a superior tooth. Its treatment has two bases: treating the infection and managing the oroantral fistula that perpetuates the infection. Communications smaller than 5mm can resolve spontaneously; bigger ones must be closed by a flap. Bichat's fat pad flap was first used in 1977 to close an oroantral fistula. It is a pedicled flap that has been shown to be successful, with advantages that make it the best option in oroantral fistula treatment. Its location allows easy access, minimum dissection, great versatility, good mobility, good blood supply, low rate of complications, no morbidity in the donor site, low risk of infection, shortened surgical time and fast cover by epithelium, and it leaves no visible scar, amongst other benefits. That is why we encourage the use of this technique and choose it as the best option for management of our patients.

  10. Treatment of a cavernous sinus dural arteriovenous fistula by deep orbital puncture of the superior ophthalmic vein

    Energy Technology Data Exchange (ETDEWEB)

    Benndorf, G. [Neuroangiography, Department of Radiology, Charite, Humboldt University Berlin (Germany); Bender, A. [Neuroradiology, Department of Radiology, Charite, Humboldt University Berlin (Germany); Campi, A. [Dept. of Neuroradiology, Hospital San Raffaele, Milan (Italy); Menneking, H. [Dept. of Maxillofacial Surgery, Charite, Humboldt University Berlin (Germany); Lanksch, W.R. [Department of Neurosurgery, Charite, Humboldt University Berlin, Augustenburger Platz 1, 13 353 Berlin (Germany)

    2001-06-01

    In a patient with progressive ophthalmological problems, including uncontrolled intraocular pressure related to a cavernous sinus dural arteriovenous fistula, urgent intervention may be necessary to prevent permanent visual loss. We report a case in which inadequate transarterial embolisation and lack of access for transvenous catheterisation, including a direct approach through the superior ophthalmic vein, preceded percutaneous puncture of the superior ophthalmic vein deep within the orbit, permitting venous occlusion without complications. This case demonstrates that deep orbital puncture of the vein is feasible for occlusion of a cavernous sinus dural arteriovenous fistula. (orig.)

  11. Endovascular management of sigmoid sinus dural arteriovenous fistula associated with sinus stenosis in an infant.

    Science.gov (United States)

    Cohen, José E; Gomori, John M; Benifla, Moni; Itshayek, Eyal; Moscovici, Samuel

    2013-01-01

    A 4-month-old female presented with a dural arteriovenous fistula (DAVF), which was successfully managed using endovascular techniques. There are very few case series reporting DAVF in infants younger than 12 months and, to our knowledge, only 60 pediatric patients with DAVF have been reported to date. Although most DAVF have a benign course, they can result in life-threatening hemorrhage. Endovascular therapies are usually indicated in the management of these neurosurgical vascular malformations. Endovascular therapy of DAVF in neonatal patients presents some major issues. Gaining arterial access may be problematic in femoral arteries too small for the introduction of a sizeable guiding catheter. The volumes of contrast and infused fluids must be carefully monitored to prevent fluid overload. Radiation exposure should be restricted as far as possible. This report contributes to the limited body of evidence on neonatal DAVF and its endovascular management.

  12. Fistulas

    Science.gov (United States)

    A fistula is an abnormal connection between two parts inside of the body. Fistulas may develop between different organs, such as between ... two arteries. Some people are born with a fistula. Other common causes of fistulas include Complications from ...

  13. Sinusitis

    Science.gov (United States)

    Sinusitis means your sinuses are inflamed. The cause can be an infection or another problem. Your sinuses ... and cause pain. There are several types of sinusitis, including Acute, which lasts up to 4 weeks ...

  14. Sinusitis

    OpenAIRE

    2000-01-01

    ¿Qué son los senos para nasales?/ ¿Qué es la sinusitis?/Tipos de sinusitis/Causas de sinusitis/Factores que predisponen/La sinusitis y su relación con otras enfermedades del tracto respiratorio/Signos y síntomas/Complicaciones de la sinusitis.

  15. Fistula

    Science.gov (United States)

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

  16. Successful sinus restoration for transverse-sigmoid sinus dural arteriovenous fistula complicated by multiple venous sinus occlusions: The usefulness of preoperative computed tomography venography

    Directory of Open Access Journals (Sweden)

    Koichiro Takemoto

    2015-01-01

    Conclusion: Sinus restoration is preferable in patients with severe cerebral venous congestion due to multiple sinus occlusions and/or a restricted collateral venous outlet. CT venography is useful for precise evaluation of the length and configuration of the occluded segment, which thus make it possible to evaluate the feasibility of stenting.

  17. Clinical and angiographic characteristics of cavernous sinus dural arteriovenous fistulas manifesting as venous infarction and/or intracranial hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Miyamoto, Naoko; Naito, Isao; Takatama, Shin; Shimizu, Tatsuya; Iwai, Tomoyuki [Geriatrics Research Institute and Hospital, Department of Neurosurgery, Maebashi (Japan); Shimaguchi, Hidetoshi [Gunma University Graduate School of Medicine, Department of Neurosurgery, Maebashi (Japan)

    2009-01-15

    Cavernous sinus (CS) dural arteriovenous fistulas (DAVFs) rarely cause venous infarction (VI) and/or intracranial hemorrhage (ICH) despite the presence of cortical venous drainage (CVD). The present study investigated the characteristics of CS DAVFs manifesting as VI/ICH. Fifty-four patients treated for CS DAVFs were retrospectively studied. Six patients presented with VI/ICH. Two of the three patients presenting with ICH had CVD only to the superficial sylvian vein (SSV) or the deep sylvian vein (DSV). Three patients presenting with VI had multiple drainages, and angiography of these patients showed a varix on the SSV, drainage into the DSV with agenesis of the second and third segment of basal vein of Rosenthal, and thrombosis of the distal petrosal vein. CS DAVF with CVD only carries higher risk of VI/ICH than multiple drainages. Many CS DAVFs presenting with VI, especially those with drainage into the petrosal vein, have multiple drainages in the early stage. Thrombosis of the inferior and superior petrosal sinuses and superior orbital vein gradually increases pressure of the CVD, and then, VI may occur. In contrast, CS DAVFs with CVD only from the beginning, common in the patients with drainage into the SSVs and DSVs, are likely to cause ICH. Angiographic risk factors causing VI/ICH are CVD only, varix formation, agenesis of the second and third segment of basal vein of Rosenthal, and thrombosis of the superior orbital vein, lateral half of the superior petrosal sinus, and distal CVD. (orig.)

  18. Sinusitis

    Science.gov (United States)

    ... the result of an infection from a virus, bacteria, or fungus. Causes The sinuses are air-filled spaces in ... than 3 months. It may be caused by bacteria or a fungus. The following may increase the risk that an ...

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

    Directory of Open Access Journals (Sweden)

    Sabzi, Feridoun

    2015-11-01

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

  20. Isolated oculomotor nerve palsy caused by cavernous sinus dural arteriovenous fistula: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Ihn, Yon Kwon; Jung, Won Sang [The Catholic Univ. of Korea, Suwon (Korea, Republic of); Kim, Bum Soo [The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2012-10-15

    Cavernous dural arteriovenous fistula (DAVF), which usually presents with conjunctival injection, proptosis, loss of visual acuity, and ophthalmoplegia, is a rare cause of ophthalmoplegia. Thus, it may be overlooked when the typical symptoms are lacking. There have been some cavernous DAVF case reports presenting with isolated oculomotor, abducens and trochlear nerve palsy. We report a patient presenting with isolated oculomotor palsy, caused by cavernous DAVF, which was treated by transvenous coil embolization. This case suggests that cavernous DAVF should be considered in the differential diagnosis of isolated oculomotor nerve palsy and for which case - selective angiography and embolization may be helpful in reaching a diagnosis and providing a guide for optimal treatment.

  1. The clinical effect of Maxillary sinus fistula neoplasty assisted with endoscopic%鼻内镜辅助下口腔上颌窦瘘修补术的临床疗效

    Institute of Scientific and Technical Information of China (English)

    顾晓莉

    2015-01-01

    目的:探讨口腔上颌窦瘘的修补方法。方法:对5例合并严重上颌窦炎的口腔上颌窦瘘患者,在鼻内镜辅助下采用口腔合瓣缝合加上颌窦内“三明治”法修补。结果:5例患者均一期愈合,随访3个月~1年,瘘口愈合良好,复查鼻窦CT上颌窦炎症消失。结论:鼻内镜辅助下口腔内合瓣缝合加上颌窦内“三明治”法修补术是治疗合并严重上颌窦炎口腔上颌窦瘘的有效方法。%Objective:To investigate the repair method of maxillary sinus fistula.Methods:5 patients with oral maxillary sinus fistula combined severe maxillary sinusitis were taken oral sympetalous suture plus maxillary sinus "sandwich" repair under endoscopic assisted.Results:All of those 5 patients were primary healing,and followed up for 3 months to 1 years,the fistula of patients healing well,and the inflammation of maxillary sinus disappeared when reviewed the sinus CT.Conclusion:Oral sympetalous suture plus maxillary sinus "sandwich" repair under endoscopic assisted is an effective treatment of patients with oral maxillary sinus fistula combined severe maxillary sinusitis.

  2. [The experience with the application of a lyophilized xenodermograft for the treatment of the patients suffering from frequently recurring inflammation of the maxillary sinus in combination with alveolar fistula].

    Science.gov (United States)

    Skakun, L N; Tsimbaliuk, A V

    2015-01-01

    The objective of the present study was to summarize the data of the special literature concerning methods of the surgical treatment of odontogenic maxillary sinusitis complicated by the alveolar fistula with the purpose of using them for the improvement of the effectiveness of the treatment of the patients presenting with this pathology. The study group was comprised of 39 patients with odontogenic diseases of paranasal sinuses and alveolar fistulas. The alveolar fistulas were closed in 20 patients by means of plastic surgery with the use of a lyophilized xenodermograft prepared from the pig's skin. Not a single case of relapse of the inflammatory process in the maxillary sinuseswas documented within one year after the treatment by means of the closure of the alveolar fistula using the lyophilizedxenodermografts.

  3. Closure of 1.5-cm alveolar oral antral fistula with intra-alveolar sinus membrane elevation and bone morphogenetic protein-2/collagen graft followed by dental implant restoration: case report.

    Science.gov (United States)

    Cottam, Jared R; Jensen, Ole T; Beatty, Lucas; Ringeman, Jason

    2013-01-01

    Closure of a 1.5-cm oral antral fistula was done in combination with sinus floor and extraction socket grafting using recombinant human bone morphogenetic protein-2 within a collagen sponge matrix. The approach to the sinus was transalveolar, with elevation of the sinus membrane done through a molar extraction socket. Following graft placement, soft tissue repair was done with a buccal advancement flap. A dental implant was subsequently placed and restored. Peri-implant bone and implant stability were well maintained at the 1-year follow up examination.

  4. Recurrent pyriform sinus fistula successfully treated by endoscopic Glubran 2 sealing: A rare case and literature review

    Science.gov (United States)

    Di Nardo, Giovanni; Valentini, Valentino; Angeletti, Diletta; Frediani, Simone; Iannella, Giannicola; Cozzi, Denis; Roggini, Mario; Magliulo, Giuseppe

    2016-01-01

    Objectives: The authors present the case of a 3-year-old girl with a history of complicated surgery for removing a third branchial cleft fistula. Methods: An endoscopic approach using N-butyl-2-acrylate and metacrilosisolfolane glue (GLUBRAN 2) to seal the fistula was performed. Results: The clinical and radiological 6-year follow-up confirmed the absence of the fistulous orifice and the persistence of scar due to previous open-neck surgical procedures. Conclusion: endoscopic Glubran 2 sealing has been an effective treatment procedure for branchial fistula. PMID:27781098

  5. [The modern strategy for the treatment of the patients presenting with odontogenic maxillary sinusitis and the oroantral fistula].

    Science.gov (United States)

    Magomedov, M M; Khelminskaya, N M; Goncharova, A V; Starostina, A E

    2015-01-01

    The objective of the present study was the comparative analysis of various methods for the plastic correction of the oroantral fistula with the use of the mucosal flap and the osteoplastic materials based on the data from the literature and on-line publkations. The characteristics of an ideal material for the plastic correction ot the oroantral fistula and the conditions for carrying out this surgery are discussed.

  6. Primitive trigeminal artery-cavernous sinus fistula and ICA-primitive trigeminal artery aneurysm:report of two cases and review of literatures

    Institute of Scientific and Technical Information of China (English)

    GUO Yuan-xing; LI Tie-lin; DUAN Chuan-zhi; WANG Qiu-jing; HUANG Qing

    2004-01-01

    The authors described two cases with primitive trigeminal artery. Case 1 was a 32-year-old woman who suffered dizziness and a serious pulsatile intracranial bruit on the left ear, and sometimes associated with pulsatile intracranial bearing-pain on the left temporal side six months before she was admitted to the hospital. She also suffered from obvious diplopia on left lateral gaze for the last 5 months. She had suffered no recent trauma. Magnetic resonance imaging(MRI) demonstrated a suspected intracranial aneurysm located in left cavernous sinus. Digital subtraction angiography (DSA) was performed and a primitive trigeminal artery-cavernous sinus fistula in left side was found. Intraluminal occlusion of the fistula was successfully performed immediately after angiography using 6 Guglielmi detachable coils (GDC), and the patient was cured finally. Case 2 was a 28-year-old woman who suffered a serious intermittent cephalodynia associated with soreness on the left body two years before she was admitted to the hospital. She had suffered no recent trauma. Magnetic resonance angiography(MRA) demonstrated a suspected intracavernous aneurysm of the right internal carotid artery, Digital subtraction angiography (DSA) was performed. Right internal carotid angiography showed a primitive trigeminal artery (PTA) run between the cavernous segment of the internal carotid artery and the distal portion of the basilar artery. On initiation of PTA of R-ICA a small wide-necked saccular aneurysm was incidentally visualized. The aneurysm was successfully embolized after angiography using 2 Stent (Neuroform, 4.5mmm × 20mmm)-assisted detachable coils (Matrix), the ICA and PTA were preserved, and the patient was cured finally.

  7. MRI in perianal fistulae

    Directory of Open Access Journals (Sweden)

    Khera Pushpinder

    2010-01-01

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

  8. 儿童梨状窝瘘的临床及影像学分析%The causes and imaging diagnosis of congenital pyriform sinus fistula in children

    Institute of Scientific and Technical Information of China (English)

    尹传高; 史自锋; 齐炜炜

    2015-01-01

    Objective To probe the cause,clinical and imaging findings of children's congenital pyriform sinus fistula (CPSF). Methods Clinical and radiographic data in 23 patients with children’s CPSF were analyzed retrospectively which were confirmed by pathology.Results 1 6 patients represented repeated swelling and pain in left anterior neck,6 of whom were misdiagnosed as thyroid abscess and suffered surgery.7 patients represented masses in left anterior neck.Ultrasound showed all patients with diffuse en-larged thyroid gland with uneven mass and separated liquid dark space or infection in deep neck soft tissue,and no CPSF was identi-fied.The subsequent esophageal barium meal confirmed the fistula in 8 patients,and other patients underwent further CT scan with image post-processing.CT showed clear fistula in 4,suspicious fistula in 7 and no fistula in 4,All fistulas were confirmed by the pa-thology.Conclusion The combination of ultrasound,esophagogram and CT with image post-processing can improve the diagnostic sensitivity and accuracy of CPSF.%目的:分析儿童先天性梨状窝瘘(CPSF)的成因、临床及影像学表现,提高对其的认识。方法回顾性分析23例经术后病理证实 CPSF 患儿的临床和影像学资料。结果23例患儿中16例以左颈前反复肿痛就诊,其中6例曾误诊为甲状腺脓肿并手术;7例以颈前肿块入院。全部患儿超声显示患侧甲状腺弥漫性肿大伴不均匀占位,部分合并分隔性液性暗区,或颈深部软组织感染,无确诊梨状窝瘘者;食管钡餐造影直接确诊瘘管8例;未明确看到瘘管者行 CT 扫描及图像后处理,明确诊断4例,可能性7例,未考虑者4例,后全部经病理证实。结论超声、食管吞钡造影和 CT 扫描的综合运用可提高儿童梨状窝瘘诊断的敏感性和正确率。

  9. Clinical observation analysis of treatment 334 patients' anal sinusitis by incision and drainage anal fistula%肛窦切开引流术治疗肛窦炎334例临床分析

    Institute of Scientific and Technical Information of China (English)

    徐征; 赵义群; 李文峰

    2012-01-01

    目的 探索肛窦炎的有效治疗方法及疗效.方法 回顾性总结我科2005~2008年634例肛窦炎治疗经过,治疗组334例,采用肛窦切开引流术;对照组300例采用保守治疗.结果 治疗后,治疗组总有效率100%;对照组总有效率80.3%.治疗组复发率明显少于对照组.结论 肛窦切开引流术可治疗肛窦炎,并有效避免了脓肿或肛瘘的发生.%Objective In order to probe into the effective therapy and curative effect. Methods Reviewed summary our hospital 634 patients, 334 anal sinusitis patients by using anal fistula curative effect and other 300 patients take conservation treatment. Results After treatment, patients in the treatment group have a 100% effective rate; an other group has a 80. 3% . Treatment group's recurrence rate is absolutely less than normal group. Conclusion Incision and drainage anal fistula can cure anal sinusitis and avoid abscess and anal fistula effective.

  10. 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.)

  11. Gastrointestinal fistula

    Science.gov (United States)

    Entero-enteral fistula; Enterocutaneous fistula; Fistula - gastrointestinal ... Most gastrointestinal fistulas occur after surgery. Other causes include: Blockage in the intestine Infection Crohn disease Radiation to the abdomen (most ...

  12. 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.

  13. [Pay attention to the imaging diagnosis of complex anal fistula].

    Science.gov (United States)

    Zhou, Zhiyang

    2015-12-01

    The diagnosis and treatment of complex anal fistula has been a significant challenge. Unwise incision and excessive exploration will lead to the secondary branch, sinus and perforation. A simple fistula may become a surgical problem and result in disastrous consequences. Preoperative accurate diagnosis of anal fistula, including in the internal opening, primary track and location of the fistula, extensions and abscess, is important for anal fistula treatment. In the diagnosis of anal fistula, imaging examination, especially MRI plays a crucial role. Localization and demarcation of anal fistula and the relationship with sphincter are important. MRI has been an indispensable confirmatory imaging examination.

  14. [Pulse synchronous bruit, swollen eye, diplopia, exophthalmos, chemosis and diplopia three weeks after a head trauma].

    Science.gov (United States)

    Tabakovic, S; Nigg, Christel; Landau, K; Zerkiebel, N

    2010-11-01

    Traumatic carotid-cavernous sinus fistulas represent an uncommon complication of a head trauma. The consequences of a delayed diagnosis are progressive ocular complications such as visual loss, extraocular muscle palsy, progressive proptosis, conjuctival chemosis, retinal vein occlusion and secondary glaucoma. Moreover, severe epistaxis, intracerebral and subarachnoidal hemorrhage may occur. We present a patient who developed a carotid-cavernous sinus fistula within three weeks after a craniocerebral injury. Despite initial exclusion of an arteriovenous fistula using duplex sonography, angiography later demonstrated the carotid-cavernous sinus fistula that was successfully occluded be means of catheter intervention. The patient's symptomatology consisting of pulse synchronous bruit, red, swollen and painful eye, diplopia, chemosis, pulsating exophthalmos, ocular hypertension and progressive visual loss allowed various differential diagnoses. Apart from inflammatory, mechanical, autoimmune, vascular and tumorous disorders, a traumatic cause was highly probable considering the patient's history of craniocerebral injury. A rapid elimination of such a fistula is necessary in order to prevent long-term damage. However it is important to consider the possible complications due to the intervention, in our case the risk of a hyperperfusion syndrome with a consecutive cerebral hemorrhage.

  15. 微弹簧圈治疗1例外伤性颈内动脉海绵窦瘘的护理体会%Nursing of patients with traumatic carotid-cavernous fistula treated with micro-coil

    Institute of Scientific and Technical Information of China (English)

    谢金婵

    2008-01-01

    颈内动脉海绵窦瘘(简称CCF)是指位于海绵窦内的颈内动脉或其分支,因外伤破裂直接与静脉交通,形成动、静脉瘘,其原因常为颅底骨折而致,在颅脑损伤中的发生率约为2.5%。据Sedzimir(1976)统计,从所在医院中1956~1965年收治的1100例头面部外伤病例中只有3例CCF病人,而Herrmann(1975)报告其所在医院收治的颅脑伤病例中只占1.8%。2007年10月28日我院收治了1例车祸2d后出现左颈内动脉海绵窦瘘的患者,行微弹簧圈治疗后痊愈出院。现将护理体会报道如下。

  16. Sinus Surgery

    Science.gov (United States)

    ... the surgical strategy was to remove all sinus mucosa from the major sinuses. The use of an ... improved drainage system is achieved, the diseased sinus mucosa has an opportunity to return to normal. FESS ...

  17. Sinus Anatomy

    Science.gov (United States)

    ... Caregivers Contact ARS HOME ANATOMY Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure ... Size + - Home > ANATOMY > Sinus Anatomy Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure ...

  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. Colovesicular Fistula

    OpenAIRE

    2012-01-01

    A fistula is an atypical connection between two epithelial surfaces, in the case of an enterovesical fistula between the urinary and gastrointestinal systems. These may be the result of a number of causes including: 1. Congenital abnormalities 2. Inflammatory diseases of the bowel (such as diverticulitis and Crohn’s Disease) 3. Cancer 4. Infection 5. Trauma 6. Iatrogenic (such as a post-operative complication) [3] A colovesical fistula (colovesicular fistula), an abnor...

  20. T tube sinus fibrin sealant implantation to assist the treatment of biliary fistula after removal of T tube%经T管窦道生物蛋白胶植入协助治疗拔T管后胆漏

    Institute of Scientific and Technical Information of China (English)

    任贵兵; 毛中鹏; 吴凤云; 张瑞奎; 马熙; 王磊

    2013-01-01

    Objective To study the treatment approach of biliary fistula after removal of T tube, in the process of laparoscopic choledocholithotomy with T tube drainage (LCTD). And, on the basis of clinical routine methods, to discuss the feasibility of fibrin glue to block T tube sinus orifice. Methods The research objects were collected for the LCTD postoperatively, biliary fistula found after the removal of T tube. Thirty-six cases were randomly divided into 2 groups. A control group of 18 cases, when bile leakage found after the removal of the T tube, food and water fasting, gastrointestinal decompression, acid and enzyme inhibition, anti infection treatments were carried out. At the same time, the endoscopic T tube sinus catheter was placed or endoscopic nasobiliary drainage undergone. The study group of 18 cases, when bile leakage found after the removal of the T tube, in addition to the routine methods carried out same as the control group, fibrin glue sealant was implanted through T tube sinus by choledochofiberscopy, to block the sinus laceration or the incomplete healing. Recovery conditions in patients of two groups were compared and statistically analyzed. Results In the control group, signs of peritonitis recovered more slowly, treatment processed for a longer time, and costs higher. Two patients underwent a second operation. In the study group, signs of peritonitis recovery more quickly, with shorter treatment time and lower cost, no second operation needed in all patients. Comparison between the two groups, each index had a significant difference (P <0.05). Conclusion For patients with bile leakage after the removal of the T tube, in addition to the routine methods of food and water fasting, gastrointestinal decompression, acid and enzyme inhibition, anti infection, endoscopic T tube sinus catheter placed or endoscopic nasobiliary drainage undergone, the implantation of fibrin glue sealant can improve the recovery speed, with lower cost, no second operation

  1. MRI manifestations of enlarged superior ophthalmic vein

    Institute of Scientific and Technical Information of China (English)

    WEI Rui-li; MA Xiao-ye; CAI Ji-ping; ZHU Huang

    2002-01-01

    Objective:To assess MRI in the evaluation of enlarged superior ophthalmic vein (SOV). Methods: MRI manifestations and etiology of forty-six patients with enlarged SOV were analyzed. Results: SOV enlargement was noted to occur in carotid-cavernous fistula, ophthalmic Graves'disease, Tolosa-Hunt syndrome, inflammation at the apex of the orbit, orbital pseudotumor and thrombosis of cavernous sinus. The dilated vein appeared as signal void tubular shadows on both T1 and T2 weighted images. The diameter of the enlarged vein was 3.5-6.0 mm. Extraocular muscle enlargement, orbital pathologies, enlarged carotid cavernous sinus etc were also revealed by MRI. Conclusion: The dilated SOV may be well demonstrated by MRI. The etiological diagnosis of enlarged SOV can be made in combination with the associated findings.

  2. Oral surgery as risk factor of odontogenic maxillary sinusitis

    OpenAIRE

    Račić Alek; Dotlić Jelena; Janošević Ljiljana

    2006-01-01

    In order to determine the risk factors of odontogenic maxillary sinusitis, a total number of 40 patients with this pathological condition was examined in three-year period. Oroantral communication was detected in 40% of patients, oroantral fistula in 25%, sinus foreign bodies in 15% and other pathological conditions in 10% of cases. The extraction of the upper lateral teeth was the cause of odontogenic sinusitis in 65% patients. Given the specific tooth, the first upper molar was the most com...

  3. Rupture of the lateral ventricle secondary to a fourth ventricle tumour resulting in an indirect nontraumatic cerebrospinal fluid fistula

    Energy Technology Data Exchange (ETDEWEB)

    Tan, S.P.; Liew, W.F. [Department of Radiology, Hospital Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur (Malaysia); Abdullah, B.J.J. [Department of Radiology, University Malaya Medical Centre (Malaysia); Waran, V. [Department of Neurosurgery, University Malaya Medical Centre (Malaysia)

    2003-01-01

    We present a rare indirect nontraumatic cerebrospinal fluid (CSF) fistula secondary to a fourth ventricle ependymoma. The fistula resulted from rupture of the left temporal horn, distant from the tumour. The fistula was well demonstrated by MRI. High-resolution CT demonstrated a defect in the roof of the sphenoid sinus, but no leakage of CSF was seen on CT cisternography. (orig.)

  4. Arteriovenous Fistula

    Science.gov (United States)

    ... home. Accessed Feb. 23, 2015. Vascular access for hemodialysis. National Kidney and Urologic Diseases Information Clearinghouse. http:// ... www.mayoclinic.org/diseases-conditions/arteriovenous-fistula/basics/definition/CON-20034876 . Mayo Clinic Footer Legal Conditions and ...

  5. Optimizing Arteriovenous Fistula Maturation

    OpenAIRE

    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.

  6. Delayed postoperative dural arteriovenous fistula presenting with progressive dementia.

    Science.gov (United States)

    Higashida, Tetsuhiro

    2015-12-09

    A 64-year-old woman underwent right suboccipital craniotomy to treat spontaneous cerebrospinal fluid (CSF) otorrhoea. Although the CSF leak was cured, the patient developed pulsatile tinnitus, ambulatory disturbance and progressive dementia. Four years after the surgery, she presented with generalised seizure. Cerebral angiography showed a dural arteriovenous fistula at the right transverse-sigmoid sinus, which was associated with sinus occlusion, retrograde blood flow in the sinus and diffuse intracranial cortical venous reflux. A combination of endovascular transarterial embolisation and transvenous embolisation with direct sinus puncture was performed. After the procedure, the patient's mental status and cognitive function improved significantly.

  7. The most often causes of odontogenic maxillary sinusitis

    Directory of Open Access Journals (Sweden)

    Račić Alek

    2004-01-01

    Full Text Available In the period 2000-2002, 40 patients with odontogenic sinusitis were examined at the Institute for ENT and Maxillofacial Surgery, Clinical Centre of Serbia. Oroantral communication was detected in 40% of the patients, oroantral fistula in 35%, sinus foreign bodies in 15% and other conditions in 10% of the cases. The extraction of the upper lateral teeth was the cause of odontogenic sinusitis in 65% of the cases. Given the specific tooth, the first upper molar was the most often cause of the condition, i.e., in 40% of cases. Odontogenic sinusitis as the complication of the oral cavity surgery was found in 85% of the patients.

  8. Sinus Tumors

    Science.gov (United States)

    ... scan of a patient with a sinus cancer (esthesioneuroblastoma) on the patient's right side (left side of ... mucoepidermoid carcinoma, melanoma, olfactory neuroblastoma (also known as esthesioneuroblastoma), sarcoma, and lymphoma. Malignant lesions from other body ...

  9. Perilymph Fistula

    Science.gov (United States)

    ... to the head or in some cases a "whiplash" injury. Other common causes include ear trauma, objects perforating the eardrum, or “ear block” on descent of an airplane or SCUBA diving. Fistulas may also develop after rapid increases in intracranial pressure, such as may ...

  10. Coronary artery fistula

    Science.gov (United States)

    Congenital heart defect - coronary artery fistula; Birth defect heart - coronary artery fistula ... A coronary artery fistula is often congenital, meaning that it is present at birth. It generally occurs when one of the coronary arteries ...

  11. Anal Abscess/Fistula

    Science.gov (United States)

    ... to determine if antibiotics are indicated. TREATMENT OF ANAL FISTULA Currently, there is no medical treatment available for ... surgery is almost always necessary to cure an anal fistula. If the fistula is straightforward (involving minimal sphincter ...

  12. Advanced cocaine-related necrotising sinusitis presenting with restrictive ophthalmolplegia.

    Science.gov (United States)

    Lascaratos, Gerassimos; McHugh, James; McCarthy, Karon; Bunting, Howard

    2016-06-01

    We report a case of bilateral infero-medial orbital wall destruction, associated with loss of sinonasal architecture. The patient presented with intermittent horizontal diplopia following an acute on chronic infective sinusitis. Eight months previously the patient had developed a midline hard palate fistula for which a palatine prosthesis had been fitted. The broad differential diagnosis is discussed, though in this patient chronic cocaine abuse was identified as the underlying aetiology. Eye movement restriction worsened progressively with bilateral inflammation around the medial and inferior rectus muscles. Attempts to resolve the recurring cycle of sinus infection and inflammation by palatal fistula closure failed despite augmented techniques mobilising flaps from both nasal and palatal sides.

  13. Evolutionary History of Multiple Dural Fistula

    Directory of Open Access Journals (Sweden)

    Braulio Martinez-Burbano MD

    2016-12-01

    Full Text Available Intracranial dural arteriovenous fistulas (DAVFs are abnormal communications between arteries and veins or dural venous sinuses, which sit between the sheets of the dura. They represent 10% to 15% of intracranial vascular malformations. Clinical manifestations and prognosis depend on the pattern of venous drainage and location. The clinical presentation of DAVF may be mistaken for vascular or nonvascular brain pathologies. For that reason, within the differential diagnosis come a wide range of conditions, such as secondary headaches, encephalopathies, dementias including those with rapid progression, neurodegenerative diseases, inflammatory processes, or tumors typically at the orbital level or in the cavernous sinus. Diagnosis requires a high degree of suspicion because of the multiplicity of symptoms and presentations, making this pathology an entity that provides a major challenge for clinicians, yet early and multidisciplinary treatment of high-grade fistulas improve the possibility of avoiding poor or unfavorable outcomes for the patient.

  14. Evolutionary History of Multiple Dural Fistula

    Science.gov (United States)

    Martinez-Burbano, Braulio; Correa Diaz, Edgar Patricio; Jácome Sánchez, Carolina

    2016-01-01

    Intracranial dural arteriovenous fistulas (DAVFs) are abnormal communications between arteries and veins or dural venous sinuses, which sit between the sheets of the dura. They represent 10% to 15% of intracranial vascular malformations. Clinical manifestations and prognosis depend on the pattern of venous drainage and location. The clinical presentation of DAVF may be mistaken for vascular or nonvascular brain pathologies. For that reason, within the differential diagnosis come a wide range of conditions, such as secondary headaches, encephalopathies, dementias including those with rapid progression, neurodegenerative diseases, inflammatory processes, or tumors typically at the orbital level or in the cavernous sinus. Diagnosis requires a high degree of suspicion because of the multiplicity of symptoms and presentations, making this pathology an entity that provides a major challenge for clinicians, yet early and multidisciplinary treatment of high-grade fistulas improve the possibility of avoiding poor or unfavorable outcomes for the patient. PMID:28203571

  15. Monti's principle in the treatment of congenital uterovesical fistula.

    Science.gov (United States)

    Lopes, Roberto Iglesias; Dénes, Francisco Tibor; Padovani, Guilherme; Sircili, Maria Helena; Srougi, Miguel

    2014-05-01

    Congenital uterovesical fistula is rare and generally associated with genital tract abnormalities derived from mullerian ducts or urogenital sinus. Management is usually challenging, and it involves vaginal reconstruction. A 15-year-old female patient presented with a 2-year history of cyclical hematuria. Investigation revealed a bicornuate uterus and complete vaginal agenesis associated with congenital uterovesical fistula. The fistula was repaired, and a neovagina was created using Monti's technique. Postoperative recovery was uneventful with normal voiding and initiation of regular menstruation through the neovagina. We discuss the options of vaginal reconstruction and stress the advantages of the technique used in this case.

  16. Application of flat-panel digital subtraction angiography in interventional therapy for carotid cavernous fistutas:initial clinical experience%平板DSA新技术在介入治疗颈内动脉海绵窦瘘中应用初探

    Institute of Scientific and Technical Information of China (English)

    石强; 梁传声; 臧培卓; 徐克

    2009-01-01

    Objective To assess the clinical value offlat-panel digital subtraction angiography (DSA)in interventional therapy for carotid-cavemous fistula (CCF). Methods Three-dimensional (3D)DSA Was performed in 12 patients with CCF before the interventional therapy.The fistular orifice was located and measured with multiplanar reconstruction technique,and the Landscap roadmap of the fistula was obtained.Fistula embolization was performed according to the location of the fistular orifice and the surrounding bony marker indicated by 3D and Landscap roadmap. Results The fistular orifices were clearly displayed in the 12 patients with an average orifice diameter of 3.7 mm.The intemal carotid artery(ICA)and the bony marker of the cavernous sinus were shown simultaneously.Ten patients received endovascular embolization wiith detachable balloon, and 1 patient was treated wiith coil and 1 with stent placement.The ICA remained patent in 11 cases and carotid artery occlusion was performed in 1 case. Conclusion The 3D flat-panel DSA provides rich infolrmati,Ion on the fistular orifice,,and the bony markers can be identified by landscape roadmap technique..The combination of these two techniques guarantees effective and safe treatment of CCE.%目的 探讨平板DSA新技术在介入治疗颈内动脉海绵窦瘘(CCF)中的应用价值.方法 12例CCF患者术前行3DDSA检查,应用多平面重建技术定位瘘口并对瘘口进行测量.治疗中利用可调控实时透视路途技术(Landscap技术)制作路径图,以3D图像所示瘘口及周围骨性标志作为对照进行封堵治疗.结果 12例CCF均可清晰定位瘘口,瘘口直径平均3.7 mm.利用Landscap技术使颈内动脉路径及海绵窦骨性标志同时可见.球囊栓塞10例,弹簧圈栓塞1例,支架封堵瘘口1例.颈内动脉通畅11例,1例行颈内动脉闭塞.结论 平板DSA 3D技术提供了瘘口的丰富信息,Landscap技术为治疗增加了骨性标志,其联合应用为治疗CCF提供了安全保障.

  17. A study of operative treatment and bacteriological examination of persistent oro-antral fistulas.

    Science.gov (United States)

    Sindet-Pedersen, S; Skoglund, L A; Hvidegaard, T; Holst, E

    1983-10-01

    A retrospective study of 35 patients with oro-antral fistulas of more than 2 weeks duration is presented. Treatment results by using the Rehrmann plastic procedure, as well as complications and sequelae are described. The results of bacteriological examination in 15 patients with maxillary sinusitis in association with oro-antral fistulas are presented. The bacteriological findings suggest that broad spectrum antibiotics in certain conditions should be administered in cases of persisting oro-antral fistulas associated with maxillary sinusitis. The results of the present study show that the Rehrmann-operation proves satisfactory even in treatment-resistent cases.

  18. NEW APPROACH TO ANORECTAL SINUS DISEASE

    OpenAIRE

    2014-01-01

    AIM: Retrospective analysis of 23 cases of persistent ano-rectal abscesses and fistulas with an unusual clinical presentation (absent external opening in all cases) resulting in modification of treatment modalities to prevent the dreaded complications of recurrence and incontinence. METHODS: 23 patients presenting with ano-rectal sinus disease from January 2012 to June 2013 were retrospectively reviewed. Patients were collected from two different institutions of Kanpur. In...

  19. An unusual foreign body in the maxillary sinus: Dental impression material.

    Science.gov (United States)

    Deniz, Y; Zengin, A Z; Karli, R

    2016-01-01

    Foreign bodies in paranasal sinuses are very rare and most of them are encountered in the maxillary sinus. These foreign bodies may be organic or inorganic and can enter the maxillary sinus through an oro-antral fistula. The oro-antral fistula is formed by a break in the bony segment of the maxillary sinus floor and usually arises subsequent to maxillary premolar and molar extractions. A 63-year-old female patient evaluated for a nonhealing, left, toothless palate lesion and chronic headache occurring over 4 years. Radiography and computed tomography revealed bone discontinuity in the left floor of the maxillary sinus and calcifications within the antrum. A blue foreign body, later identified as dental impression material, was removed by intranasal endoscopy. A careful oral examination is recommended prior to prosthetic restorations. In addition, paranasal sinus foreign bodies should be surgically removed to prevent secondary soft tissue reactions.

  20. Other methods in diagnosis

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    950223 A study on the application of TCCDFI in theCCSF.ZHAO Yali(李亚利),et al.Dept Diagnosis UI-trasonic,Tangdu Hop,4th Milit Med Univ,Xian710038.Natl Med J China 1995;75(3):141—143.Transcranial color Doppler flow imaging (TCCDFI)allows for simultaneous two-dimentional structuralimaging and Doppler evaluation of blood flow throughintact skull.With this technique,we evaluated 10 pa-tients with carotid cavernous sinus fistulae (CCSF)and 35 normal velunteers.Each of them was confirmed

  1. Traumatic basilar pseudoaneurysm with a basilar-cavernous arteriovenous fistula

    Energy Technology Data Exchange (ETDEWEB)

    Connor, S.E.J.; Deasy, N.P.; Jeffree, M.A. [Dept. of Neuroradiology, King' s Coll. Hospital, London (United Kingdom); Martin, A.J.; Strong, A.J. [Dept. of Neurosurgery, King' s Coll. Hospital, London (United Kingdom)

    2001-03-01

    A traumatic pseudoaneurysm of the basilar artery with a basilar-cavernous sinus arteriovenous fistula was diagnosed in a 12-year-old girl using CT, MRI and angiography. It was successfully treated by coil embolisation. We speculate on the mode of formation of this rare traumatic lesion. (orig.)

  2. The most often causes of odontogenic maxillary sinusitis

    OpenAIRE

    Račić Alek; Dimitrijević Milovan; Đukić Vojko

    2004-01-01

    In the period 2000-2002, 40 patients with odontogenic sinusitis were examined at the Institute for ENT and Maxillofacial Surgery, Clinical Centre of Serbia. Oroantral communication was detected in 40% of the patients, oroantral fistula in 35%, sinus foreign bodies in 15% and other conditions in 10% of the cases. The extraction of the upper lateral teeth was the cause of odontogenic sinusitis in 65% of the cases. Given the specific tooth, the first upper molar was the most often cause of the c...

  3. Arteriovenous shunt graft ulceration with sinus and graft epithelialization

    Directory of Open Access Journals (Sweden)

    Pooja Singhal

    2015-03-01

    Full Text Available Arteriovenous fistula and grafts are used as access sites for patients with chronic kidney disease and are prone for complications. Stent grafts are used to treat access site complications. We report a rare and unusual finding of epithelialization of the sinus tract and the lumen of a polytetrafluoroethylene graft, following ulceration of the overlying skin.

  4. Adenoid Cystic Carcinoma Mimicking an Oroantral Fistula: A Case Report

    Science.gov (United States)

    Monteiro, Bárbara Vanessa de Brito; Grempel, Rafael Grotta; Gomes, Daliana Queiroga de Castro; Godoy, Gustavo Pina; Miguel, Márcia Cristina da Costa

    2013-01-01

    Introduction Adenoid cystic carcinoma (ACC) is one of the most frequent malignant salivary gland tumors, which commonly affects the minor salivary glands of the mouth and is rare in the nose and paranasal sinuses. In the maxillary sinus, ACC can mimic inflammatory diseases and has a poor prognosis. Objective To report a case of a 50-year-old man with ACC of the maxillary sinus whose clinical findings in the alveolar ridge mimicked an oroantral fistula. Case Report An excisional biopsy was performed and histopathologic analysis revealed ACC. Lung metastases and residual tumor in the maxillary sinus were detected by imaging methods. In view of the poor general health of the patient, no new surgical intervention was performed and he was only treated by radiotherapy and follow-up. Conclusion Although rare in the maxillary sinus, ACC should be included in the differential diagnosis of lesions affecting this site. PMID:25992095

  5. Adenoid Cystic Carcinoma Mimicking an Oroantral Fistula: A Case Report

    Directory of Open Access Journals (Sweden)

    Monteiro, Bárbara Vanessa de Brito

    2014-01-01

    Full Text Available Introduction Adenoid cystic carcinoma (ACC is one of the most frequent malignant salivary gland tumors, which commonly affects the minor salivary glands of the mouth and is rare in the nose and paranasal sinuses. In the maxillary sinus, ACC can mimic inflammatory diseases and has a poor prognosis. Objective To report a case of a 50-year-old man with ACC of the maxillary sinus whose clinical findings in the alveolar ridge mimicked an oroantral fistula. Case Report An excisional biopsy was performed and histopathologic analysis revealed ACC. Lung metastases and residual tumor in the maxillary sinus were detected by imaging methods. In view of the poor general health of the patient, no new surgical intervention was performed and he was only treated by radiotherapy and follow-up. Conclusion Although rare in the maxillary sinus, ACC should be included in the differential diagnosis of lesions affecting this site.

  6. Clinical Study on the Etiology of Postthyroidectomy Skin Sinus Formation

    Directory of Open Access Journals (Sweden)

    Shan Jin

    2017-01-01

    Full Text Available Background. Thyroidectomy is one of the most frequently performed surgical procedures worldwide. Despite technical advances and high experience of thyroidectomy of specialized centers, it is still burdened by a significant rate of postoperative complications. Among them, the skin sinus formation is an extremely rare postthyroidectomy complication. Here, we first report the incidence of the skin sinus formation after thyroidectomy to identify the causes for skin sinus formation after thyroidectomy and to discuss its prevention and treatment options. Methods. A retrospective analysis was carried out of patients who underwent excision operation of fistula for postthyroidectomy skin sinus formation. Data were retrieved from medical records department of the Affiliated Hospital of Inner Mongolia Medical University. Results. Of the 5,686 patients who underwent thyroid surgery, only 5 patients (0.088% had developed skin sinus formation. All 5 patients successfully underwent complete excision of fistula. Conclusion. Infection, foreign body, thyroid surgery procedure, combined disease, and iatrogenic factors may be related with skin sinus formation after thyroidectomy. To reduce the recurrence of postoperative infections and sinus formation, intra- and postoperative compliance with aseptic processing, intraoperative use absorbable surgical suture/ligature, repeated irrigation and drainage, and postoperative administration of anti-inflammatory treatment are to be followed.

  7. Chronic sinusitis (image)

    Science.gov (United States)

    ... and cartilage and lined with a mucous membrane. Sinusitis occurs when the membranes becomes inflamed and painful, ... a result of a blocked sinus opening. Chronic sinusitis is often caused by inflammation and blockage due ...

  8. Computed Tomography (CT) -- Sinuses

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Sinuses Computed tomography (CT) of the ... of CT of the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed tomography, more commonly ...

  9. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... the Sinuses? What is CT (Computed Tomography) of the Sinuses? Computed tomography, more commonly known as a ... of page What are some common uses of the procedure? CT of the sinuses is primarily used ...

  10. Historical and clinical features of 200 cases of equine sinus disease.

    Science.gov (United States)

    Dixon, P M; Parkin, T D; Collins, N; Hawkes, C; Townsend, N B; Fisher, G; Ealey, R; Barakzai, S Z

    2011-10-22

    The historical and clinical findings in 200 referred cases of equine sinus disease were reviewed retrospectively. Univariable and multivariable analyses were performed to detect significant differences in historical or clinical features between various categories of sinus disease. The causes of sinus disease were classified as subacute primary (less than two months duration) (n=52), chronic primary (more than two months duration) (n=37), dental (n=40), sinus cyst (n=26), traumatic (n=13) or mycotic sinusitis (n=7), sinus neoplasia (n=10), dental-related oromaxillary fistula (n=8) and intrasinus progressive ethmoid haematoma (n=7). The majority of sinus disorders were of chronic duration at the time of referral and most (including 97 per cent of chronic primary sinusitis cases) had not responded to previous antibiotic therapy and/or sinus lavage in some cases. Clinical signs included unilateral nasal discharge in most cases, including purulent or mucopurulent discharge in all horses with primary, dental and mycotic sinusitis. Haemorrhagic nasal discharge was a feature of traumatic sinusitis and intrasinus progressive ethmoid haematomas. Firm facial swellings and nasal airflow obstruction were features of sinus cysts and neoplasms. Ipsilateral lymphadenitis was a more prominent feature of sinus disease with active infections such as primary, dental or mycotic sinusitis.

  11. Congenital tracheobiliary fistula.

    NARCIS (Netherlands)

    Croes, F.; Nieuwaal, N.H. van; Heijst, A.F.J. van; Enk, G.J. van

    2010-01-01

    Congenital tracheobiliary fistula is a rare malformation that can present with a variety of respiratory symptoms. We present a case of a newborn patient with a tracheobiliary fistula and severe respiratory insufficiency needing extracorporal membrane oxygenation to recover.

  12. Chronic Maxillary Sinusitis Associated with an Unusual Foreign Body: A Case Report

    Directory of Open Access Journals (Sweden)

    Yunus Feyyat Şahin

    2012-01-01

    Full Text Available Foreign bodies in maxillary sinuses are unusual clinical conditions, and they can cause chronic sinusitis by mucosal irritation. Most cases of foreign bodies in maxillary sinus are related to iatrogenic dental manipulation and only a few cases with non-dental origin are reported. Oroantral fistulas secondary to dental procedures are the most common way of insertion. Treatment is surgical removal of the foreign body either endoscopically or with a combined approach, with Caldwell-Luc procedure if endoscopic approach is inadequate for visualisation. In this case, we present a 24-year-old male patient with unilateral chronic maxillary sinusitis due to a wooden toothpick in left maxillary sinus. The patient had a history of upper second premolar tooth extraction. CT scan revealed sinus opacification with presence of a foreign body in left maxillary sinus extending from the floor of the sinus to the orbital base. The foreign body, a wooden toothpick, was removed with Caldwell-Luc procedure since it was impossible to remove the toothpick endoscopically. There was no obvious oroantral fistula in the time of surgery, but the position of the toothpick made us to think that it was inserted through a previously healed fistula, willingly or accidentally.

  13. Ureteroarterial Fistula

    Directory of Open Access Journals (Sweden)

    D. H. Kim

    2009-01-01

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

  14. Endoscope-assisted surgery for pyriform sinus fistula in children over 13 years: a review of 147 cases at a single institution%内镜辅助治疗儿童梨状窝瘘13年随访:单中心147例报道

    Institute of Scientific and Technical Information of China (English)

    郑继翠; 朱琳琳; 肖现民; 郑珊; 董岿然; 沈淳; 李凯

    2014-01-01

    目的 探讨内镜辅助治疗儿童先天性梨状窝瘘(congenital pyriform sinus fistula,PSF)的经验及疗效.方法 回顾性分析1999年7月至2012年12月内镜辅助治疗147例PSF患儿(男90例,女57例)的临床资料.本组临床表现为颈部反复感染、颈部肿块和呼吸受限等.17例在新生儿期或幼儿期表现为颈部囊肿.本组发病年龄在生后1 d~13.8岁,平均3.7岁;发病后6 d~14.8年明确诊断,平均32.0个月;手术年龄为17 d~15岁,平均5.5岁.术前行食管吞钡造影、颈部超声显像、颈部CT、同位素核素显像等检查.炎症控制期胃镜辅助治疗.结果 瘘位于左侧138例,右侧7例,双侧2例.术中成功使用胃镜辅助找到瘘管143例(97.3%).术中发现瘘管自甲状软骨下角后方穿出34例,下角前14例,下角下12例.术中发生食道损伤2例,1例术后声音嘶哑.术后随访时间3~157.2月,5例(3.4%)复发,其中2例再次手术切除瘘管,另3例随访6.3~97.7月无临床症状.余142例术后恢复良好.结论 PSF并不如想象中少见,在治疗儿童颈部感染性疾病或肿块,特别是左侧病变时,应提高警惕.内镜辅助有助于寻找定位瘘管,从而使PSF切除更容易、精确,减少手术创伤.%Objective Congenital pyriform sinus fistula (PSF) is relatively rare,but it often presents diagnostic and therapeutic challenges.Here we reported our experience of endoscope-assisted surgery for pediatric PSF.Methods Since 1999,a total of 147 children (90 males,57 females) with PSF had been enrolled.Their clinical manifestations included recurrent lateral neck infection,neck mass and respiratory distress.Preoperative examinations included barium enema,ultrasound,computed tomography and thyroid scan.After treatment and resolution of infection; fistula was demonstrated endoscopically.With a callback after a week,they were followed up for 3-157.2months.Results The age-of-onset ranged from the first day of life to 13.83 years (mean,3

  15. Oral surgery as risk factor of odontogenic maxillary sinusitis

    Directory of Open Access Journals (Sweden)

    Račić Alek

    2006-01-01

    Full Text Available In order to determine the risk factors of odontogenic maxillary sinusitis, a total number of 40 patients with this pathological condition was examined in three-year period. Oroantral communication was detected in 40% of patients, oroantral fistula in 25%, sinus foreign bodies in 15% and other pathological conditions in 10% of cases. The extraction of the upper lateral teeth was the cause of odontogenic sinusitis in 65% patients. Given the specific tooth, the first upper molar was the most common cause of the condition, i.e. in 40% of cases. It may be concluded that odontogenic sinusitis is the complication of the oral cavity surgery in 85% of patients, what should be taken into consideration in prevention.

  16. Selective Transvenous Coil Embolization of Dural Arteriovenous Fistula: A Report of Three Cases

    OpenAIRE

    2007-01-01

    We herein report three cases of dural arteriovenous fistula (DAVF) in which the venous outlet immediately adjacent to the fistula was selectively embolized. Case 1: A 69-year-old man presented with a subarachnoid hemorrhage (SAH). Angiography demonstrated a DAVF in the left superior petrous sinus. Case 2: A 59-year-old woman presented with dizziness. Angiography demonstrated a DAVF adjacent to great vein of Galen. The DAVF drained through the great vein of Galen with retrograde leptomeningeal...

  17. STUDY OF ENTEROCUTANEOUS FISTULA

    Directory of Open Access Journals (Sweden)

    Arti

    2015-03-01

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

  18. Embryological Consideration of Dural Arteriovenous Fistulas

    Science.gov (United States)

    TANAKA, Michihiro

    2016-01-01

    The topographical distribution of dural arteriovenous fistulas (DAVFs) was analyzed based on the embryological anatomy of the dural membrane. Sixty-six consecutive cases of intracranial and spinal DAVFs were analyzed based on the angiography, and each shunt point was identified according to the embryological bony structures. The area of dural membranes was categorized into three different groups: a ventral group located on the endochondral bone (VE group), a dorsal group located on the membranous bone (DM group) and a falcotentorial group (FT group) located in the falx cerebri, tentorium cerebelli, falx cerebelli, and diaphragm sellae. The FT group was designated when the dural membrane was formed only with the dura propria (meningeal layer of the dura mater) and not from the endosteal dura. Cavernous sinus, sigmoid sinus, and anterior condylar confluence was categorized to VE group, which had a female predominance, more benign clinical presentations, and a lower rate of cortical and spinal venous reflux. Transverse sinus, confluence, and superior sagittal sinus belonged to the DM group. Olfactory groove, falx, tent of the cerebellum, and nerve sleeve of spinal cord were categorized to the FT group, which presented later in life and which had a male predominance, more aggressive clinical presentations, and significant cortical and spinal venous reflux. The DAVFs was associated with the layers of the dural membrane characterized by the two different embryological bony structures. The FT group was formed only with the dura propria as an independent risk factor for aggressive clinical course and hemorrhage of DAVFs. PMID:27250699

  19. Heterotopic salivary gland presenting as a discharging sinus in the base of the neck

    Directory of Open Access Journals (Sweden)

    Shraddha Jain

    2011-12-01

    Full Text Available We report a case of congenital heterotopic salivary gland with draining sinus in the lower neck on the right side of a 10-year-old female, which we initially thought to be a branchial fistula. Heterotopic salivary glands are rare lesions in the neck and when present appear very similar to branchial cleft sinus or fistula. This congenital lesion is rare. This is probably the first report from India. It is important to report this case to raise the awareness of this condition.

  20. Management of colovesical fistula.

    Science.gov (United States)

    Rao, P N; Knox, R; Barnard, R J; Schofield, P F

    1987-05-01

    The clinical presentation and management of 24 patients treated for colovesical fistula were reviewed. It is concluded that an aggressive investigative approach in the management of patients with suspected colovesical fistula is rewarding. Cystoscopy and barium enema appear to be the most useful investigative tools. Once found the fistulae should be managed surgically. Radical excision of the sigmoid colon with primary anastomosis is the treatment of choice and is accompanied by no mortality and a very low complication rate.

  1. Traumatic displacement of teeth into maxillary sinus cavity: an unusual dentoalveolar fracture.

    Science.gov (United States)

    Gumus, Nazim; Coban, Yusuf Kenan

    2006-11-01

    We present an unusual dentoalveolar fracture case who had displacement of teeth into maxillary sinus cavity. This patient was 15 years old. He had oral bleeding and lost teeth after falling from the top of a building. Examination of maxillofacial region showed that there were left maxillary teeth lost, alveolar fracture, gingival bleeding and laserations. Maxillofacial bones were found intact. Canine, both premolars and the first molar teeth on left maxilla were lost. Pantomographic evaluation viewed two teeth in the left maxillary sinus. In addition, computerized tomography clearly showed oroantral fistula, alveolar fracture and teeth into maxillary sinus. Extraction of teeth from sinus cavity was performed as well as repair of oroantral fistula and alveolar fracture. This patient is thought that dentoalveolar injury may be more serious than expected according to the oral examination and it requires careful evaluation, even if dentoalveolar trauma does not pose a significant morbid risk.

  2. Management of Oro-antral Communication and Fistula: Various Surgical Options

    Science.gov (United States)

    Khandelwal, Pulkit; Hajira, Neha

    2017-01-01

    Oro-antral communication and fistula can occur as a result of inadequate and improper treatment. Inadvertent communication with the maxillary sinus can occur during certain surgical procedures in the maxillary posterior region. Though, spontaneous healing may occur in defects which are smaller than 2 mm but larger communications require immediate attention and should be treated without delay, in order to avoid sinusitis and further complications leading to patient discomfort.

  3. Approaching chronic sinusitis.

    Science.gov (United States)

    Sarber, Kathleen M; Dion, Gregory Robert; Weitzel, Erik K; McMains, Kevin C

    2013-11-01

    Chronic sinusitis is a common disease that encompasses a number of syndromes that are characterized by sinonasal mucosal inflammation. Chronic sinusitis can be defined as two or more of the following symptoms lasting for more than 12 consecutive weeks: discolored rhinorrhea, postnasal drip, nasal obstruction, facial pressure or pain, or decreased sense of smell. Chronic sinusitis is further classified as chronic sinusitis with polyposis, chronic sinusitis without polyposis, or allergic fungal sinusitis using physical examination, and histologic and radiographic findings. Treatment methods for chronic sinusitis are based upon categorization of the disease and include oral and inhaled corticosteroids, nasal saline irrigations, and antibiotics in selected patients. Understanding the various forms of chronic sinusitis and managing and ruling out comorbidities are key to successful management of this common disorder.

  4. [Maxillary sinus hypoplasia].

    Science.gov (United States)

    Plaza, G; Ferrando, J; Martel, J; Toledano, A; de los Santos, G

    2001-03-01

    Maxillary sinus hypoplasia is rare, with an estimated prevalence of 1-5%. Out of the CT scans performed in sinusal patients between March 1998 and June 1999, we report on 4 isolated maxillary sinus hypoplasia, 4 maxillary sinus hypoplasia associated to concha bullosa, and 10 isolated conchae bullosas. All cases were evaluated by nasosinusal endoscopy and CT scan. Size, location and uni/bilateral presentation of concha bullosa is correlated to maxillary sinus hypoplasia presence, specially with regards to uncinate process presence, medial or lateral retraction. The pathogenesis of maxillary sinus hypoplasia is reviewed, and its relation to concha bullosa, evaluating how this could explain some cases of the so called chronic maxillary sinus atelectasia, as an acquired and progressive variant of maxillary sinus hypoplasia in adults.

  5. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... is painless, noninvasive and accurate. It’s also the most reliable imaging technique for determining if the sinuses ... CT scan of the sinuses, the patient is most commonly positioned lying flat on the back. The ...

  6. Histoplasma capsulatum sinusitis.

    OpenAIRE

    1997-01-01

    Sinusitis is commonly reported in patients with AIDS. In addition to the usual bacterial pathogens isolated from immunocompetent patients, sinusitis in patients with AIDS may be caused by a variety of unusual bacteria, viruses, fungi, parasites, and mycobacteria. Histoplasma capsulatum has not typically been associated with sinusitis in either group of patients. We report a case of sinusitis caused by H. capsulatum in a patient with AIDS.

  7. Ruptured Sinus of Valsalva Aneurysm Initially Misdiagnosed as Ventricular Septal Defect by Echocardiography

    Directory of Open Access Journals (Sweden)

    GR Rezaian

    2009-06-01

    Full Text Available Aneurysms of sinus of valsalva are rare cardiac lesions and most of them are in congenital origin. The malformation consists of a separation or lack of fusion between the media of the aorta and the annulus fibrosis of the aortic valve. The structure becomes aneurysmal and may rupture to form a fistula. We present a case of ruptured sinus of valasalva aneurysm in a 25-year-old man. The diagnosis was made by echocardiography and confirmed at operation.

  8. Ruptured Sinus of Valsalva Aneurysm and Coarctation of Aorta in a Woman at Early Postpartum Period

    Directory of Open Access Journals (Sweden)

    Erol Sener

    2014-01-01

    Full Text Available Coarctation of aorta and sinus of Valsalva aneurysm are frequently missed congenital cardiac defects that their diagnosis might be delayed. To our knowledge, coincidence of these cardiac defects is unusual and has not been reported in the literature before. Here, we present a patient with coarctation of aorta and ruptured noncoronary sinus of Valsalva aneurysm leading to aorto-right atrial fistula in the early postpartum period and our management of this unusual case.

  9. Microscopic Examination of Oral Sinus Tracts and Their Associated Periapical Lesions,

    Science.gov (United States)

    1983-05-01

    the more proper term sinus tract should be used." In 1961, Bender and Seltzer (3) reported that they found sinus tracts to be lined with granulation...42: 511-517. 2. An annotated glossary of terms used in endodontics. 3rd ed. Chicago, 1981, 7:G4-G23. 3. Bender IB, Seltzer S. The oral fistula: its...and cysts: an evaluation of histopathological and radiographic findings. JADA 1970; 80: 1056-1059. 18. Seltzer S, Soltanoff W, Bender IB. Epithelial

  10. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... equipment to evaluate the paranasal sinus cavities – hollow, air-filled spaces within the bones of the face surrounding the ... paranasal sinus cavities. The paranasal sinuses are hollow, air-filled spaces located within the bones of the face and ...

  11. Vesicouterine fistula: MRI diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, J.M.; Lomas, D.J. [Dept. of Radiology, Addenbrooke' s Hospital and University of Cambridge, Cambridge (United Kingdom); Lee, G.; Doble, A. [Dept. of Urology, Addenbrooke' s Hospital and University of Cambridge (United Kingdom); Sharma, S.D. [Dept. of Urology, Peterborough NHS Trust Hospital (United Kingdom)

    1999-07-01

    A case of vesicouterine fistula in a young woman following caesarean section is presented. The diagnosis was established successfully using heavily T2-weighted MRI which clearly demonstrated fluid within the fistula, obviating the need for conventional radiographic contrast examination. (orig.)

  12. Anal abscess and fistula.

    Science.gov (United States)

    Sneider, Erica B; Maykel, Justin A

    2013-12-01

    Benign anorectal diseases, such as anal abscesses and fistula, are commonly seen by primary care physicians, gastroenterologists, emergency physicians, general surgeons, and colorectal surgeons. It is important to have a thorough understanding of the complexity of these 2 disease processes so as to provide appropriate and timely treatment. We review the pathophysiology, presentation, diagnosis, and treatment options for both anal abscesses and fistulas.

  13. Spontaneous aortocaval fistula.

    Directory of Open Access Journals (Sweden)

    Rajmohan B

    2002-07-01

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

  14. The silent sinus syndrome.

    Science.gov (United States)

    Monos, Tova; Levy, Jaime; Lifshitz, Tova; Puterman, Moshe

    2005-05-01

    Patients with silent sinus syndrome typically present for investigation of facial asymmetry. Unilateral, spontaneous enophthalmos and hypoglobus are the prominent findings at examination. Imaging of the orbit and sinuses characteristically show unilateral maxillary sinus opacification and collapse with inferior bowing of the orbital floor. It has been suggested that SSS is due to hypoventilation of the maxillary sinus secondary to ostial obstruction and sinus atelectasis with chronic negative pressure within the sinus. Treatment involves functional endoscopic sinus surgery for reestablishing a functional drainage passage, and a reconstructive procedure of the floor of the orbit for repairing the hypoglobus and cosmetic deformity. Ophthalmologists, otorhinolaryngologists, and radiologists must be familiarized with this relatively newly reported disease.

  15. Nonrespiratory Sinus Arrhythmia

    Directory of Open Access Journals (Sweden)

    Barbosa Filho José

    2002-01-01

    Full Text Available We report here 2 cases of sinus arrhythmia considered to be a form of nonrespiratory sinus arrhythmia because they did not have variances in the RR interval sequence within the oscillations modulated by respiration. Because the patients had pulsus alternans similar that observed in bigeminy, and because they did not have signs or symptoms of heart failure, we believe the arrhythmias represent intrinsic alterations of the electric activity of the sinus node

  16. Tratamento endoscópico do cisto odontogênico com extensão intra-sinusal Endoscopic treatment of odontogenic cyst with intra-sinusal extension

    Directory of Open Access Journals (Sweden)

    Antonio C. Cedin

    2005-06-01

    Full Text Available Cistos odontogênicos são lesões pouco comuns que podem ocorrer após inflamação da polpa dentária. A abordagem terapêutica destes cistos é realizada em consultórios odontológicos e, dependendo de sua extensão, pode ocasionar a formação de fístula oroantral e rinossinusite crônica. O objetivo deste trabalho é propor o tratamento videoendoscópico do cisto odontogênico com expressão em seio maxilar. Realizou-se um estudo retrospectivo de quatro casos de cistos de origem dentária, com extensão intra-sinusal, complicados com fístula oroantral e sinusite crônica de seio maxilar após curetagem em consultório odontológico. Utilizamos a técnica videoendoscópica via transmaxilar para acessarmos o cisto intra-sinusal. Os quatro pacientes apresentaram resolução do quadro infeccioso e cicatrização da fístula oroantral, sem recidiva durante o seguimento. A cirurgia videoendoscópica é um método seguro e efetivo para tratamento do cisto odontogênico descrito, podendo contribuir para prevenir a formação de fístula oroantral e supuração de seio maxilar.Odontogenic cyst is a common lesion that can happen after inflammation of the dental pulp. The therapeutic approach of these cysts is made at dentist's offices, and depending on their extension, they may develop oroantral fistula and chronic sinusitis. The objective of this study is to propose the videoendoscopic treatment of the odontogenic cyst with expression in the maxillary sinus. We made a retrospective study of four cases of cysts of dental origin, with intra-sinusal extension, complicated with oroantral fistula and chronic sinusitis of maxillary sinus after curettage in a dentist's office. We used the videoendoscopic technique through transmaxillary approach to access the intra-sinusal cyst. All the four patients presented resolution of the infectious manifestation and healing of the oroantral fistula, without recurrence within two years of follow

  17. Pilonidal Sinus of the Glans Penis Associated with Actinomyces Case Reports and Review of Literature

    Directory of Open Access Journals (Sweden)

    Shylashree Chikkamuniyappa

    2004-01-01

    Full Text Available Pilonidal sinus is a well-recognized condition that occurs most commonly in the sacrococcygeal area of younger men. It is hypothesized to be an acquired chronic inflammation condition due mainly to hair trapped beneath the surface. A pilonidal sinus in the sacrococcygeal region is associated with recurrent infection, abscess formation, cellulitis, fistulae, and rarely, squamous cell carcinoma. A pilonidal sinus of the penis is a rare entity. The association of a penile pilonidal cyst and Actinomyces is even more uncommon with only three cases reported previously. Two cases of pilonidal sinus are reported in this paper. One of the cases was associated with actinomycosis. Pilonidal sinus of the penis should be considered in the clinical and pathological differential diagnosis and has to be distinguished from balanoposthitis, epidermal cyst, and carcinoma. The knowledge about possible association with actinomycosis is important to ensure early treatment.

  18. Pilonidal Sinus of the Penis

    Directory of Open Access Journals (Sweden)

    Hugh F. O'Kane

    2004-01-01

    Full Text Available A pilonidal sinus is a subcutaneous sinus containing hair. It is most commonly found in the natal cleft of hirsute men. Here we describe the unusual finding of a pilonidal sinus arising on the male foreskin.

  19. Pancreaticopleural fistula : CT demonstration

    Energy Technology Data Exchange (ETDEWEB)

    Hahm, Jin Kyeung [Chuncheon Medical Center, ChunChon (Korea, Republic of)

    1997-03-01

    In patients with chronic pancreatitis, the pancreaticopleural fistula is known to cause recurrent exudative or hemorrhagic pleural effusions. These are often large in volume and require treatment, unlike the effusions in acute pancreatitis. Diagnosis can be made either by the finding of elevated pleural fluid amylase level or, using imaging studies, by the direct demonstration of the fistulous tract. We report two cases of pancreaticopleural fistula demonstrated by computed tomography.

  20. Odontogene sinusitis maxillaris

    NARCIS (Netherlands)

    Weijerman, J.E.

    1972-01-01

    Een oroantrale fistel blijkt in 51,7% der gevallen geleid te hebben tot een chronische en slechts in 29,2% tot een acute sinusitis (tabel 7 blz.72). Een verklaring hiervoor is vermoedelijk de goede drainagemogelijkheid van de sinus doordat het ostium meestal open is en bovendien afvoer van de pus vi

  1. Sinus MRI scan

    Science.gov (United States)

    ... A CT scan may be preferred in emergency cases, since it is faster and often available in the emergency room. Note: MRI is not as effective as CT in defining the anatomy of the sinuses, and therefore is not typically used for suspected acute sinusitis.

  2. Endoscopic Sinus Surgery

    Science.gov (United States)

    ... sinus cavities (cancerous or non-cancerous growths), leaking brain fluid into the nose, tear duct blockage, and others. Additionally, recent advances ... bone at the bottom of the brain and brain itself that are next to the nose and sinuses have been removed via the nostril, ...

  3. Diagnosis and management of trigemino-cavernous fistulas: case reports and review of the literature.

    Science.gov (United States)

    Miller, Timothy R; Jindal, Gaurav; Mohan, Suyash; Fortes, Manuel; Hurst, Robert; Pukenas, Bryan; Gandhi, Dheeraj

    2015-01-01

    Although usually asymptomatic, a persistent trigeminal artery (PTA) can rarely be associated with a direct fistula to the cavernous sinus (ie, trigemino-cavernous fistula). We present three patients with trigemino-cavernous fistulas; two were subsequently treated using modern endovascular techniques while the third initially declined therapy. We then review the literature of reported cases of this unusual entity. The aberrant anatomy associated with a PTA presents unique challenges to the management of these lesions, and must be well delineated prior to treatment. Finally, conservative management of trigemino-cavernous fistulas, either de novo or recurrent, may be considered if they demonstrate no evidence of cortical venous reflux and patient symptoms are tolerable.

  4. Advances in diagnosis and treatment of cerebral venous system diseases

    Directory of Open Access Journals (Sweden)

    Xiao-yun LIU

    2016-11-01

    Full Text Available Cerebral venous system diseases include cerebral venous thrombosis (CVT, venous sinus stenosis, carotid cavernous fistula (CCF, intracranial arteriovenous malformation (AVM and so on. In recent years, due to the rapid development of neuroimaging and interventional technology, more and more cerebral venous system diseases have been timely diagnosed and treated, such as magnetic resonance black-blood thrombus imaging (MRBTI in the diagnosis of CVT, stenting in the treatment of venous sinus stenosis, micro coil plus Onyx glue or covered stents in the treatment of CCF, which allow us to make a deeper recognition of cerebral venous system diseases. Therefore, this paper will introduce the latest diagnosis and treatment of cerebral venous system diseases. DOI: 10.3969/j.issn.1672-6731.2016.11.006

  5. Is routine endoanal ultrasound useful in anal fistulas?

    Directory of Open Access Journals (Sweden)

    I. Pascual Migueláñez

    Full Text Available Objective: to evaluate the effectiveness of endoanal ultrasound with hydrogen peroxide enhancement in the assessment of anal fistula (tract and internal opening, and to value the utility of this examination for anal or perianal suppuration when performed by a colorectal surgeon trained in this technique. Patients: endoanal ultrasound was performed in 103 patients with anal or perianal suppuration. Twenty patients were excluded: 9 had the external opening closed, and 11 had cryptoglandular abscesses. All ultrasound scans were performed by the same explorer using a B&K Diagnostic Ultrasound System with a 7 MHz endoprobe. The examination was based on the identification of the three anal planes, then hydrogen peroxide was infused and the procedure was repeated. Results: out of 83 patients included, 11 had a perianal sinus and 72 an anal fistula. In all fistulas the main tract was found: 24 were inter-sphinteric (33.33%, 33 trans-sphincteric (45.83%, 3 supra-sphincteric (4.17%, and 12 extra-sphincteric (16.67%. An internal opening was identified in 69 (95.83%. Conclusions: endoanal ultrasound with hydrogen peroxide enhancement is an effective examination to visualize fistulous tracts and internal openings. We think it is highly useful for anal or perianal suppuration to identify abscesses, to recognize a perianal sinus, to check the sphincteric condition, and to plan subsequent surgery.

  6. Fistula Vesiko Vaginalis

    Directory of Open Access Journals (Sweden)

    Luki Ertandri

    2016-08-01

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

  7. [Tuberculous prostato-rectal fistula].

    Science.gov (United States)

    Rabii, Redouane; Fekak, Hamid; el Manni, Ahmed; Joual, Abdenbi; Benjelloun, Saad; el Mrini, Mohammed

    2002-09-01

    In a 60-year-old man admitted for right epididymo-orchitis with scrotal fistula and urine leak via the rectum, the diagnosis of tuberculosis was based on histological examination of a tissue sample of the scrotal fistula. The fistula was successfully treated with tuberculostatic drugs and cystostomy.

  8. 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.

  9. Fistulas complicating diverticulitis.

    Science.gov (United States)

    Vasilevsky, C A; Belliveau, P; Trudel, J L; Stein, B L; Gordon, P H

    1998-01-01

    This study was undertaken to assess the appropriate management of patients with diverticulitis complicated by fistula formation. A retrospective chart review was conducted on patients with symptoms of a fistula who presented between 1975 to 1995. There were 42 patients (32 women, 76%; 10 men, 24%) who ranged in age from 46 to 89 years (mean 69.8 +/- 9.8). Six patients had multiple fistulas. The types of fistulas included colovesical (48%), colovaginal (44%), colocutaneous (4%), colotubal (2%), and coloenteric (2%). Operative procedures consisted of resection and primary anastomosis in 38 patients and a Hartmann's operation in one. Three patients were managed conservatively with antibiotics (two due to poor performance status, the third due to resolution of symptoms). There were no operative deaths. The postoperative course was uncomplicated in 69%, while 12 patients (31%) experienced 19 complications (40%). These consisted of urinary tract infection (9.5%), atelectasis (7.1%), prolonged ileus (4.8%), arrhythmias (4.8%) and renal failure, myocardial infarction, pseudomembranous colitis, peroneal nerve palsy, unexplained fever, pulmonary edema (2.4% each). There were no anastomotic leaks and no deaths. Hospital stay ranged from 6 to 31 days (mean 12.3 +/- 7.6). Fistulas due to diverticulitis were safely managed by resection and primary anastomosis without mortality and with acceptable morbidity in this series. Patients deemed to be poor operative risks can be managed with a course of nonoperative treatment.

  10. Lesson Nine Sinus node dysfunction

    Institute of Scientific and Technical Information of China (English)

    鲁端; 吴文烈

    2004-01-01

    @@ Sinus node dysfunction most often is found in the elderly as an isolated phenomenon. Although interruption of the blood supply to the sinus node may produce dysfunction, the correlation between obstruction of the sinus node artery and clinical evidence of sinus node dysfunction is poor.

  11. [Cryptoglandular anal fistulas].

    Science.gov (United States)

    de Parades, Vincent; Zeitoun, Jean-David; Bauer, Pierre; Atienza, Patrick

    2008-10-31

    Cryptoglandular anal fistulae are the most frequently occurring form of perianal sepsis. Characteristically they have an endoanal primary opening, a fistula track and an abscess and/or an external purulent opening. Antibiotic therapy is not of use in initial management except in special cases. Treatment of an abscess, if present, is required urgently and when possible, consists of its incision under local anaesthesia. Treating the fistula track occurs afterwards and aims to dry up the purulent discharge and avoid recurrence of the abscess by means of surgical fistulotomy. These techniques are very effective in terms of eradication of the problem but there is sometimes a risk of anal incontinence. This explains the increasing interest in sphincter preserving techniques using the advancement of a covering flap of rectal mucosa and the injection of fibrin glue.

  12. CLINICAL STUDY OF FISTULA IN ANO

    Directory of Open Access Journals (Sweden)

    Raj

    2015-10-01

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

  13. NEW APPROACH TO ANORECTAL SINUS DISEASE

    Directory of Open Access Journals (Sweden)

    Singh

    2014-07-01

    Full Text Available AIM: Retrospective analysis of 23 cases of persistent ano-rectal abscesses and fistulas with an unusual clinical presentation (absent external opening in all cases resulting in modification of treatment modalities to prevent the dreaded complications of recurrence and incontinence. METHODS: 23 patients presenting with ano-rectal sinus disease from January 2012 to June 2013 were retrospectively reviewed. Patients were collected from two different institutions of Kanpur. Intra-operatively the probe was introduced from the internal opening and extended outwards towards the skin taking the shortest route followed by incising the tip of the probe. This converted the sinus tract into a fistula after which either of the two techniques was employed: (a Surgery (fistulotomy alone in cases where small chunk of sphincteric muscle mass was to be cut. Here the internal opening was below the ano-rectal ring. (b Surgery along with placement of kshar-sutra in cases where internal opening was too near to the ano-rectal ring or above it. Sphincteric part of the tract was saved from cutting by encircling it with kshar-sutra during surgery. RESULTS: All our patients had symptomatic relief and we achieved complete healing of the wound in all of them with no incidence of persistence of the disease after six months of follow-up, no incidence of recurrence and no incidence of anal incontinence. CONCLUSIONS: Thorough clinical examination resulted in identifying the peculiarity of our cases and also helped us in establishing the etiological factors along with the involved anatomy. Special procedure adopted in our study helped us in preventing complications and ensuring complete healing of the wounds

  14. Endovascular treatment of sphenoid wing dural arteriovenous fistula with pure cortical venous drainage.

    Science.gov (United States)

    Fukuda, Hitoshi; Miyake, Kosuke; Kunieda, Takenobu; Murao, Kenichi

    2014-07-01

    Curative endovascular treatment of sphenoid wing dural arteriovenous fistula (dAVF) with pure cortical venous drainage is challenging because of its rarity, lack of accessible dural sinus for transvenous embolization (TVE), and proximity of skull base vital regions. Direct surgery to disconnect venous reflux has been favored. We report the curative endovascular treatment of two sphenoid wing dAVFs with pure cortical venous drainage. One patient revealed complete obliteration of dAVF by a single session of transarterial embolization (TAE). As part of strategic TAE for this complex dAVF, we used a novel approach to create a complete flow-arrest condition in which coils and an occlusion balloon were combined. A liquid agent was then injected across the pathological fistula and into the parent venous apparatus, thereby occluding the lesion. The other patient was treated with percutaneous TVE after TAE was unsuccessful. With a specific strategy and appropriate devices, the microcatheter was successfully introduced through sigmoid sinus, transverse sinus, superior sagittal sinus, and refluxing cortical vein by puncture of the jugular vein. Coils were deployed at the venous side of the fistula, resulting in successful obliteration of the dAVF. Sphenoid wing dAVF with pure cortical venous drainage could be curable by endovascular treatment with proper strategy and instruments when anatomical condition permits.

  15. Improvement of depression after treatment of dural arteriovenous fistula: a case report and a review.

    Science.gov (United States)

    Nakagawa, Minoru; Sugiu, Kenji; Tokunaga, Koji; Sakamoto, Chihoko; Fujiwara, Kenjiro

    2012-01-01

    Patients with dural arteriovenous fistulas (DAVFs) in the transverse-sigmoid sinus suffer from several symptoms: bruit, headache, visual impairment, and so on. But depression is rare in patients with DAVF. The authors reported a rare case presenting the improvement of depression after the treatment of a dural arteriovenous fistula in the left transverse-sigmoid sinus. A 46-year-old male had suffered from depression and was treated with antidepressants at a local hospital for four years. The patient was temporarily laid off due to his depression. Afterwards, he had Gerstmann's syndrome and came to our hospital. A DAVF in the left transverse-sigmoid sinus was demonstrated on the angiogram. The DAVF was successfully treated with endovascular surgery, coil embolization of the isolated diseased sinus through the mastoid emissary vein which was a draining vein from the fistula. After this treatment, his depression as well as Gerstmann's syndrome was improved and the quantity of the antidepressants decreased. The patient returned to work without any antidepressant two years after the treatment. DAVFs might be one of the causes of depression. It may be necessary to evaluate cerebral vessels in patients suffering from depression by using MRA or 3D-CTA even if there are not any abnormal findings on plain CT scans.

  16. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... benefits vs. risks? Benefits A CT scan is one of the safest means of studying the sinuses. ... CT scanning provides very detailed images of many types of tissue as well as the lungs, bones, ...

  17. Laparoscopic treatment of genitourinary fistulae.

    Science.gov (United States)

    Garza Cortés, Roberto; Clavijo, Rafael; Sotelo, Rene

    2012-09-01

    We present the laparoscopic management of genitourinary fistulae, mainly five types of fistulae, vesicovaginal, ureterovaginal, vesicouterine, rectourethral and rectovesical fistula. Vesicovaginal fistula (VVF) is mostly secondary to urogynecologic procedures in developed countries, abdominal hysterectomy being the main cause of this condition; they represent 84.9% of the genitourinary fistulae (1).Management has been described for this type of fistula, where low success rate (7-12%) has been reported. Ureterovaginal fistulas may occur following pelvic surgery, particularly gynecological procedures, or as a result of vaginal foreign bodies or stone fragments after shock wave lithotripsy, patients typically present with global and persistent urine leakage through the vagina, this causes patient discomfort, distress, and typically protection is used to stay dry, the initial management is often conservative but typically fails. Vesicouterine fistula is a rare condition that only occurs in 1 to 4% of genitourinary fistulas, the primary cause is low segment cesareansection, and clinically presents in three different forms, which will be described. Treatment of this type of fistulae has been conservative,with hormone therapy and surgery, depending on the presenting symptoms. Recto-urinary (rectovesical and rectourethral) fistulae (RUF) are uncommon and can be difficult to manage clinically. Although they may develop in patients with inflammatory bowel disease and perirectal abscesses, rectourethral fistula frequently result as an iatrogenic complication of extirpative or ablative prostate procedures. Rectovesical fistula usually develops following radical prostatectomy, and occurs along the vesicourethral anastomotic line or along the suture line of a posterior "racquet-handle" closure of the bladder. Conservative management consisting of urinary diversion, broad-spectrum antibiotics and parenteral nutrition is often initially attempted but these measures often fail

  18. [Can dental problems have influence on difficulties in treating paranasal sinusitis in children?].

    Science.gov (United States)

    Malicka, Małgorzata; Zieliński, Rafał; Piotrowska, Violetta; Andrzejewski, Jarosław; Zakrzewska, Anna

    2011-01-01

    Paranasal sinusitis is a condition that is treated by a General Practitioner and in case it fails it requires specialistic therapy. In most cases the inflammation is connected with nasal mucosa infection. However, in older children and adolescents sinusitis caused by spreading of tooth and gingiva inflammatory process can be an essential therapeutic and diagnostic problem. It is most often connected with periapical lesions, complications following dental procedures and oroantral fistula inflammation. Inflammatory process originally concerns maxillary sinus, however, it often undergoes generalization and it affects all or most of sinuses unilaterally or bilaterally. In microbiology of odontogenic sinusitis the dominant bacteria are the bacteria typical for peridental lesions (Streptococcus sanguis, Streptococcus salivarius, Streptococcus mutans and anaerobic bacteria). Odontogenic sinusitis frequently causes life threatening complications that require heroic drug and surgical treatment. Therapeutic and diagnostic problems are presented in case studies of 5 children aged from 10 to 17, who are treated in Children's Otolaryngology, Audiology and Phoniatrics Clinic in Łódź. There seems to be the need to emphasize the importance of thorough examination of oral cavity in all the children suffering from sinusitis, especially unilateral sinusitis. It is so essential on account of the gravity of the problem and serious complications that accompany the conditions.

  19. Cranialization of the frontal sinus for secondary mucocele prevention following open surgery for benign frontal lesions.

    Directory of Open Access Journals (Sweden)

    Gilad Horowitz

    Full Text Available OBJECTIVE: To compare frontal sinus cranialization to obliteration for future prevention of secondary mucocele formation following open surgery for benign lesions of the frontal sinus. STUDY DESIGN: Retrospective case series. SETTING: Tertiary academic medical center. PATIENTS: Sixty-nine patients operated for benign frontal sinus pathology between 1994 and 2011. INTERVENTIONS: Open excision of benign frontal sinus pathology followed by either frontal obliteration (n = 41, 59% or frontal cranialization (n = 28, 41%. MAIN OUTCOME MEASURES: The prevalence of post-surgical complications and secondary mucocele formation were compiled. RESULTS: Pathologies included osteoma (n = 34, 49%, mucocele (n = 27, 39%, fibrous dysplasia (n = 6, 9%, and encephalocele (n = 2, 3%. Complications included skin infections (n = 6, postoperative cutaneous fistula (n = 1, telecanthus (n = 4, diplopia (n = 3, nasal deformity (n = 2 and epiphora (n = 1. None of the patients suffered from postoperative CSF leak, meningitis or pneumocephalus. Six patients, all of whom had previously undergone frontal sinus obliteration, required revision surgery due to secondary mucocele formation. Statistical analysis using non-inferiority test reveal that cranialization of the frontal sinus is non-inferior to obliteration for preventing secondary mucocele formation (P<0.0001. CONCLUSION: Cranialization of the frontal sinus appears to be a good option for prevention of secondary mucocele development after open excision of benign frontal sinus lesions.

  20. Treatment of non-IBD anal fistula

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  1. Aorta-to-right atrium fistula, an unusual complication of endocarditis

    Institute of Scientific and Technical Information of China (English)

    Miao-yan CHEN; Dan-dan ZHONG; Zhi-qiang YING

    2009-01-01

    Infective endocarditis (IE) remains a serious disease. Aorta-to-right atrium fistula is a rare but very serious compli-cation of IE and predicts a higher mortality. This report describes a 50-year-old man with endocarditis, vegetation, perforation of noncoronary sinus, and formation of two aorta-to-right atrium fistulas with native valves detected by transthoracic echocardi-ography. This disease is lethal despite developments in cardiac imaging and antibacterial therapy. Early diagnosis, aggressive antibacterial therapy, and surgical treatment may improve the prognosis.

  2. Nephrocutaneous fistula as the initial manifestation of asymptomatic nephrolithiasis: A call for radical management

    Directory of Open Access Journals (Sweden)

    Raman Tanwar

    2015-01-01

    Full Text Available Renal stones are a common affliction presenting in an acute setting. We report a case of asymptomatic renal stone in an elderly gentleman presenting initially as a discharging lumbar sinus managed by subcapsular nephrectomy and radical excision of the fistula tract. Nephrocutaneous fistula is most commonly associated with tuberculosis, xanthogranulomatous pyelonephritis, and rarely with complicated calyceal stones, and its occurrence with asymptomatic pelvic stones is rare. We present the points in favor of radical open surgery in the management of such patients.

  3. Fistula in ano

    DEFF Research Database (Denmark)

    Madsen, S M; Myschetzky, P S; Heldmann, U;

    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....

  4. Fistula in ano

    DEFF Research Database (Denmark)

    Madsen, S M; Myschetzky, P S; Heldmann, U;

    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...... fistulae and patients with no active fistulation we performed a retrospective study....

  5. Controversies in Fistula in Ano

    OpenAIRE

    2012-01-01

    Managing a complex fistula in ano can be a daunting task for most surgeons; largely due to the two major dreaded complications—recurrence & fecal incontinence. It is important to understand the anatomy of the anal sphincters & the aetiopathological process of the disease to provide better patient care. There are quite a few controversies associated with fistula in ano & its management, which compound the difficulty in treating fistula in ano. This article attempts to clear some of those major...

  6. [Laparoscopic operation for colovesical fistula].

    Science.gov (United States)

    Tvedskov, Tove H Filtenborg; Ovesen, Henrik; Seiersen, Michael

    2008-01-14

    Since 2005 the surgical department of Roskilde County Hospital has treated selected patients with colovesical fistulas laparoscopically. We describe two patients with symptoms of pneumaturia and urinary tract infections. CT scanning, cystoscopy and sigmoideoscopy showed colovesical fistula and laparoscopic operation was performed. The operating times were 280 and 285 minutes and the length of their hospital stays was four and three days without complications. We suggest that laparoscopic operation for colovesical fistula can be a good alternative to open operation on selected patients.

  7. Treatment of non-IBD anal fistula

    DEFF Research Database (Denmark)

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

    2015-01-01

    The course of the fistula tract in relation to the anal sphincter is identified by clinical examination under general anaesthesia using a fistula probe and injection of fluid into the external fistula opening. In the event of a complex fistula or in the case of fistula recurrence, this should...... be supplemented with an endoluminal ultrasound scan and/or an MRI scan. St. Mark's fistula chart should be used for the description. Simple fistulas are amenable to fistulotomy, whereas treatment of complex fistulas requires special expertise and management of all available treatment modalities to tailor...

  8. Segmentation of Sinus Images for Grading of Severity of Sinusitis

    Science.gov (United States)

    Iznita Izhar, Lila; Sagayan Asirvadam, Vijanth; Lee, San Nien

    Sinusitis is commonly diagnosed with techniques such as endoscopy, ultrasound, X-ray, Computed Tomography (CT) scan and Magnetic Resonance Imaging (MRI). Out of these techniques, imaging techniques are less invasive while being able to show blockage of sinus cavities. This project attempts to develop a computerize system by developing algorithm for the segmentation of sinus images for the detection of sinusitis. The sinus images were firstly undergo noise removal process by median filtering followed by Contrast Limited Adapted Histogram Equalisation (CLAHE) for image enhancement. Multilevel thresholding algorithm were then applied to segment the enhanced images into meaningful regions for the detection and diagnosis of severity of sinusitis. The multilevel thresholding algorithms based on Otsu method were able to extract three distinct and important features namely bone region, hollow and mucous areas from the images. Simulations were performed on images of healthy sinuses and sinuses with sinusitis. The developed algorithms are found to be able to differentiate and evaluate healthy sinuses and sinuses with sinusitis effectively.

  9. ORBITAL MANIFESTATIONS OF SINUS DISEASE

    Directory of Open Access Journals (Sweden)

    Jyothirmayi

    2015-01-01

    Full Text Available AIM : To study the orbital manifestations in patients with sinus disease. METHODS : Patients wit h paranasal sinus disease presenting to OPD at Government ENT Hospital, AMC, Visakhapatnam from January 2012 to June 2014 were screened for orbital manifestations. Out of these, thirteen patients with orbital disease were referred to GREH, AMC, Visakhapatn am and were thoroughly investigated and managed appropriately. RESULTS : Out of the 14 patients 4 were female and 10 were male. Age ranged from 19 years to 70 years. 5 had maxillary sinus disease (4 - carcinoma and 1 case of mucormycosis. Frontal sinus dis ease was seen in two patients, one fibrous dysplasia and one malignancy. Five patients had ethmoidal sinus disease of which three patients were found to have ethmoidal sinus tumour (Malignant melanoma, Squamous cell Carcinoma. More than two sinuses were i nvolved in 2 patients. CONCLUSIONS : Early screening of patients with sinus disease by an Ophthalmologist can help in preventing severe vision threatening orbital complications.

  10. [Mucormycosis in paranasal sinuses].

    Science.gov (United States)

    Volkenstein, S; Unkel, C; Neumann, A; Sudhoff, H; Dermoumi, H; Jahnke, K; Dazert, S

    2009-08-01

    Three patients with mucormycosis of the paranasal sinuses were treated in the University ENT departments in Bochum and Essen in recent years. All patients were immunocompromised for different reasons and had reduced resistance against microorganism infection. They presented with symptoms of orbital complications of sinusitis. The further progress of these life-threatening fungal infections with a mortality rate between 35 and 70% depends on early and definitive diagnosis and radical surgical therapy to reduce the amount of infectious agent. The difficulties of early diagnosis by imaging, histology, microbiology, or molecular biology and postoperative therapeutic options especially with amphotericin B, liposomal amphotericin B, and posaconazole are illustrated and discussed.

  11. 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.

  12. [Histopathologic study of chronic sinusitis].

    Science.gov (United States)

    Wayoff, M; Parache, R M; Bodelet, B; Gazel, P

    1983-01-01

    The conventional histopathology of the sinus is a criterium for the therapeutic indication, since it is possible to distinguish between granulomatous chronic sinusitis, chronic sinusitis with oedema and nasal polyposis. Each one of these clinical pictures has his own etiology and requires a specific therapeutic approach.

  13. Endovascular treatment of a giant internal carotid artery bifurcation aneurysm with drainage into cavernous sinus

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhen-hai; YANG Xin-jian; WU Zhong-xue; LI You-xiang; JIANG Peng

    2012-01-01

    This report documents the treatment of a giant aneurysm of the internal carotid artery bifurcation with a fistula to the cavernous sinus,which appeared following closed head trauma.A 39-year-old man suffered from a blunt head trauma in an automobile accident.Two weeks after the trauma,progressive chemosis of left eye was presented.Four months after the trauma,digital subtraction angiography showed an internal carotid artery bifurcation aneurysm,with drainage into the cavernous sinus.The lesion was successfully obliterated with preservation of the parent artery by using coils in conjunction with Onyx.Follow-up angiography obtained 3 months postoperatively revealed persistent obliteration of the aneurysm and fistula as well as patency of the parent artery.Endovascular treatment involving the use of coils combined with Onyx appears to be a feasible and effective option for treatment of this hard-to-treat lesion.

  14. Acute fulminant invasive fungal sinusitis with cavernous sinus syndrome.

    Science.gov (United States)

    Chi, Tzu-Hang; Chen, Hsien-Shen; Yuan, Chien-Han; Su, Feng-Ming

    2014-11-01

    Acute fulminant invasive fungal sinusitis is most commonly found in immunocompromised patients with conditions such as diabetes mellitus, malignancies and acquired immune deficiency syndrome. The most common pathogens are Aspergillus and Mucoraceae and the sinus most frequently involved is the maxillary sinus. Fever, rhinorrhea, facial pain, headache, and diplopia are common presenting symptoms. Complications of this infection include intracranial and / or intraorbital spread of the infection; the prognosis is poor. Here, a rare case of acute fulminant invasive fungal sinusitis with cavernous sinus syndrome is reported.

  15. Modern management of anal fistula.

    Science.gov (United States)

    Limura, Elsa; Giordano, Pasquale

    2015-01-07

    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

  16. Transvenous embolization with a combination of detachable coils and Onyx for a complicated cavernous dural arteriovenous fistula

    Institute of Scientific and Technical Information of China (English)

    HE Hong-wei; JIANG Chu-han; WU Zhong-xue; LI You-xiang; LU Xian-li; WANG Zhong-cheng

    2008-01-01

    Background Treatment of cavemous dural arteriovenous fistulas (DAVF) is usually made by a transartedal approach.However,in many complicated patients,treatments via transarterial approaches can not be achieved,and only an operation via a transvenous approach is feasible.We aimed to study the feasibility of transarterial embolJzation of cavernous dural arteriovenous fistulas with a combination detachable coils and Onyx to embolize a complicated cavemous DAVF via a transvenous approach.Methods From August 2006 to August 2007,six cases of complicated cavernous DAVF were embolized with a combination of detachable coils and Onyx via a transvenous approach.Three cases were male and the other three were female.Their ages ranged from 36 to 69 years old.The fistula was in the right lateral cavernous sinus in one case,in the left lateral cavernous sinus in another,and in the bilateral cavernous sinus in 4 cases.One fistula was fed by the right internal carotid artery and its meningohypophyseal trunk;one was fed by the branches of the left internal carotid artery and left extemal carotid artery;four were fed by the branches of the bilateral internal carotid artery and/or the bilateral external carotid artery.One case was drained via one lateral inferior petrosal sinus;three were drained via bilateral inferior petrosal sinuses;one was drained via one lateral ophthalmic and facial veins;one was drained via the infedor petrosal sinus and the ophthalmic and facial veins.Four were embolized via the inferior petrosal sinus,and two were embolized via the ophthalmic and facial veins.Results Among six cases of complicated cavernous DAVF,four were fully embolized with Onyx by a single operation,and two cases were fully embolized with Onyx following two operations.Transient headache was found after operation in all patients,but was cured after several days by the symptomatic treatments.In one case,the first operation via the inferior petrosal sinus was a failure;the feeding branches of

  17. Computed Tomography (CT) -- Sinuses

    Medline Plus

    Full Text Available ... the best way to see if treatment is working or if a finding is stable or changed over time. top of page What are the benefits vs. risks? Benefits A CT scan is one of the safest means of studying the sinuses. CT is the most reliable imaging ...

  18. 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.

  19. [Perianal fistula and anal fissure].

    Science.gov (United States)

    Heitland, W

    2012-12-01

    CRYPTOGLANDULAR ANAL FISTULA: Perianal abscesses are caused by cryptoglandular infections. Not every abscess will end in a fistula. The formation of a fistula is determined by the anatomy of the anal sphincter and perianal fistulas will not heal on their own. The therapy of a fistula is oriented between a more aggressive approach (operation) and a conservative treatment with fibrin glue or a plug. Definitive healing and the development of incontinence are the most important key points. ANAL FISSURES: Acute anal fissures should be treated conservatively by topical ointments, consisting of nitrates, calcium channel blockers and if all else fails by botulinum toxin. Treatment of chronic fissures will start conservatively but operative options are necessary in many cases. Operation of first choice is fissurectomy, including excision of fibrotic margins, curettage of the base and excision of the sentinel pile and anal polyps. Lateral internal sphincterotomy is associated with a certain degree of incontinence and needs critical long-term observation.

  20. [The anal fistula disease and abscess].

    Science.gov (United States)

    Strittmatter, Bernhard

    2004-01-01

    There are two forms of anal fistulas arising from its pathogenesis: the acute stage is the abscess, whereas the chronic stage is the fistula in ano. The classification of the fistula in ano is named after Parks. Pathogenesis and classification are explained. For complete cure, every abscess needs precise examination to be able to show the course and shape of the fistula. The surgical procedure depends on the fistula tract. Most fistulas can be operated by means of a fistulotomy or fistulectomy. Recovery depends on locating the total fistula tract.

  1. Sinus augmentation surgery after endoscopic sinus surgery for the treatment of chronic maxillary sinusitis: a case report.

    Science.gov (United States)

    Tobita, Takayoshi; Nakamura, Mikiko; Ueno, Takaaki; Sano, Kazuo

    2011-10-01

    Chronic sinusitis develops when the ostiomeatal complex becomes stenosed by the swelling of the sinus mucosa. Previously, the Caldwell-Luc method was performed for the treatment of chronic sinusitis. But postoperative complications, such as discomfort of the buccal skin and recurrence of sinusitis, frequently occurred after the operation. Today, endoscopic sinus surgery (ESS) has become widely used for the treatment of chronic sinusitis. The features of ESS allow for the restoration of the physical function of the sinus membrane and preservation of the physiological environment of the sinus. Therefore, sinus augmentation surgery can be safely performed at an insufficient alveolar bone height below the maxillary sinus when sinusitis is eliminated by the ESS. This article documents a patient history involving chronic sinusitis that was treated by the ESS therapy before sinus augmentation surgery as a pretreatment for insertion of dental implants.

  2. New Techniques for Treating an Anal Fistula

    OpenAIRE

    Song, Kee Ho

    2012-01-01

    Surgery for an anal fistula may result in recurrence or impairment of continence. The ideal treatment for an anal fistula should be associated with low recurrence rates, minimal incontinence and good quality of life. Because of the risk of a change in continence with conventional techniques, sphincter-preserving techniques for the management complex anal fistulae have been evaluated. First, the anal fistula plug is made of lyophilized porcine intestinal submucosa. The anal fistula plug is exp...

  3. Effects of maxillary sinus floor elevation surgery on maxillary sinus physiology

    NARCIS (Netherlands)

    Timmenga, NM; Raghoebar, GM; Liem, RSB; van Weissenbruch, R; Manson, WL; Vissink, A

    2003-01-01

    In a prospective study, the effects of elevation surgery of the maxillary sinus floor on maxillary sinus physiology were assessed. Seventeen consecutive patients without preoperative anamnestic, clinical and radiological signs of maxillary sinusitis underwent sinus floor elevation surgery with iliac

  4. Perforation of the sinus membrane during sinus floor elevation

    DEFF Research Database (Denmark)

    von Arx, Thomas; Fodich, Ivo; Bornstein, Michael M;

    2014-01-01

    PURPOSE: To analyze the frequency of perforation of the sinus membrane during maxillary sinus floor elevation (SFE) and to assess possible risk factors. MATERIALS AND METHODS: Seventy-seven cases of SFE performed with a lateral window approach were evaluated retrospectively. Clinical and radiogra......PURPOSE: To analyze the frequency of perforation of the sinus membrane during maxillary sinus floor elevation (SFE) and to assess possible risk factors. MATERIALS AND METHODS: Seventy-seven cases of SFE performed with a lateral window approach were evaluated retrospectively. Clinical...... (presence and height of septum, height of residual ridge, thickness of lateral sinus wall, width of antrum, and thickness and status of sinus membrane). RESULTS: The following factors presented with at least a 10% difference in rates of perforations: smokers (46.2%) versus nonsmokers (23.4%), simultaneous...... the lateral window approach....

  5. Cytological approach for diagnosis of non-healing oroantral fistula associated with candidiasis

    Directory of Open Access Journals (Sweden)

    Kiran B Jadhav

    2014-01-01

    Full Text Available Oroantral fistula (OAF and oral candidiasis are common to come across as separate individual lesions. However when candida organisms infect maxillary sinus through OAF then diagnosis should not be limited to clinical diagnosis only. In such situation role of cytological examination can prove to be fruitful. A female with chronic long standing OAF, not responding to conventional treatment approach is reported. On incisional biopsy, the case was diagnosed as chronic maxillary sinusitis with OAF. However patient did not respond to any treatment approach and later presented with a more progressive lesion involving maxillary sinus. A cytosmear stained with periodic acid Schiff stain, revealed the presence of numerous candidal hyphae. Finally, case was diagnosed as OAF with a superadded candidal infection. Patient responded well to antifungal treatment followed by reclosure of OAF. We should not neglect a simple cytological examination which may prevent wrong diagnosis and wrong treatment.

  6. Internal fistulas in diverticular disease.

    Science.gov (United States)

    Woods, R J; Lavery, I C; Fazio, V W; Jagelman, D G; Weakley, F L

    1988-08-01

    Internal fistulas in diverticular disease are uncommon and have a reputation of being difficult to treat. Eighty four patients treated from 1960 to April 1986, representing 20.4 percent (84 of 412) of the surgically treated diverticular disease patients, were reviewed. Eight patients had multiple fistulas. Sixty-five percent (60 to 92) of fistulas were colovesical, 25 percent (23 of 92) colovaginal, 6.5 percent (6 of 92) coloenteric, and 3 percent (3 of 92) colouterine fistulas. There were 66 percent (35 of 53) males and 34 percent (18 of 53) females with colovesical fistulas only. Hysterectomies had been performed in 50 percent (12 of 24) and 83 percent (19 of 23) of females with colovesical and colovaginal fistulas, respectively. Operative management included: resection anastomosis, resection with anastomosis and diversion, Hartmann procedure, and three-stage procedure. In the latter half of the series there was a significant decrease in staging procedures with no significant statistical difference in complications. There were three deaths (3.5 percent) in the series. Other complications included: wound infection, 21 percent (18 of 84), enterocutaneous fistula, 1 percent (4 of 84), and anastomotic dehiscence, 5 percent (4 of 84). Primary anastomosis can be performed with acceptable morbidity and mortality and today is the procedure of choice, leaving staging procedures to selected patients.

  7. Idiopathic fistula-in-ano

    Institute of Scientific and Technical Information of China (English)

    Sherief Shawki; Steven D Wexner

    2011-01-01

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

  8. Cryptoglandular anal fistula.

    Science.gov (United States)

    de Parades, V; Zeitoun, J-D; Atienza, P

    2010-08-01

    Fistula arising from the glands of the anal crypts is the most common form of anoperineal sepsis. It is characterized by a primary internal orifice in the anal canal, a fistulous tract, and an abscess and/or secondary perineal orifice with purulent discharge. Antibiotics are not curative. The treatment of an abscess is urgent and consists, whenever possible, of incision and drainage under local anesthesia. Definitive treatment of the fistulous tract can await a second stage. The primary aim is to control infection without sacrificing anal continence. Fistulotomy is the basis for all treatments but the specific technique depends on the height of the fistula in relation to the sphincteric mechanism. Overall results of fistulotomy are excellent but there is some risk of anal incontinence. This explains the growing interest in sphincter sparing techniques such as the mucosal advancement flap, the injection of fibrin glue, and the plug procedure. However, results of these procedures are not yet good enough and leave much room for improvement.

  9. 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.

  10. 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.

  11. [Orbital complications of sinusitis].

    Science.gov (United States)

    Šuchaň, M; Horňák, M; Kaliarik, L; Krempaská, S; Koštialová, T; Kovaľ, J

    2014-12-01

    Orbital complications categorised by Chandler are emergency. They need early diagnosis and agresive treatment. Stage and origin of orbital complications are identified by rhinoendoscopy, ophtalmologic examination and CT of orbite and paranasal sinuses. Periorbital cellulitis and early stage of orbital cellulitis can be treated conservatively with i. v. antibiotics. Monitoring of laboratory parameters and ophtalmologic symptoms is mandatory. Lack of improvement or worsening of symptoms within 24-48 hours and advanced stages of orbital complications are indicated for surgery. The purpose of the study is to evaluate epidemiology, clinical features and management of sinogenic orbital complications. Retrospective data of 8 patients with suspicion of orbital complication admited to hospital from 2008 to 2013 were evaluated. Patients were analyzed in terms of gender, age, CT findings, microbiology, clinical features, stage and treatment. Male and female were afected in rate 1,66:1. Most of patients were young adult in 3rd. and 4th. decade of life (62,5 %). Acute and chronic sinusitis were cause of orbital complication in the same rate. The most common origin of orbital complication was ethmoiditis (62,5 %), than maxillary (25 %) and frontal (12,5 %) sinusitis. Polysinusitis with affection of ethmoidal, maxillary and frontal sinuses (75 %) was usual CT finding. Staphylococcus epidermidis and Staphylococcus aureus were etiological agens in half of cases. Periorbital oedema (100 %), proptosis, chemosis (50 %), diplopia and glaucoma (12,5 %) were observed. Based on examinations, diagnosis of periorbital oedema/preseptal cellulitis was made in 3 (37,5 %), orbital cellulitis in 3 (37,5 %) and subperiosteal abscess in 2 cases (25 %). All patients underwent combined therapy - i. v. antibiotics and surgery within 24 hours. Eradication of disease from ostiomeatal complex (OMC), drainage of affected sinuses and drainage of subperiosteal abscess were done via fuctional endonasal

  12. Contemporary applications of frontal sinus trephination: A systematic review of the literature.

    Science.gov (United States)

    Patel, Alpen B; Cain, Rachel B; Lal, Devyani

    2015-09-01

    Our objective was to perform a systematic review of the literature on contemporary indications and outcomes for frontal sinus trephination and present an illustrative case of an endoscopically assisted repair of a subcutaneous frontal sinus fistula by trephination technique. PubMed and Ovid databases were used as data sources. A systematic review of the English literature was completed to review reports of frontal trephination from 1980 to 2014. Articles meeting inclusion criteria for inflammatory and noninflammatory indications were reviewed. Articles were systematically reviewed and graded by evidence-based medicine level. An illustrative case from our institution is then presented. The systematic review identified 2,621 published studies. Thirty-eight studies were identified for inclusion. The indications, techniques, outcomes, safety, and complications were reviewed for noninflammatory and inflammatory conditions. There were 32 retrospective case series, reports, or cohort studies (level 4), four systematic reviews (level 3), one prospective analysis (level 3), and one meta-analysis (level 2). Due to the heterogeneity of study cases and inclusion criteria, a meta-analysis was not feasible. We also present a novel closure of an anterior skull base defect resulting in a subcutaneous fistula with use of a frontal trephination approach. The frontal sinus trephination should not be regarded as a procedure of the past, as it useful in the armamentarium of the modern sinus and skull base surgeon. This approach provides access for instrumentation for hard-to-reach frontal sinus disease either purely through a trephination approach or as a supplementation to the transnasal endoscopic approach. Evidence supporting frontal sinus trephination is of levels 2, 3, and 4. Level of evidence: NA.

  13. Understanding Biofilms in Chronic Sinusitis.

    Science.gov (United States)

    Tajudeen, Bobby A; Schwartz, Joseph S; Palmer, James N

    2016-02-01

    Chronic sinusitis is a burdensome disease that has substantial individual and societal impact. Although great advances in medical and surgical therapies have been made, some patients continue to have recalcitrant infections. Microbial biofilms have been implicated as a cause of recalcitrant chronic sinusitis, and recent studies have tried to better understand the pathogenesis of chronic sinusitis as it relates to microbial biofilms. Here, we provide an overview of biofilms in chronic sinusitis with emphasis on pathogenesis, treatment, and future directions. In addition, recent evidence is presented, elucidating the role of bitter taste receptors as a possible key factor leading to biofilm formation.

  14. Odontogenic maxillary sinusitis: a review.

    Science.gov (United States)

    Simuntis, Regimantas; Kubilius, Ričardas; Vaitkus, Saulius

    2014-01-01

    Maxillary sinusitis of odontogenic origin is a well-known condition in both the dental and otolaryngology communities. It occurs when the Schneiderian membrane is violated by conditions arising from dentoalveolar unit. This type of sinusitis differs in its pathophysiology, microbiology, diagnostics and management from sinusitis of other causes, therefore, failure to accurately identify a dental cause in these patients usually lead to persistent symptomatology and failure of medical and surgical therapies directed toward sinusitis. Unilateral recalcitrant disease associated with foul smelling drainage is a most common feature of odontogenic sinusitis. Also, high-resolution CT scans and cone-beam volumetric computed tomography can assist in identifying dental disease. Sometimes dental treatment alone is adequate to resolve the odontogenic sinusitis and sometimes concomitant or subsequent functional endoscopic sinus surgery or Caldwell-Luc operation is required. The aim of this article is to give a review of the most common causes, symptoms, diagnostic and treatment methods of odontogenic maxillary sinusitis. Search on Cochrane Library, PubMed and Science Direct data bases by key words resulted in 35 articles which met our criteria. It can be concluded that the incidence of odontogenic sinusitis is likely underreported in the available literature.

  15. 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.

  16. Colovesical fistula presenting with epididymitis.

    Science.gov (United States)

    Arneill, Matthew; Hennessey, Derek Barry; McKay, Damian

    2013-04-23

    This article reports a case of colovesical fistula presenting with epididymitis. A 75-year-old man with a recent conservatively managed localised diverticular perforation presented to hospital with acute pain and swelling of his left testicle and epididymis. On further questioning, the patient reported passing air in his urine. Urine cultures grew Enterococcus faecalis. Ultrasound scan confirmed a diagnosis of bacterial epididymitis and the patient was treated with intravenous antibiotics. Subsequent CT imaging revealed air in the bladder and a colovesical fistula. The patient went on to have Hartmann's procedure with repair of the bladder defect. This case highlights that: (1) Colovesical fistulae may rarely present with epididymitis. (2) Colovesical fistulae are the most common cause of pneumaturia.

  17. Colovesical fistula presenting with epididymitis

    Science.gov (United States)

    Arneill, Matthew; Hennessey, Derek Barry; McKay, Damian

    2013-01-01

    This article reports a case of colovesical fistula presenting with epididymitis. A 75-year-old man with a recent conservatively managed localised diverticular perforation presented to hospital with acute pain and swelling of his left testicle and epididymis. On further questioning, the patient reported passing air in his urine. Urine cultures grew Enterococcus faecalis. Ultrasound scan confirmed a diagnosis of bacterial epididymitis and the patient was treated with intravenous antibiotics. Subsequent CT imaging revealed air in the bladder and a colovesical fistula. The patient went on to have Hartmann's procedure with repair of the bladder defect. This case highlights that: (1) Colovesical fistulae may rarely present with epididymitis. (2) Colovesical fistulae are the most common cause of pneumaturia. PMID:23616326

  18. Esophagogastric fistula complicating Nissen fundoplication

    OpenAIRE

    Marcel Tafen; Nader Tehrani; Afshin A. Anoushiravani; Avinash Bhakta; Timothy G. Canty; Christine Whyte

    2016-01-01

    Esophagogastric fistula or double-lumen esophagus is a rare condition. There have been fewer than 15 reported cases in adults and only one reported case in the pediatric population. Esophagogastric fistulas typically develop in patients with preexisting gastrointestinal reflux, esophagogastric surgery, esophageal ulcers, or carcinoma. Our case involves a 5-year old girl presenting with odynophagia and nocturnal cough who had a prior Nissen fundoplication. She was found to have an esophagogast...

  19. Ureteroarterial fistula: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Sun; Kim, Ji Chang [Daejeon St Mary' s Hospital, Daejeon (Korea, Republic of)

    2007-01-15

    Ureteroarterial fistula is an extremely rare complication, but is associated with a high mortality rate. Previous pelvic surgery, long standing ureteral catheter insertion, radiation therapy, vascular surgery and vascular pathology contribute the development of this uncommon entity. Herein, a case of ureteroarterial fistula in a 69-year-old female patient, who presented with a massive hematuria, proven in a second attempt at angiography, is reported.

  20. Cholecystic fistula with atypical symptoms

    DEFF Research Database (Denmark)

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

    2008-01-01

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

  1. Pancreaticopleural Fistula: Revisited

    Directory of Open Access Journals (Sweden)

    Norman Oneil Machado

    2012-01-01

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

  2. Spontaneous nephrocutaneous fistula

    Directory of Open Access Journals (Sweden)

    Alberto A. Antunes

    2004-08-01

    Full Text Available Spontaneous renal fistula to the skin is rare. The majority of cases develop in patients with antecedents of previous renal surgery, renal trauma, renal tumors, and chronic urinary tract infection with abscess formation. We report the case of a 62-year old woman, who complained of urine leakage through the skin in the lumbar region for 2 years. She underwent a fistulography that revealed drainage of contrast agent to the collecting system and images suggesting renal lithiasis on this side. The patient underwent simple nephrectomy on this side and evolved without intercurrences in the post-operative period. Currently, the occurrence of spontaneous renal and perirenal abscesses is extremely rare, except in patients with diabetes, neoplasias and immunodepression in general.

  3. [Endoscopic management of postoperative biliary fistulas].

    Science.gov (United States)

    Farca, A; Moreno, M; Mundo, F; Rodríguez, G

    1991-01-01

    Biliary fistulas have been managed by surgical correction with no good results. From 1986 to 1990, endoscopic therapy was attempted in 24 patients with postoperative persistent biliary-cutaneous fistulas. Endoscopic retrograde cholangiography demonstrated residual biliary stones in 19 patients (79%). The mean fistula drainage was 540 ml/day, and in 75% the site of the fistula was near the cistic duct stump. Sphincterotomy with or without biliary stent placement resulted in rapid resolution of the fistula in 23 patients (95.8%). In those patients treated with biliary stents the fistula healed spectacularly in 24-72 hrs.

  4. [Surgical treatment of anal fistula].

    Science.gov (United States)

    Zeng, Xiandong; Zhang, Yong

    2014-12-01

    Anal fistula is a common disease. It is also quite difficult to be solved without recurrence or damage to the anal sphincter. Several techniques have been described for the management of anal fistula, but there is no final conclusion of their application in the treatment. This article summarizes the history of anal fistula management, the current techniques available, and describes new technologies. Internet online searches were performed from the CNKI and Wanfang databases to identify articles about anal fistula management including seton, fistulotomy, fistulectomy, LIFT operation, biomaterial treatment and new technology application. Every fistula surgery technique has its own place, so it is reasonable to give comprehensive individualized treatment to different patients, which may lead to reduced recurrence and avoidance of damage to the anal sphincter. New technologies provide promising alternatives to traditional methods of management. Surgeons still need to focus on the invention and improvement of the minimally invasive techniques. Besides, a new therapeutic idea is worth to explore that the focus of surgical treatment should be transferred to prevention of the formation of anal fistula after perianal abscess.

  5. Acute bacterial sinusitis in children.

    Science.gov (United States)

    DeMuri, Gregory; Wald, Ellen R

    2013-10-01

    On the basis of strong research evidence, the pathogenesis of sinusitis involves 3 key factors: sinusostia obstruction, ciliary dysfunction, and thickening of sinus secretions. On the basis of studies of the microbiology of otitis media, H influenzae is playing an increasingly important role in the etiology of sinusitis, exceeding that of S pneumoniae in some areas, and b-lactamase production by H influenzae is increasing in respiratory isolates in the United States. On the basis of some research evidence and consensus,the presentation of acute bacterial sinusitis conforms to 1 of 3 predicable patterns; persistent, severe, and worsening symptoms. On the basis of some research evidence and consensus,the diagnosis of sinusitis should be made by applying strict clinical criteria. This approach will select children with upper respiratory infection symptoms who are most likely to benefit from an antibiotic. On the basis of some research evidence and consensus,imaging is not indicated routinely in the diagnosis of sinusitis. Computed tomography or magnetic resonance imaging provides useful information when complications of sinusitis are suspected. On the basis of some research evidence and consensus,amoxicillin-clavulanate should be considered asa first-line agent for the treatment of sinusitis.

  6. Managing acute invasive fungal sinusitis.

    Science.gov (United States)

    Dwyhalo, Kristina M; Donald, Carrlene; Mendez, Anthony; Hoxworth, Joseph

    2016-01-01

    Acute invasive fungal sinusitis is the most aggressive form of fungal sinusitis and can be fatal, especially in patients who are immunosuppressed. Early diagnosis and intervention are crucial and potentially lifesaving, so primary care providers must maintain a high index of suspicion for this disease. Patients may need to be admitted to the hospital for IV antifungal therapy and surgical debridement.

  7. Aggressiv fibromatose i sinus frontalis

    DEFF Research Database (Denmark)

    Godballe, Christian; Jensen, Søren Gade; Krogdahl, Annelise

    2009-01-01

    Aggressive fibromatosis (AF) is a benign tumour with expansive and locally invasive growth. It is very rarely seen in the head and neck area. We present a 52-year-old female patient with AF localized to the left frontal sinus. The condition was initially mistaken for chronic sinusitis however...

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

    OpenAIRE

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

    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.

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

    Directory of Open Access Journals (Sweden)

    Naeem Liaqat

    2016-01-01

    Full Text Available 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.

  10. Antibiotics for acute maxillary sinusitis

    DEFF Research Database (Denmark)

    Ahovuo-Saloranta, Anneli; Borisenko, Oleg V; Kovanen, Niina;

    2008-01-01

    BACKGROUND: Expert opinions vary on the appropriate role of antibiotics for sinusitis, one of the most commonly diagnosed conditions among adults in ambulatory care. OBJECTIVES: We examined whether antibiotics are effective in treating acute sinusitis, and if so, which antibiotic classes...... or antibiotics from different classes for acute maxillary sinusitis in adults. We included trials with clinically diagnosed acute sinusitis, whether or not confirmed by radiography or bacterial culture. DATA COLLECTION AND ANALYSIS: At least two review authors independently screened search results, extracted...... with a pooled RR of 0.74 (95% CI 0.65 to 0.84) at 7 to 15 days follow up. None of the antibiotic preparations was superior to each other. AUTHORS' CONCLUSIONS: Antibiotics have a small treatment effect in patients with uncomplicated acute sinusitis in a primary care setting with symptoms for more than seven...

  11. Transvenous Coil Embolization for Dural Arteriovenous Fistulas of the Ophthalmic Sheath: Report of Two Cases and Review of the Literature

    Science.gov (United States)

    Hwang, Juyoung; Jo, Kyung-Il; Yeon, Je Young; Hong, Seung-Chyul

    2016-01-01

    We present two patients with a dural arteriovenous fistula (dAVF) of the ophthalmic sheath who developed progressive exophthalmos, conjunctival chemosis, and visual loss. These symptoms mimic those of cavernous sinus dAVFs. Dural AVFs of the ophthalmic sheath are extremely rare and their clinical management is controversial. We successfully treated these two patients by transvenous coil embolization. Transvenous embolization appears to be a safe and effective method to treat dAVFs of the ophthalmic sheath.

  12. Treatment of non-IBD anal fistula.

    Science.gov (United States)

    Lundby, Lilli; Hagen, Kikke; Christensen, Peter; Buntzen, Steen; Thorlacius-Ussing, Ole; Andersen, Jens; Krupa, Marek; Qvist, Niels

    2015-05-01

    The course of the fistula tract in relation to the anal sphincter is identified by clinical examination under general anaesthesia using a fistula probe and injection of fluid into the external fistula opening. In the event of a complex fistula or in the case of fistula recurrence, this should be supplemented with an endoluminal ultrasound scan and/or an MRI scan. St. Mark's fistula chart should be used for the description. Simple fistulas are amenable to fistulotomy, whereas treatment of complex fistulas requires special expertise and management of all available treatment modalities to tailor the right operation to the individual patient. The given levels of evidence and grades of recommendations are according to the Oxford Centre for Evidence-based Medicine (www.cemb.net).

  13. Experimental model of anal fistula in rats

    OpenAIRE

    Arakaki, Mariana Sousa; Santos,Carlos Henrique Marques dos; Falcão, Gustavo Ribeiro; Cassino,Pedro Carvalho; Nakamura, Ricardo Kenithi; Gomes,Nathália Favero; Santos,Ricardo Gasparin Coutinho dos

    2013-01-01

    INTRODUCTION: the management of anal fistula remains debatable. The lack of a standard treatment free of complications stimulates the development of new options. OBJECTIVE: to develop an experimental model of anal fistula in rats. METHODS: to surgically create an anal fistula in 10 rats with Seton introduced through the anal sphincter musculature. The animals were euthanized for histological fistula tract assessment. RESULTS: all ten specimens histologically assessed had a lumen and surroundi...

  14. [APPLICATION OF FISTULA PLUG WITH THE FIBRIN ADHESIVE IN TREATMENT OF RECTAL FISTULAS].

    Science.gov (United States)

    Aydinova, P R; Aliyev, E A

    2015-05-01

    Results of surgical treatment of 21 patients, suffering high transsphincteric and extrasphincteric rectal fistulas, were studied. In patients of Group I the fistula passage was closed, using fistula plug obturator; and in patients of Group II--by the same, but preprocessed by fibrin adhesive. The fistula aperture germeticity, prophylaxis of rude cicatrices development in operative wound zone, promotion of better fixation of bioplastic material were guaranteed, using fistula plug obturator with preprocessing, using fibrin adhesive.

  15. VAAFT: Video Assisted Anal Fistula Treatment; Bringing revolution in Fistula treatment

    OpenAIRE

    2015-01-01

    Objective: To share our findings that the new treatment modality Video Assisted Anal Fistula Treatment (VAAFT) is a better alternate to the conventional treatments of Fistula in Ano in our setup with minor changes in the initial method described by Meinero. Methods: Karl Storz Video equipment including Meinero Fistuloscope was used. Key steps are visualization of the fistula tract, correct localization of the internal fistula opening under direct vision and endoscopic treatment of the fistula...

  16. Dural arteriovenous fistulae after forehead knife-cut injury

    Institute of Scientific and Technical Information of China (English)

    朱刚; 陈志; 冯华

    2004-01-01

    @@ Dural arteriovenous fistulae (DAVF) is a rare intracranial vascular disease. It is pathologically characterized by direct shunting of the intracranial artery and vein, which results in cerebral ischemia, intracranial hemorrhage, neural deficit and intracranial murmur. The etiological mechanism of DAVF is not well known, but most researchers think it is associated with congenital abnormal development, especially abnormal development of dural blood vessels at the stage of embryogenesis. Recently, some researchers have found that DAVF is also associated with some acquired factors. This article reports a case who developed DAVF within 2 years after debridement of frontal bone fragmentation, depressed fracture, left frontal lobe contusion and superior sagittal sinus injury due to forehead knife-cut injury. The pathogenic mechanism was explored through a review of the related literatures.

  17. 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

  18. 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.

  19. Improvement of Depression after Treatment of Dural Arteriovenous Fistula: A Case Report and a Review

    Directory of Open Access Journals (Sweden)

    Minoru Nakagawa

    2012-01-01

    the treatment of a dural arteriovenous fistula in the left transverse-sigmoid sinus. A 46-year-old male had suffered from depression and was treated with antidepressants at a local hospital for four years. The patient was temporarily laid off due to his depression. Afterwards, he had Gerstmann's syndrome and came to our hospital. A DAVF in the left transverse-sigmoid sinus was demonstrated on the angiogram. The DAVF was successfully treated with endovascular surgery, coil embolization of the isolated diseased sinus through the mastoid emissary vein which was a draining vein from the fistula. After this treatment, his depression as well as Gerstmann's syndrome was improved and the quantity of the antidepressants decreased. The patient returned to work without any antidepressant two years after the treatment. DAVFs might be one of the causes of depression. It may be necessary to evaluate cerebral vessels in patients suffering from depression by using MRA or 3D-CTA even if there are not any abnormal findings on plain CT scans.

  20. Anal fistula with foot extension—Treated by kshara sutra (medicated seton) therapy: A rare case report

    Science.gov (United States)

    Ramesh, P. Bhat

    2013-01-01

    INTRODUCTION An ‘anal’ fistula is a track which communicates anal canal or rectum and usually is in continuity with one or more external openings. Distant communication from rectum is rare. It is a challenging disease because of its recurrence especially, with high level and distant communications. Ksharasutra (medicated seton) therapy is being practiced in India with high success rate (recurrence of 3.33%) in the management of complicated anal fistula. PRESENTATION OF CASE A 56 year old man presented with recurrent boils in the left lower limb at different places from thigh to foot. He underwent repeated incision and drainage at different hospitals. Examination revealed sinus with discharge and multiple scars on left lower limb from thigh up to foot. Suspecting anal fistula, MRI was advised which revealed a long cutaneous fistula from rectum to left lower limb. Patient was treated with Ksharasutra therapy. Within 6 months of treatment whole tract was healed completely. DISCUSSION Sushrutha (500BC) was the first to explain the role of surgical excision and use of kshara sutra for the management of anal fistula. Ksharasutra therapy showed least recurrence. Fistula from rectum to foot is of extremely rare variety. Surgical treatment of anal fistula requires hospitalization, regular post-operative care, is associated with a significant risk of recurrence (0.7–26.5%) and a high risk of impaired continence (5–40%). CONCLUSION Rectal fistula communicating till foot may be a very rare presentation in proctology practice. Kshara sutra treatment was useful in treating this condition, with minimal surgical intervention with no recurrence. PMID:23702360

  1. IDIOPATHIC SICK SINUS SYNDROME

    Directory of Open Access Journals (Sweden)

    S. Y. Nikulina

    2015-12-01

    Full Text Available Aim. To evaluate changes in hereditary burden of sick sinus syndrome (SSS in families of patients with SSS and assess heart rate variability (HRV in patients with SSS.Results. 33 families of patients with SSS were examined. Clinical study, ECG-Holter monitoring, atropine test, transesophageal left atrial stimulation, echocardiography, veloergometry were fulfilled in all probands and their relatives in 1990 and 2005-2006. Cardiorhythmography was done in patients with SSS only in 2005-2006.Results. Increase in hereditary burden with SSS from 31 to 35% is registered during 15 years. Significant growth of patients with SSS was observed among daughters (from 50 to 71%, nephews (from 33 to 50% and nieces (from 0 to 20%. HRV analysis shows prevalence of sympathetic system activity in patients with SSS.Conclusion. Growth of hereditary burden with SSS especially among female relatives is shown. HRV analysis can be used for SSS diagnostics.

  2. Laparoscopic repair of vesicovaginal fistula

    Directory of Open Access Journals (Sweden)

    Miłosz Wilczyński

    2011-06-01

    Full Text Available A vesicovaginal fistula is one of the complications that a gynaecologist is bound to face after oncological operations, especially in postmenopausal women. Over the years there have been introduced many techniques of surgical treatment of this entity, including transabdominal and transvaginal approaches.We present a case of a 46-year-old patient who suffered from urinary leakage via the vagina due to the presence of a vesicovaginal fistula that developed after radical abdominal hysterectomy and subsequent radiotherapy. The decision was made to repair it laparoscopically due to retracted, fibrous and scarred tissue in the vaginal apex that precluded a transvaginal approach. A small cystotomy followed by an excision of fistula borders was performed. After six-month follow-up no recurrence of the disease has been noted.We conclude that laparoscopy is an interesting alternative to traditional approaches that provides comparable results.

  3. Anal fistula. Past and present.

    Science.gov (United States)

    Zubaidi, Ahmad M

    2014-09-01

    Anal fistula is a common benign condition that typically describes a miscommunication between the anorectum and the perianal skin, which may present de novo, or develop after acute anorectal abscess. Athough anal fistulae are benign, the condition can still negatively influence a patient's quality of life by causing minor pain, social hygienic embarrassment, and in severe cases, frank sepsis. Despite its long history and prevalence, anal fistula management remains one of the most challenging and controversial topics in colorectal surgery today. The end goals of treatment include draining the local infection, eradicating the fistulous tract, and minimizing recurrence and incontinence rates. The goal of this review is to ensure surgeons and physicians are aware of the different imaging and treatment choices available, and to report expected outcomes of the various surgical modalities so they may select the most suitable treatment. 

  4. Radiology in diagnostics of odontogenic maxillary sinusitis

    Directory of Open Access Journals (Sweden)

    Chekhonatskaya М.L

    2013-09-01

    Full Text Available The purpose: to prove diagnostic capabilities of modern radiation techniques in odontogenic maxillary sinusitis. Material and methods: The study involved 546 patients with sinusitis. The following methods have been used: X-ray of the paranasal sinuses, contrast maxillary sinus radiography, contact intraoral radiographs, orthopantomography, computer tomography and magnetic resonance imaging. Results. In 7,9% of cases the presence of odontogenic sinusitis has been established, in 92,1 % rhinogenous sinusitis has been revealed. The work provides information about the effectiveness of various radiation techniques in the diagnosis of odontogenic sinusitis. Conclusion. For suspected odontogenic sinusitis, treatment of choice includes the combined use of X-ray of the paranasal sinuses in the mentoanterior projection and contact intraoral radiographs of «causal teeth». Computer tomography is the most informative additional method to clarify the diagnosis of odontogenic sinusitis.

  5. Fistulas secondary to gynecological and obstetrical operations

    Directory of Open Access Journals (Sweden)

    Jakovljević Branislava N.

    2003-01-01

    Full Text Available The authors present urogenital and rectogenital fistulas treated at the Department of Obstetrics and Gynecology in Novi Sad in the period from 1976 to 1999. The study comprised 28 cases of fistula out of which 17 were vesicovaginal, 3 ureterovaginal, 1 vesicorecto vaginal and 7 recto vaginal. During the investigated period there were 182 Wertheim operations, 3864 total abdominal hysterectomies, 1160 vaginal hysterectomies and 7111 cesarean sections. The vesicovaginal fistulas were most frequent with the incidence of 0.33%, whereas the tocogenic fistulas did not occur. Urogenital fistulas secondary to radical hysterectomy are extremely rare thanks to the administered measures of prevention during the surgical procedure.

  6. Radiology in diagnostics of odontogenic maxillary sinusitis

    OpenAIRE

    Chekhonatskaya М.L; llyasova Е.В.; Konnov V.V.; Priezzheva V.N.; Kochanov S.V.; Khmara T.G.; Arushanian A.R.

    2013-01-01

    The purpose: to prove diagnostic capabilities of modern radiation techniques in odontogenic maxillary sinusitis. Material and methods: The study involved 546 patients with sinusitis. The following methods have been used: X-ray of the paranasal sinuses, contrast maxillary sinus radiography, contact intraoral radiographs, orthopantomography, computer tomography and magnetic resonance imaging. Results. In 7,9% of cases the presence of odontogenic sinusitis has been established, in 92,1 % rhinoge...

  7. Ectopic third molar in the maxillary sinus

    OpenAIRE

    Mohan, Shishir; Kankariya, Hasti; Harjani, Bhupendra; Sharma, Harendra

    2011-01-01

    Ectopic eruption of teeth into a region other than the oral cavity is rare although there have been reports of teeth in the nasal septum, mandibular condyle, coronoid process, palate, chin and maxillary sinus. Occasionally, a tooth may erupt in the maxillary sinus and present with local sinonasal symptoms attributed to chronic sinusitis. We present a case of an ectopic maxillary third molar tooth that caused chronic purulent sinusitis in relation to the right maxillary sinus.

  8. 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.)

  9. Enigma of primary aortoduodenal fistula

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

  10. Coronary artery fistulas as a cause of angina: How to manage these patients?

    Energy Technology Data Exchange (ETDEWEB)

    Buccheri, Dario; Dendramis, Gregory, E-mail: gregorydendramis@libero.it; Piraino, Davide; Chirco, Paola Rosa; Carità, Patrizia; Paleologo, Claudia; Andolina, Giuseppe; Assennato, Pasquale; Novo, Salvatore

    2015-07-15

    Coronary artery fistulas represent the most common hemodynamically significant congenital defect of the coronary arteries and the clinical presentation is mainly dependent on the severity of the left-to-right shunt. We describe a case of a 55-year-old man with history of chest pain and without history of previous significant chest wall trauma or any invasive cardiac procedures. A coronary multislice computed tomography showed two large coronary fistulas arising from the left anterior descending coronary artery and ending in an angiomatous plexus draining into the common pulmonary trunk. Coronary angiography confirmed the CT finding and showed a third fistulous communication arising from the sinus node artery. Although coronary fistulas are infrequent, they are becoming increasingly important because their management and treatment could prevent serious complications. The latest guidelines of the American College of Cardiology/American Heart Association indicate as Class I recommendation the percutaneous or surgical closure for large fistulas regardless of symptoms. In this manuscript, we provide a detailed review of the literature on this topic, focusing on the clinical management of these patients.

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

    Science.gov (United States)

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

    2015-12-01

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

  12. [Maxillary sinus carcinoma combined with maxillary sinus fungal sinusitis: one case report].

    Science.gov (United States)

    Peng, Zhenxing; Xu, Xianfa; Wei, Bojun

    2016-01-01

    A 70 years old male patient complained a sense of swelling on right facial, mild pain, and the obstruction of right nasal, no complain of facial numbness and toothache. Physical examination showed the slight bulging on right facial with mild tenderness, purulent nasal secretions on the right middle nasal meatus, and no significant neoplasm. CT scan showed that soft density tissue in the right maxillary sinus,and the high density tissue in some period. Postoperative diagnosis: carcinoma of maxillary sinus with fungal sinusitis.

  13. [Surgical dilemmas. Sinus floor elevation].

    Science.gov (United States)

    ten Bruggenkate, C M; Schulten, E A J M; Zijderveld, S A

    2008-12-01

    Limited alveolar bone height prevents the placement of dental implants. Sinus floor elevation is an internal augmentation of the maxillary sinus that allows implants to be placed. The principle of this surgical procedure is the preparation of a 'top hinge door', that is raised together with the Schneiderian membrane in the cranial direction. The space which created under this lid is filled with a bone transplant. Autogenous bone is the standard transplant material, despite the fact that a second surgery site is necessary. Under certain circumstances bone substitutes can be used, with a longer healing phase. If sufficient alveolar bone height is available to secure implant stability, simultaneous implantation and sinus floor elevation are possible. Considering the significant anatomical variation in the region of the maxillary sinus, a sound knowledge of the anatomy is of great importance.

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

    Directory of Open Access Journals (Sweden)

    shahin abdollahi fakhim

    2014-10-01

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

  15. Sinus Balloon Dilation as Treatment for Acute Sphenoid Sinusitis with Impaired Vision for a Child

    Directory of Open Access Journals (Sweden)

    Yin Zhao

    2016-01-01

    Full Text Available This paper is about sinus balloon dilatation in treatment of acute left sphenoid sinusitis with left impaired vision in a child. Balloon catheter dilatation (BCD of the sinus ostia is a new technique. It has been shown to be a minimally invasive technique to manage chronic sinusitis. However, this method is rarely used in the treatment of acute sinusitis. So far, we know of no reported cases of sinus balloon dilatation in treatment of this case, especially for children.

  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. Gastropulmonary Fistula after Bariatric Surgery

    Directory of Open Access Journals (Sweden)

    Maya Doumit

    2009-01-01

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

  18. Cerebral sinus venous thrombosis

    Directory of Open Access Journals (Sweden)

    Hernando Raphael Alvis-Miranda

    2013-01-01

    Full Text Available Cerebral sinus venous thrombosis (CSVT is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment.

  19. Cerebral sinus venous thrombosis

    Science.gov (United States)

    Alvis-Miranda, Hernando Raphael; Milena Castellar-Leones, Sandra; Alcala-Cerra, Gabriel; Rafael Moscote-Salazar, Luis

    2013-01-01

    Cerebral sinus venous thrombosis (CSVT) is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT) and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment. PMID:24347950

  20. 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.

  1. ENTEROCUTANEOUS FISTULAS, OUR EXPERIENCE IN MANAGEMENT

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    Anantha Ramani Pratha

    2016-06-01

    Full Text Available Enterocutaneous fistulas are a surgeon’s nightmare, more so if they occur after one’s own surgery. They are a challenge, testing the surgeon’s patience and expertise. Their management remains a team work. The success depends on the wellbeing of the patient during this great ordeal of management. In this article, we are reviewing and presenting the experience gained by us while managing 58 cases of enterocutaneous fistulas. We have studied the causes, the time of occurrence, the duration of conservative treatment, the methods of investigations and definitive treatment and ultimate outcome of our management of 58 cases of postoperative enterocutaneous fistulas, in a period of 5 years. Total 58 cases, postoperative enterocutaneous fistulas were the most common type (75%, 4 lost for followup. All fistulas were initially managed conservatively. Patients were maintained on total parenteral nutrition, evaluated for the cause and site of leak. High output fistulas were made as controlled fistula by diverting the loop to exterior following stabilisation, to minimise spillage and sepsis. Low output fistulas explored and definitive treatment carried out if there is persistent leak after 8 weeks. 8 ileal fistulas healed spontaneously (13.7%. 3 malignant rectal fistulas sent for radiotherapy. Initial damage control surgery was done in 15 cases (ileal+sigmoid+rectum (25.86%. Definitive surgery was done in 39 cases (67%. Out of 54 cases, 15 expired-(27.7%

  2. Enterovesical fistulae: aetiology, imaging, and management.

    Science.gov (United States)

    Golabek, Tomasz; Szymanska, Anna; Szopinski, Tomasz; Bukowczan, Jakub; Furmanek, Mariusz; Powroznik, Jan; Chlosta, Piotr

    2013-01-01

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

  3. Treating anal fistula with the anal fistula plug: case series report of 12 patients

    OpenAIRE

    Saba, Reza Bagherzadeh; Tizmaghz, Adnan; Ajeka, Somar; Karami, Mehdi

    2016-01-01

    Introduction Recurrent and complex high fistulas remain a surgical challenge. This paper reports our experience with the anal fistula plug in patients with complex fistulas. Methods Data were collected prospectively and analyzed from consecutive patients undergoing insertion of a fistula plug from January 2011 through April 2014 at Hazrat-e-Rasoul Hospital in Tehran. We ensured that sepsis had been eradicated in all patients prior to placement of the plug. During surgery, a conical shaped col...

  4. Urethral Fistula and Scrotal Abscess Associated with Colovesical Fistula Due to the Sigmoid Colon Cancer

    OpenAIRE

    2015-01-01

    We report here a rare case of urethral fistula and scrotal abscess associated with colovesical fistula due to sigmoid colon cancer. An 84-year-old male was referred to our hospital complaining of macrohematuria, fecaluria, pneumaturia and micturitional pain. Computed tomography (CT) showed colovesical fistula. Other examinations, including colonoscopy and cystoscopy, did not reveal a clear cause for the colovesical fistula. Only an elevated serum level of the tumor marker CA19-9 suggested the...

  5. VAAFT - Videoassisted anal fistula treatment: a new approach for anal fistula

    OpenAIRE

    Mendes,Carlos Ramon Silveira; FERREIRA, Luciano Santana de Miranda; Sapucaia,Ricardo Aguiar; LIMA, Meyline Andrade; Araujo, Sergio Eduardo Alonso

    2014-01-01

    INTRODUCTION: Anal fistula is an epithelised path between the rectum or anal canal and the perianal region. The use of laparoscopic surgery with a minimally invasive procedure has led to the development of video-assisted surgical treatment of anal fistula.OBJECTIVE: To describe the surgical technique VAAFT as a new approach to fistula.CONCLUSION: This is a safe and reproducible procedure. It enables the study of the entire fistula, obtaining the identification of accessory paths, cavitations ...

  6. Sick sinus syndrome: a review.

    Science.gov (United States)

    Semelka, Michael; Gera, Jerome; Usman, Saif

    2013-05-15

    Sick sinus syndrome refers to a collection of disorders marked by the heart's inability to perform its pacemaking function. Predominantly affecting older adults, sick sinus syndrome comprises various arrhythmias, including bradyarrhythmias with or without accompanying tachyarrhythmias. At least 50 percent of patients with sick sinus syndrome develop alternating bradycardia and tachycardia, also known as tachy-brady syndrome. Sick sinus syndrome results from intrinsic causes, or may be exacerbated or mimicked by extrinsic factors. Intrinsic causes include degenerative fibrosis, ion channel dysfunction, and remodeling of the sinoatrial node. Extrinsic factors can be pharmacologic, metabolic, or autonomic. Signs and symptoms are often subtle early on and become more obvious as the disease progresses. They are commonly related to end-organ hypoperfusion. Cerebral hypoperfusion is most common, with syncope or near-fainting occurring in about one-half of patients. Diagnosis may be challenging, and is ultimately made by electrocardiographic identification of the arrhythmia in conjunction with the presence of symptoms. If electrocardiography does not yield a diagnosis, inpatient telemetry monitoring, outpatient Holter monitoring, event monitoring, or loop monitoring may be used. Electrophysiologic studies also may be used but are not routinely needed. Treatment of sick sinus syndrome includes removing extrinsic factors, when possible, and pacemaker placement. Pacemakers do not reduce mortality, but they can decrease symptoms and improve quality of life.

  7. Sex determination using maxillary sinus

    Directory of Open Access Journals (Sweden)

    Ranjith Kumar Kanthem

    2015-01-01

    Full Text Available Background: Individual identification is a subtle concept and often one of the most important priorities in mass disasters, road accidents, air crashes, fires, and even in the investigation of criminal cases. Matching specific features detected on the cadaver with data recorded during the life of an individual is an important aspect in forensics, and can be performed by fingerprint analysis, deoxyribonucleic acid matching, anthropological methods, radiological methods and other techniques which can facilitate age and sex identification. Sinus radiography is one such method that has been used for determination of the sex of an individual. Hence, an attempt is being made to use the different dimensions of the maxillary sinus in the determination of sex using coronal and axial sections of plain computed tomography (CT scan. Materials and Methods: A total of 30 patients including 17 male and 13 female, visiting the Outpatient Department of the Mamata General Hospital were included as the study subjects. The dimensions of right and left maxillary sinuses of 30 subjects from plain CT were measured using SYNGO software and statistical analysis was done. Results: Sex determination using height, length, width, and volume of the maxillary sinus on both sides showed statistically significant results with a higher percentage of sexual dimorphism in the case of volume. Conclusion: Volume of the right maxillary sinus can be used as accurate diagnostic parameter for sex determination.

  8. Bronchopleural fistula following laparoscopic liver resection.

    Science.gov (United States)

    Bhardwaj, Neil; Kundra, Amritpal; Garcea, Giuseppe

    2014-10-09

    A rare case is presented of a 58-year-old woman who developed a bronchopleural fistula following a laparoscopic liver resection for a colorectal metastasis. The bronchopleural fistula was finally diagnosed when after repeated admissions for chest infections, the patient coughed up surgical clips. We propose a management plan based on our experience and hope this case report will add to the scarce reports of postoperative bronchopleural fistula cases in the literature.

  9. Enterovesical Fistulae: Aetiology, Imaging, and Management

    OpenAIRE

    2013-01-01

    Background and Study Objectives. Enterovesical fistula (EVF) is a devastating complication of a variety of inflammatory and neoplastic diseases. Radiological imaging plays a vital role in the diagnosis of EVF and is indispensable to gastroenterologists and surgeons for choosing the correct therapeutic option. This paper provides an overview of the diagnosis of enterovesical fistulae. The treatment of fistulae is also briefly discussed. Material and Methods. We performed a literature revie...

  10. 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.

  11. Anatomy of the carotid sinus nerve and surgical implications in carotid sinus syndrome

    NARCIS (Netherlands)

    Toorop, Raechel J.; Scheltinga, Marc R.; Moll, Frans L.; Bleys, Ronald L.

    2009-01-01

    Background: The carotid sinus syndrome (CSS) is characterized by syncope and hypotension due to a hypersensitive carotid sinus located in the carotid bifurcation. Some patients ultimately require surgical sinus denervation, possibly by transection of its afferent nerve (carotid sinus nerve [CSN]). T

  12. Unexpected location of pilonidal sinuses.

    Science.gov (United States)

    Sion-Vardy, N; Osyntsov, L; Cagnano, E; Osyntsov, A; Vardy, D; Benharroch, D

    2009-12-01

    Pilonidal sinuses usually occur in the sacrococcygeal area in young men, and occasionally can be found in other ectopic sites. We present a retrospective case review on unusual locations of pilonidal sinuses in the past 4 years. The lesion sites were as follows: one on the penis, two on the scalp, two on the abdomen, one on the neck, two in the groin and two in the axilla. Abdominal and penile lesions are uncommon, but the other locations reported are unusually rare. To our knowledge, the groin has not been reported previously as a site of a pilonidal sinus, although the histological appearance of hidradenitis suppurativa may well resemble it. When trying to clarify the pathogenesis of these occurrences, we found that recurrent hair removal was a common characteristic of the patients we contacted, and this may have been the initiating trauma.

  13. Osteoblastoma of the ethmoid sinus

    Energy Technology Data Exchange (ETDEWEB)

    Park, Yong-Koo [Kyung Hee University, Department of Pathology, School of Medicine, Seoul (Korea); Kyung Hee University Hospital, Department of Pathology, Seoul (Korea); Kim, Eui Jong [Kyung Hee University, Department of Diagnostic Radiology, School of Medicine, Seoul (Korea); Kim, Sung Wan [Kyung Hee University, Department of Otolaryngology, School of Medicine, Seoul (Korea)

    2007-05-15

    An osteoblastoma is a benign bone tumor that most often occurs in the vertebral column and the long bones of the extremities. Paranasal sinus involvement is very rare. We report an osteoblastoma of the ethmoid sinus in a 13-year-old boy who presented with exophthalmos. CT demonstrated an expansile, lesion of the right ethmoid sinus, which caused the orbital contents to be compressed and deviated to the right. A mixture of ground glass opacity and dense bone was present. The less dense portions of the lesion showed intense enhancement on MRI; a signal void was present on all sequences in the densely sclerotic areas. Curettage was performed. Histologically, the lesion was composed of proliferating osteoblasts along with small trabeculae of woven bone and rich vascular fibrous stroma. The literature concerning occurrence of osteoblastoma in this unusual location is reviewed and discussed. (orig.)

  14. Pancreaticoatmospheric fistula following severe acute necrotising pancreatitis.

    Science.gov (United States)

    Simoneau, Eve; Chughtai, Talat; Razek, Tarek; Deckelbaum, Dan L

    2014-12-17

    Severe acute necrotising pancreatitis is associated with numerous local and systemic complications. Abdominal compartment syndrome requiring urgent decompressive laparotomy is a potential complication of this disease process and is associated with increased morbidity and mortality. We describe the case of a pancreaticoatmospheric fistula following decompressive laparotomy in a patient with severe acute necrotising pancreatitis. While this fistula was managed successfully using the current standard of care for pancreatic fistulas, the wound care for in this patient with drainage of the fistula through an open abdomen, is a significant challenge.

  15. 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...... 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. Patients with cancer may only need treatment for the acute bleeding episode, and an endovascular approach has the advantage...

  16. Operative treatment of radiation-induced fistulae

    Energy Technology Data Exchange (ETDEWEB)

    Balslev, I.; Harling, H.

    1987-01-01

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

  17. Colovesical fistulae in the sigmoid diverticulitis.

    Science.gov (United States)

    Cirocchi, R; La Mura, F; Farinella, E; Napolitano, V; Milani, D; Di Patrizi, M S; Trastulli, S; Covarelli, P; Sciannameo, F

    2009-01-01

    In most cases Colovesical fistulae are complications of diverticular disease and representing the most common kind of colodigestive fistula; less common are colovaginal, colocutaneous, coloenteric and colouterine fistula. In this article we review the literature concerning colovesical fistulae in colorectal surgery for sigmoid diverticulitis and report on two cases that required a surgical treatment, one elective and the other in emergency. In both cases we performed a sigmoid resection with a primary anastomosis and small vesical window-ectomy placing a Foley catheter for about 10 days.

  18. 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.

  19. New techniques for treating an anal fistula.

    Science.gov (United States)

    Song, Kee Ho

    2012-02-01

    Surgery for an anal fistula may result in recurrence or impairment of continence. The ideal treatment for an anal fistula should be associated with low recurrence rates, minimal incontinence and good quality of life. Because of the risk of a change in continence with conventional techniques, sphincter-preserving techniques for the management complex anal fistulae have been evaluated. First, the anal fistula plug is made of lyophilized porcine intestinal submucosa. The anal fistula plug is expected to provide a collagen scaffold to promote tissue in growth and fistula healing. Another addition to the sphincter-preserving options is the ligation of intersphincteric fistula tract procedure. This technique is based on the concept of secure closure of the internal opening and concomitant removal of infected cryptoglandular tissue in the intersphincteric plane. Recently, cell therapy for an anal fistula has been described. Adipose-derived stem cells have two biologic properties, namely, ability to suppress inflammation and differentiation potential. These properties are useful for the regeneration or the repair of damaged tissues. This article discusses the rationales for, the estimated efficacies of, and the limitations of new sphincter-preserving techniques for the treatment of anal fistulae.

  20. Sick sinus syndrome: a family study.

    Science.gov (United States)

    Rogińska, Natalia; Bieganowska, Katarzyna

    2014-02-01

    A case of related individuals affected by sick sinus syndrome is presented in this study. The clinical and electrocardiographic signs of sinus node dysfunction and the most common causes of this disease are presented. Subsequently, the article includes descriptions of sinus node disease in three related children as well as details of the disease in their relatives. A literature review of the genetics of familial sinus node dysfunction concludes the study.

  1. Clinical Features and Treatments of Odontogenic Sinusitis

    OpenAIRE

    Lee, Kyung Chul; Lee, Sung Jin

    2010-01-01

    Purpose The aim of this study was to investigate how clinical features such as sex, age, etiologic factors, and presenting symptoms of odontogenic sinusitis are differentiated from other types of sinusitis. Also, this study was designed to find methods for reducing the incidence of odontogenic sinusitis. Materials and Methods A retrospective chart analysis was completed on twenty-seven patients with odontogenic sinusitis. They were all treated at Kangbuk Samsung Hospital between February 2006...

  2. Colovesical fistula presenting with epididymitis

    OpenAIRE

    2013-01-01

    This article reports a case of colovesical fistula presenting with epididymitis. A 75-year-old man with a recent conservatively managed localised diverticular perforation presented to hospital with acute pain and swelling of his left testicle and epididymis. On further questioning, the patient reported passing air in his urine. Urine cultures grew Enterococcus faecalis. Ultrasound scan confirmed a diagnosis of bacterial epididymitis and the patient was treated with intravenous antibiotics. Su...

  3. Sudden Hemianopsia Secondary to Ethmoid Sinus Mucocele

    Directory of Open Access Journals (Sweden)

    Morganti, Ligia

    2014-01-01

    Full Text Available Paranasal sinus mucoceles are benign cystic lesions, filled with mucus, occurring due to an obstruction of involved sinus ostium. They are indolent, locally expansive, and destructive. Surgical treatment must be performed and, when done at the correct time, may prevent sequelae. We present a case of ethmoid sinus mucocele with orbit involvement and permanent optical nerve injury.

  4. Choledochoduodenal fistula of ulcer etiology

    Directory of Open Access Journals (Sweden)

    Čolović Radoje

    2010-01-01

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

  5. Morphometric study of maxillary sinus by computed tomography. Assessment of sinus floor bone reconstruction

    OpenAIRE

    2012-01-01

    Rehabilitation with dental implants in posterior maxilla is difficult because of the presence of maxillary sinus with anatomical variations. The aim of this research was to evaluate the sinus volume to install one or more implants without invading the sinus membrane. Forty (40) maxillary sinuses were evaluated in 22 skulls by computed tomography measuring in the axial, coronal and sagittal slice. The sinus were classified according to the remaining alveolar bone and a dental implant in the pl...

  6. 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.

  7. Bacterial colonization or infection in chronic sinusitis.

    Science.gov (United States)

    Pandak, Nenad; Pajić-Penavić, Ivana; Sekelj, Alen; Tomić-Paradžik, Maja; Cabraja, Ivica; Miklaušić, Božana

    2011-12-01

    The aim of this study was the determination of bacteria present in maxillary and ethmoid cavities in patients with chronic sinusitis and to correlate these findings with bacteria simultaneously present in their nasopharynx. The purpose of this correlation was to establish the role of bacteria found in chronically inflamed sinuses and to evaluate if the bacteria present colonized or infected sinus mucosa. Nasopharyngeal and sinus swabs of 65 patients that underwent functional endoscopic sinus surgery were cultivated and at the same time the presence of leukocytes were determined in each swab. The most frequently found bacteria in nasopharynx were Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus spp., Streptococcus viridans and Streptococcus pneumoniae. Maxillary or ethmoidal sinus swabs yielded bacterial growth in 47 (72.31%) patients. The most frequently found bacteria in sinuses were Staphylococcus epidermidis, Staphylococcus aureus, Klebsiella spp. and Streptococci (pneumoniae, viridans and spp.). The insignificant number of leukocytes was present in each sinus and nasopharyngeal swab. Every published microbiology study of chronic sinusitis proved that sinus mucosa were colonized with bacteria and not infected, yet antibiotic therapy was discussed making no difference between infection and colonization. Chronic sinusitis should be considered a chronic inflammatory condition rather than bacterial infection, so routine antibiotic therapy should be avoided. Empiric antibiotic therapy should be prescribed only in cases when the acute exacerbation of chronic sinusitis occurs and the antibiotics prescribed should aim the usual bacteria causing acute sinusitis. In case of therapy failure, antibiotics should be changed having in mind that under certain circumstances any bacteria colonizing sinus mucosa can cause acute exacerbation of chronic sinusitis.

  8. Systemic corticosteroids for acute sinusitis

    NARCIS (Netherlands)

    Venekamp, R.P.; Thompson, M.J.; Hayward, G.; Heneghan, C.J.; Mar, C.B. Del; Perera, R.; Glasziou, P.P.; Rovers, M.M.

    2014-01-01

    BACKGROUND: Acute sinusitis is the inflammation and swelling of the nasal and paranasal mucous membranes and is a common reason for patients to seek primary care consultations. The related impairment of daily functioning and quality of life is attributable to symptoms such as facial pain and nasal c

  9. Cavernous Sinus Thrombosis in Children

    Directory of Open Access Journals (Sweden)

    Rochelle Sweis

    2016-03-01

    Full Text Available Investigators from the Children’s Hospital of Philadelphia analyzed the clinical and radiographic findings in 12 cases of cavernous sinus thrombosis (CST seen between 2000 and 2013, and conducted a literature search and review of the pooled data.

  10. MICROSCOPE-ASSISTED DISSECTION OF PREAURICULAR SINUS: OUR EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Polisetti Ravibabu

    2016-06-01

    Full Text Available BACKGROUND PAS (Preauricular Sinus is a common congenital condition of external ear. It is seen in front of external ear as a small dimple or pit. When infected, it presents as swelling with pain and discharge from sinus with foul smell. There are many terminologies used for this condition like preauricular pit, preauricular tract and helical fistula. 1 It was first described by Heusinger in 1864. 2 It is more often unilateral than bilateral. Right side is more involved and females are more affected than males. 3 PAS is an embryological malformation associated with development of pinna in 6th week of gestation. Embryologically six mesenchymal hillocks form the auricle - three hillocks from first arch and three hillocks from the 2 nd arch. These hillocks fuse to form the pinna and incomplete fusion of these hillocks give rise to preauricular sinus. 1 Another theory states that PAS develops from ectodermal folding. (4,5,6 OBJECTIVE The rationale of this study is to highlight the surgical advantage achieved with the aid of operating microscope combined with standard surgical techniques. MATERIALS AND METHODS A prospective longitudinal study was conducted in the department of ENT, Santhiram Medical College and General Hospital, Nandyal between November 2013 and March 2015. A total of 7 patients were diagnosed with preauricular sinus and were planned for excision. A thorough ENT examination was done and the syndromes commonly associated with PAS were ruled out. All patients were examined by a physician for systemic diseases and were declared fit for surgery. All the cases were operated by first author under local anaesthesia. Surgery was done using simple elliptical incision around preauricular sinus pit and dissection proceeded with the aid of operating microscope (Carl Zeiss, Movena. RESULTS Out of 7 patients, 5 were females and 2 were males. 6 were unilateral and only one case was bilateral, 4 cases were right sided and 2 were left sided. Two

  11. Unusual ocular manifestations of silent sinus syndrome

    Directory of Open Access Journals (Sweden)

    Fabricio Lopes da Fonseca

    2014-01-01

    Full Text Available Silent sinus syndrome is an acquired condition in which there is a gradual collapse of the orbital floor and inward retraction of the maxillary sinus (atelectasis of the maxillary sinus. This in turn may cause associated ocular occurrences of enophthalmos and hypotropia. This is a report of an 8 year-old boy with silent sinus syndrome and associated ocular motility disorders. The association between silent sinus syndrome and ocular motility disturbance has been recently described in the literature. However, this is an infrequent association, mainly in childhood.

  12. 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.)

  13. Computed tomography demonstration of cholecystogastric fistula

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    Chung Kuao Chou, MD, MPH

    2016-06-01

    Full Text Available Cholecystogastric fistula is a rare complication of chronic cholecystitis or long-standing cholelithiasis. It results from the gradual erosion of the approximated, chronically inflamed wall of the gall bladder and stomach with fistulous tract formation. The present case describes the direct visualization of a cholecystogastric fistula by computed tomography in a patient without prior biliary system complaints.

  14. Diagnosis and treatment of inflammatory intestinovesical fistulas.

    Science.gov (United States)

    Szentgyörgyi, E; Kondás, J; Szöke, D; Balogh, A; Orbán, L

    1989-01-01

    The histories of 3 patients operated for inflammatory intestinovesical fistulas are reviewed. Two of them were treated for colovesical, one for ileovesical fistula. The questions concerning the development, diagnostics and surgical management are discussed in detail. The importance of cystoscopy in diagnosis is emphasized. In all three patients one-session operations were performed with good results.

  15. Urethral diverticulo-rectal fistula in AIDS.

    Science.gov (United States)

    Lee, W H; Yang, W J; Rha, K H; Chang, K H; Kim, J M; Lee, M S

    2001-10-01

    A 41-year-old heterosexual African man was evaluated for persistent urethral discharge, pneumaturia and watery diarrhea. Radiographic and endoscopic procedures established the diagnosis of a rectourethral fistula. The differential diagnosis of an acquired rectourethral fistula and the significance of AIDS are discussed.

  16. Diagnosis and Treatment of Transsphincteric Perianal Fistulas

    NARCIS (Netherlands)

    D.D.E. Zimmerman (David)

    2003-01-01

    textabstractFistula’ is the Latin word for a reed, pipe or flute. In medicine it implies a chronic granulating track connecting two epithelium lined surfaces. These surfaces may be cutaneous or mucosal. Perianal fistulas run from the anal canal to the perianal skin or perineum. Perianal fistulas are

  17. Identification of epithelialization in high transsphincteric fistulas

    NARCIS (Netherlands)

    L.E. Mitalas (Litza); R.S. van Onkelen (Robbert); K. Monkhorst (Kim); D.D.E. Zimmerman (David); M.P. Gosselink (Martijn Pieter); W.R. Schouten (Ruud)

    2012-01-01

    textabstractBackground At present, transanal advancement flap repair (TAFR) is the treatment of choice for transsphincteric fistulas passing through the upper and middle third of the external anal sphincter. It has been suggested that epithelialization of the fistula tract contributes to the failure

  18. 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...

  19. Surgical correction of ruptured aneurysms of the sinus of Valsalva using on-pump beating-heart technique

    Directory of Open Access Journals (Sweden)

    Lin Hui

    2010-05-01

    Full Text Available Abstract Background Rupture of aneurysms of the sinus of Valsalva results in abrupt onset of congestive heart failure. On-pump beating-heart surgery may reduce cardiac impairment by maintaining coronary blood flow and avoiding cardioplegia. Herein, we report the operative correction of thirty-one patients of ruptured aneurysms of the sinus of Valsalva, using the on-pump beating-heart technique. Methods Thirty-one patients with ruptured aneurysms of the sinus of Valsalva underwent operative corrections using the on-pump beating-heart technique. In patients with fistula diameter less than 1 cm and no aortic regurgitation, the aorta was unclamped throughout cardiopulmonary bypass(CPB while receiving antegrade heart perfusion. In remainder of patients, retrograde perfusion was used. Results After intracardiac manipulation was complete and the nasopharyngeal temperature was raised to 36-37°C, the patients were smoothly weaned off CPB. There were no early or late postoperative deaths. All patients were in New York Heart Association functional class I at follow-up (range, 0.5-1 year. Mild-to-moderate aortic valve regurgitation was observed in one patient. No recurrence of the left-to-right shunt from ruptured aneurysms of the sinus of Valsalva was observed. Conclusions Beating heart on pump allows adequate examination of the aortic lesion under near-physiologic conditions, allows decrease in ischemia-reperfusion injury and potentially decreases the risk of serious or fatal rhythm disturbances. On-pump beating-heart technique for repair of ruptured aneurysm of sinus of Valsalva is feasible and promising. Antegrade heart perfusion is suitable for patients with a fistula diameter

  20. [Odontogenic maxillary sinusitis caused by dental restoration].

    Science.gov (United States)

    Sato, Kiminori

    2014-06-01

    We report herein on 5 patients with odontogenic maxillary sinusitis caused by a dental restoration (caries cutting, cavity preparation, inlay restoration). Odontogenic maxillary sinusitis was noted following dental restoration. Even though the pulp cavity and dental pulp were intact, the odontogenic maxillary sinusitis occurred caused by an apical lesion. Infection by way of the dentinal tubules was suggested to be a cause of the pathophysiology. Endoscopic sinus surgery was indicated in patients with intractable odontogenic maxillary sinusitis caused by the dental restoration. Cone-beam x-ray CT was useful for the accurate diagnosis of odontogenic maxillary sinusitis caused by a dental restoration. Physicians should thus be aware of the possibility that a tooth, which has undergone dental restoration, may cause odontogenic maxillary sinusitis.

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

    Science.gov (United States)

    Larson, Kelsey E; Valente, Stephanie A

    2016-01-01

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

  2. Physiologic assessment of coronary artery fistula

    Energy Technology Data Exchange (ETDEWEB)

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

    1991-01-01

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

  3. Three Vessel Coronary Cameral Fistulae Associated with New Onset Atrial Fibrillation and Angina Pectoris

    Directory of Open Access Journals (Sweden)

    Murat Yuksel

    2014-01-01

    Full Text Available Coronary cameral fistulas are abnormal communications between a coronary artery and a heart chamber or a great vessel which are reported in less than 0.1% of patients undergoing diagnostic coronary angiography. All three major coronary arteries are even less frequently involved in fistula formation as it is the case in our patient. A 68-year-old woman was admitted to cardiology clinic with complaints of exertional dyspnea and angina for two years and a new onset palpitation. Standard 12-lead electrocardiogram revealed atrial fibrillation (AF with a ventricular rate of 114 beat/minute and accompanying T wave abnormalities and minimal ST-depression on lateral derivations. Transthoracic echocardiographic examination was normal except for diastolic dysfunction, minimally mitral regurgitation, and mild to moderate enlargement of the left atrium. Sinus rhythm was achieved by medical cardioversion with amiodarone infusion. Coronary angiography revealed diffuse and multiple coronary-left ventricle fistulas originating from the distal segments of both left and right coronary arterial systems without any stenosis in epicardial coronary arteries. The patient’s symptoms resolved almost completely with medical therapy. High volume shunts via coronary artery to left ventricular microfistulas may lead to increased volume overload and subsequent increase in end-diastolic pressure of the left ventricle and may cause left atrial enlargement.

  4. Anatomical aspects of sinus floor elevations.

    Science.gov (United States)

    van den Bergh, J P; ten Bruggenkate, C M; Disch, F J; Tuinzing, D B

    2000-06-01

    Inadequate bone height in the lateral part of the maxilla forms a contra-indication for implant surgery. This condition can be treated with an internal augmentation of the maxillary sinus floor. This sinus floor elevation, formerly called sinus lifting, consists of a surgical procedure in which a top hinge door in the lateral maxillary sinus wall is prepared and internally rotated to a horizontal position. The new elevated sinus floor, together with the inner maxillary mucosa, will create a space that can be filled with graft material. Sinus lift procedures depend greatly on fragile structures and anatomical variations. The variety of anatomical modalities in shape of the inner aspect of the maxillary sinus defines the surgical approach. Conditions such as sinus floor convolutions, sinus septum, transient mucosa swelling and narrow sinus may form a (usually relative) contra-indication for sinus floor elevation. Absolute contra-indications are maxillary sinus diseases (tumors) and destructive former sinus surgery (like the Caldwell-Luc operation). The lateral sinus wall is usually a thin bone plate, which is easily penetrated with rotating or sharp instruments. The fragile Schneiderian membrane plays an important role for the containment of the bonegraft. The surgical procedure of preparing the trap door and luxating it, together with the preparation of the sinus mucosa, may cause a mucosa tear. Usually, when these perforations are not too large, they will fold together when turning the trap door inward and upward, or they can be glued with a fibrin sealant, or they can be covered with a resorbable membrane. If the perforation is too large, a cortico-spongious block graft can be considered. However, in most cases the sinus floor elevation will be deleted. Perforations may also occur due to irregularities in the sinus floor or even due to immediate contact of sinus mucosa with oral mucosa. Obstruction of the antro-nasal foramen is, due to its high location, not a

  5. Anal fistulas : New perspectives on treatment and pathogenesis

    NARCIS (Netherlands)

    R.S. van Onkelen (Robbert)

    2015-01-01

    markdownabstractAbstract The objective of modern anal fistula treatment is healing of the fistula without diminished fecal continence. Sphincter saving techniques have been developed for anal fistulas, for which fistulotomy is not suitable. Treatment of these anal fistulas remains challenging and

  6. Relationship between development of accessory maxillary sinus and chronic sinusitis

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    Caner Sahin

    2015-01-01

    Full Text Available Background: We aimed to investigate whether there is a relationship between development of accessory maxillary osmium (AMO and chronic sinusitis. Material and Methods: A total of 100 patients who had endoscopic sinus surgery for chronic rhinosinusitis (CRS constituted the study group while 100 patients who had septoplasty were taken as the control group. The patients were examined for the presence of AMO using rigid endoscope. Results: The prevalence of AMO was 14% in the rhinosinusitis group and 9% in the control group. The difference between the groups was statistically significant (P < 0.05. Conclusion: Our study revealed that AMO prevalence is significantly higher in patients with CRS when compared with the controls. CRS may enhance perforation of fontanelle and formation of AMO.

  7. [Maxillary sinus malformations (double wall bone) lead to chronic sinusitis in a case].

    Science.gov (United States)

    Pang, Chaofu; Gu, Feng; Fang, Yingqi

    2014-09-01

    Chronic rhinosinusitis is a common otorhinolaryngological disease, although the incidence of chronic sinusitis is the result of many factors, the local anatomic abnormalities is one of the most important reasons. When maxillary sinus dysplasia that sinus cavity becomes small. These was some sinus cavity partial or complete bony septum malformation used to be reported occasionally, according to reports in the literature of this malformation rate is below 2%, bony divides sinus cavity is divided into 2 to 3 independent lacunar deformity are very rare, next we will introduce a case of sinus cavity that been divided into double deck by bone wall.

  8. 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.

  9. 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.

  10. Radiologic recognition of bronchopleural fistula.

    Science.gov (United States)

    Friedman, P J; Hellekant, C A

    1977-08-01

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

  11. Frequency of the odontogenic maxillary sinusitis extended to the anterior ethmoid sinus and response to surgical treatment

    OpenAIRE

    Crovetto Martínez, Rafael; Martin Arregui, Francisco Javier; Zabala López de Maturana, Aitor; Tudela Cabello, Kiara; Crovetto de la Torre, Miguel Angel

    2014-01-01

    Objectives: Odontogenic sinusitis usually affects the maxillary sinus but may extend to the anterior ethmoid sinuses. The purpose of this study is to determine the percentage of odontogenic maxillary sinusitis extended to the anterior ethmoid sinuses and determine also the surgical resolution differences between odontogenic maxillary sinusitis and odontogenic maxillary associated to anterior ethmoidal sinusitis. Study Design: This is a retrospective cohort study performed on 55 patients diagn...

  12. Introducing the operation method for curing anal fistula by laser

    Science.gov (United States)

    Ji, Bingzhi

    1993-03-01

    The key to the treatment of anal fistula lies in scavenging the infected anal gland thoroughly, which is the source of anal fistula infection. The fistula tract at the internal orifice of the anal fistula is cut 1 cm using laser with the infectious source completely degenerated and the wound gassified and scanned. The residual distal fistula softens and disappears upon the action of organic fibrinolysin.

  13. [Big osteoma of ethmoid sinus].

    Science.gov (United States)

    Peng, Ping

    2014-04-01

    Sinus osteoma is a common nasal and sinus disease, while the clinical cases of osteoma with a diameter greater than 30 millimeter are rarely seen. This paper reports a case of a 39-years-old male patient discovered with one-year long swelling pain in the right eye. The patients' right eye was mildly prominent and he suffered from hypopsia and diplopia. After CT scanned, he have ethmoid osteoma been discovered, besides, the right media rectus compression and orbital apex compression and consequent pathologically were diagnosed. The solid tumor ranged widely from the anterior skull base to the superior and interior orbital walls,and thus deprived the patient's complete surgical resection. As an attempt to prevent complications, most parts of the tumors were sur gically removed.

  14. Preauricular sinus: When to operate?

    Directory of Open Access Journals (Sweden)

    Anuj Kumar Goel

    2011-01-01

    Full Text Available Purpose: Experiences with preauricular sinus (PAS excision in pediatric age group. Materials and Methods: A retrospective analysis of 110 patients who underwent PAS excision was done. A total of 112 excisions (63 left, 49 right were performed by standard surgical technique. All the patients were operated upon in an infection-free period under general anesthesia. Results: A total of 32 excisions had bad surgical results in the form of bad scar or recurrence, out of which 28 had history of symptomatic sinus infection preoperatively. Conclusions: Surgical excision of PAS should be done in quiescent phase; once infected, it becomes very difficult to eradicate the infection and also the chances of bad surgical results (bad scar or recurrence increase manifold.

  15. Enterovesical Fistulae: Aetiology, Imaging, and Management

    Directory of Open Access Journals (Sweden)

    Tomasz Golabek

    2013-01-01

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

  16. Enterovesical Fistulae: Aetiology, Imaging, and Management

    Science.gov (United States)

    Golabek, Tomasz; Szymanska, Anna; Szopinski, Tomasz; Bukowczan, Jakub; Furmanek, Mariusz; Powroznik, Jan; Chlosta, Piotr

    2013-01-01

    Background and Study Objectives. Enterovesical fistula (EVF) is a devastating complication of a variety of inflammatory and neoplastic diseases. Radiological imaging plays a vital role in the diagnosis of EVF and is indispensable to gastroenterologists and surgeons for choosing the correct therapeutic option. This paper provides an overview of the diagnosis of enterovesical fistulae. The treatment of fistulae is also briefly discussed. Material and Methods. We performed a literature review by searching the Medline database for articles published from its inception until September 2013 based on clinical relevance. Electronic searches were limited to the keywords: “enterovesical fistula,” “colovesical fistula” (CVF), “pelvic fistula”, and “urinary fistula”. Results. EVF is a rare pathology. Diverticulitis is the commonest aetiology. Over two-thirds of affected patients describe pathognomonic features of pneumaturia, fecaluria, and recurrent urinary tract infections. Computed tomography is the modality of choice for the diagnosis of enterovesical fistulae as not only does it detect a fistula, but it also provides information about the surrounding anatomical structures. Conclusions. In the vast majority of cases, this condition is diagnosed because of unremitting urinary symptoms after gastroenterologist follow-up procedures for a diverticulitis or bowel inflammatory disease. Computed tomography is the most sensitive test for enterovesical fistula. PMID:24348538

  17. ETHMOIDAL SINUSITIS WITH PRESEPTAL ABSCESS: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Vikramjit

    2014-08-01

    Full Text Available Complications of sinusitis are rare nowadays because of higher and broad spectrum antibiotics. Preseptal abscess may rarely present as a complication of sinusitis. Our patient presented with a preseptal abscess with underlying ethmoidal sinusitis. The patient was treated with antibiotics; Incision and drainage of the preseptal abscess were done and infection in the ethmoidal sinuses was eradicated by endoscopic sinus surgery

  18. [Secondary aorto-enteric fistula].

    Science.gov (United States)

    Giordanengo, F; Boneschi, M; Miani, S; Erba, M; Beretta, L

    1998-01-01

    Aortic graft fistula is a rare and life-threatening complication after aortic reconstruction. The incidence ranges from 0.5 to 4%, and even if the diagnosis and treatment is appropriate, the results of surgery are poor: mortality rate ranges from 14 to 70%. The optimal method of treatment is still controversial; prosthetic removal and extra-anatomic bypass has been advocated as the standard method, but more recently, because the high mortality rate associated with this procedure, some have prompted to recommend in situ aortic graft replacement as a more successful treatment. Personal experience with incidence (0.7%) outcome and mortality (57%) in 7 patients treated over a period of 6 years (1990-1996) is reported. Results from this group are compared with another group (6 patients) previously treated (1975-1982) for the same pathology. Our results after 10 years, show the same incidence (0.7 vs 0.6%) and an elevated and unchanged mortality (57 vs 66%). Better results in the management of aorto-enteric fistulas could be achieved with the removal of infected infrarenal aortic prosthetic grafts and in situ homografts replacement.

  19. Cerebellar Hemorrhage due to a Direct Carotid–Cavernous Fistula after Surgery for Maxillary Cancer

    Science.gov (United States)

    Kamio, Yoshinobu; Hiramatsu, Hisaya; Kamiya, Mika; Yamashita, Shuhei; Namba, Hiroki

    2017-01-01

    Infratentorial cerebral hemorrhage due to a direct carotid–cavernous fistula (CCF) is very rare. To our knowledge, only four such cases have been reported. Cerebellar hemorrhage due to a direct CCF has not been reported. We describe a 63-year-old female who presented with reduced consciousness 3 days after undergoing a maxillectomy for maxillary cancer. Computed tomography showed a cerebellar hemorrhage. Magnetic resonance angiography showed a left-sided direct CCF draining into the left petrosal and cerebellar veins through the left superior petrosal sinus (SPS). Her previous surgery had sacrificed the pterygoid plexus and facial vein. Increased blood flow and reduced drainage could have led to increased venous pressure in infratentorial veins, including the petrosal and cerebellar veins. The cavernous sinus has several drainage routes, but the SPS is one of the most important routes for infratentorial venous drainage. Stenosis or absence of the posterior segment of the SPS can also result in increased pressure in the cerebellar and pontine veins. We emphasize that a direct CCF with cortical venous reflux should be precisely evaluated to determine the hemodynamic status and venous drainage from the cavernous sinus. PMID:28061497

  20. Late recovery from foreign body sinusitis after maxillary sinus floor augmentation.

    Science.gov (United States)

    Felisati, Giovanni; Saibene, Alberto Maria; Lenzi, Riccardo; Pipolo, Carlotta

    2012-12-12

    A 55-year-old male patient was referred to our clinic with signs and symptoms of recurring sinusitis after a right maxillary sinus floor augmentation for implantological purposes. Investigations showed an antibiotic-resistant ethmoidomaxillary sinusitis resulting from bone graft infection and displacement of previously inserted xenograft material into the maxillary sinus. The patient thus underwent a surgical procedure combining nasal endoscopy and oral surgery in order to remove the infected graft and restore sinusal drainage. The procedure was apparently successful but sinusitis relapsed after surgery and persisted despite 2 weeks of antibiotic therapy and local medications. A CT scan showed persistence of grafting fragments in the maxillary sinus. A new surgical procedure was scheduled while a more accurate endoscopic local medication was performed. Six hours after the treatment, the patient spontaneously expelled the fragments and promptly recovered. The patient successfully underwent another maxillary sinus floor augmentation procedure 6 months later.

  1. 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.)

  2. Diagnosis and management of colovesical fistulas.

    Science.gov (United States)

    Shatila, A H; Ackerman, N B

    1976-07-01

    Diagnosis and management may present difficult problems in patients with colovesical fistulas. Symptoms in the urinary tract are most common, and cystoscopy, and cystography are the most valuable diagnostic procedures. It may not always be possible to demonstrate the fistula by diagnostic tests, and a high index of suspicion should be maintained in patients with inflammatory or neoplastic disease of the rectosigmoid area or bladder with recurrent cystitis. Definitive treatment should include resection of the fistula and diseased segment of the intestine. Both one stage and multistage procedures have their place in the treatment of this condition. There are specific criteria for success for a one stage procedure.

  3. Vesicoovarian Fistula on an Endometriosis Abscessed Cyst

    Directory of Open Access Journals (Sweden)

    C. Tran

    2014-01-01

    Full Text Available 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 of vesical fistula.

  4. Anal fistula: intraoperative difficulties and unexpected findings.

    Science.gov (United States)

    Abou-Zeid, Ahmed A

    2011-07-28

    Anal fistula surgery is a commonly performed procedure. The diverse anatomy of anal fistulae and their proximity to anal sphincters make accurate preoperative diagnosis essential to avoid recurrence and fecal incontinence. Despite the fact that proper preoperative diagnosis can be reached in the majority of patients by simple clinical examination, endoanal ultrasound or magnetic resonance imaging, on many occasions, unexpected findings can be encountered during surgery that can make the operation difficult and correct decision-making crucial. In this article we discuss the difficulties and unexpected findings that can be encountered during anal fistula surgery and how to overcome them.

  5. Anal fistula: Intraoperative difficulties and unexpected findings

    Institute of Scientific and Technical Information of China (English)

    Ahmed A Abou-Zeid

    2011-01-01

    Anal fistula surgery is a commonly performed procedure. The diverse anatomy of anal fistulae and their proximity to anal sphincters make accurate preoperative diagnosis essential to avoid recurrence and fecal incontinence. De-spite the fact that proper preoperative diagnosis can be reached in the majority of patients by simple clinical ex-amination, endoanal ultrasound or magnetic resonance imaging, on many occasions, unexpected findings can be encountered during surgery that can make the oper-ation difficult and correct decision-making crucial. In this article we discuss the difficulties and unexpected find-ings that can be encountered during anal fistula sur-gery and how to overcome them.

  6. Brain Abscesses Associated with Asymptomatic Pulmonary Arteriovenous Fistulas

    Science.gov (United States)

    Nam, Taek-Kyun; Park, Yong-sook; Kwon, Jeong-taik

    2017-01-01

    Brain abscess commonly occurs secondary to an adjacent infection (mostly in the middle ear or paranasal sinuses) or due to hematogenous spread from a distant infection or trauma. Pulmonary arteriovenous fistulas (AVFs) are abnormal direct communications between the pulmonary artery and vein. We present two cases of brain abscess associated with asymptomatic pulmonary AVF. A 65-year-old woman was admitted with a headache and cognitive impairment that aggravated 10 days prior. An magnetic resonance (MR) imaging revealed a brain abscess with severe edema in the right frontal lobe. We performed a craniotomy and abscess removal. Bacteriological culture proved negative. Her chest computed tomography (CT) showed multiple AVFs. Therapeutic embolization of multiple pulmonary AVFs was performed and antibiotics were administered for 8 weeks. A 45-year-old woman presented with a 7-day history of progressive left hemiparesis. She had no remarkable past medical history or family history. On admission, blood examination showed a white blood cell count of 6290 cells/uL and a high sensitive C-reactive protein of 2.62 mg/L. CT and MR imaging with MR spectroscopy revealed an enhancing lesion involving the right motor and sensory cortex with marked perilesional edema that suggested a brain abscess. A chest CT revealed a pulmonary AVF in the right upper lung. The pulmonary AVF was obliterated with embolization. There needs to consider pulmonary AVF as an etiology of cerebral abscess when routine investigations fail to detect a source. PMID:28061502

  7. Giant osteoma of the ethmoidal sinus

    Directory of Open Access Journals (Sweden)

    Marambaia, Otavio

    2009-06-01

    Full Text Available Introduction: The osteomas are osseous lesions with slow and asymptomatic growth that most of the times is a finding in radiological exams requested for other reason. It's the most common benign neoplasm of the paranasal sinuses. The osteomas are located mainly in the frontal sinus (57% to 80%, followed by the ethmoidal sinuses (20%, maxillary sinuses and rarely in the sphenoid sinus. It has a discreet predominance in the male sex 1.5 and its incidence is higher in the 3rd and 4th decades of life. The treatment is surgical no matter the size. Objective: To describe a case of giant osteoma of the ethmoidal sinus including a brief literature review. Case Report: JDA, male, 33 years old, presented with a right constant nasal obstruction for 01 year. Upon exam, he presented with facial asymmetry with lateralization of the right ocular globe. The computed tomography of the paranasal sinuses showed a lesion with density of soft parts occupying partially the right nasal cavity, ethmoid sinus and right maxillary. The patient was submitted to surgery with full exeresis of the lesion. The anatomopathological exam confirmed osteoma. The patient evolved without evidences of the lesion recurrence. Final Comments: The osteomas in the ethmoidal sinus, irrespectively of the size and due to the risk of complications, must be operated.

  8. Secondary silent sinus syndrome:case report

    Institute of Scientific and Technical Information of China (English)

    王绪锐; 赵小冬

    2004-01-01

    @@ Silent sinus syndrome (SSS) is characterized by spontaneous and progressive unilateral enophthalmos with no other symptoms. Maxillary sinus atelectasis displayed on CT will be helpful for clinical diagnosis. The operation for better maxillary sinus ventilation shows good therapeutic effects and prognosis. In 1964, Montgometry1 described the first case of patient whose enophthalmos was caused by mucocele of the maxillary sinus. Since then, all otolaryngologists have taken more and more attention to this syndrome. And by June 2000, a total of 45 cases had been reported worldwide.

  9. [Update on Current Care Guideline: Sinusitis].

    Science.gov (United States)

    Hytönen, Maija; Nokso-Koivisto, Johanna; Huovinen, Pentti; Ilkko, Eero; Jousimaa, Jukkapekka; Kivistö, Juho; Korppi, Matti; Liira, Helena; Malmivaara, Antti; Numminen, Jura; Pirilä, Tapio

    2013-01-01

    Patients with common cold have often symptoms similar to sinusitis. These symptoms often resolve in time, but symptomatic treatment (e.g. analgesics, decongestants) may be used. If symptoms continue for over 10 days, or severe symptoms continue for over 3 days, or symptoms turn worse in the course of the disease, bacterial sinusitis should be suspected. Diagnosis is based on clinical findings, and can be confirmed with ultrasound examination. Amoxicillin, penicillin or doxicyclin are recommended for bacterial sinusitis. Patients with chronic or recurrent sinusitis should be referred to specialist care.

  10. Odontogenic maxillary sinusitis obscured by midfacial trauma.

    Science.gov (United States)

    Simuntis, Regimantas; Kubilius, Ričardas; Ryškienė, Silvija; Vaitkus, Saulius

    2015-01-01

    We present a case of odontogenic maxillary sinusitis whose sinonasal symptomatology was thought to be the consequence of a previous midfacial trauma. The patient was admitted to the Clinic of Oral and Maxillofacial Surgery after more than 10 years of exacerbations of sinonasal symptoms, which began to plague soon after a facial contusion. We decided to perform CT of paranasal sinuses, and despite the absence dental symptomatology, the dental origin of sinusitis was discovered. The majority of sinonasal symptoms resolved after appropriate dental treatment, and there was no need for nasal or sinus surgery.

  11. Experimental porcine model of complex fistula-in-ano

    Science.gov (United States)

    A Ba-Bai-Ke-Re, Ma-Mu-Ti-Jiang; Chen, Hui; Liu, Xue; Wang, Yun-Hai

    2017-01-01

    AIM To establish and evaluate an experimental porcine model of fistula-in-ano. METHODS Twelve healthy pigs were randomly divided into two groups. Under general anesthesia, the experimental group underwent rubber band ligation surgery, and the control group underwent an artificial damage technique. Clinical magnetic resonance imaging (MRI) and histopathological evaluation were performed on the 38th d and 48th d after surgery in both groups, respectively. RESULTS There were no significant differences between the experimental group and the control group in general characteristics such as body weight, gender, and the number of fistula (P > 0.05). In the experimental group, 15 fistulas were confirmed clinically, 13 complex fistulas were confirmed by MRI, and 11 complex fistulas were confirmed by histopathology. The success rate in the porcine complex fistula model establishment was 83.33%. Among the 18 fistulas in the control group, 5 fistulas were confirmed clinically, 4 complex fistulas were confirmed by MRI, and 3 fistulas were confirmed by histopathology. The success rate in the porcine fistula model establishment was 27.78%. Thus, the success rate of the rubber band ligation group was significantly higher than the control group (P < 0.05). CONCLUSION Rubber band ligation is a stable and reliable method to establish complex fistula-in-ano models. Large animal models of complex anal fistulas can be used for the diagnosis and treatment of anal fistulas. PMID:28348488

  12. 重视复杂性肛瘘的影像学诊断%Pay attention to the imaging diagnosis of complex anal fistula

    Institute of Scientific and Technical Information of China (English)

    周智洋

    2015-01-01

    The diagnosis and treatment of complex anal fistula has been a significant challenge. Unwise incision and excessive exploration will lead to the secondary branch , sinus and perforation. A simple fistula may become a surgical problem and result in disastrous consequences. Preoperative accurate diagnosis of anal fistula , including in the internal opening, primary track and location of the fistula, extensions and abscess, is important for anal fistula treatment. In the diagnosis of anal fistula, imaging examination, especially MRI plays a crucial role. Localization and demarcation of anal fistula and the relationship with sphincter are important. MRI has been an indispensable confirmatory imaging examination.%复杂性肛瘘的诊治一直是临床上的严峻挑战. 不明智的切口和过分的探查,将导致继发的分支、窦道和穿孔形成,使一个简单的瘘变成一个外科难题,给患者带来灾难性的后果. 肛瘘术前的精确诊断,包括内口、原发瘘管、分支瘘管和脓肿的识别和定位,是对肛瘘分型和治疗的基本要求. 在肛瘘的诊断中,影像学检查,尤其是MRI扮演着非常重要的角色. 对肛瘘的分型定位、内口显示、瘘管数量和走行及其与括约肌之间关系的判断,MRI已经是不可或缺的确证性影像学检查.

  13. Treating Sinusitis: Don't Rush to Antibiotics

    Science.gov (United States)

    ... AAAAI) Treating Sinusitis (AAAAI) Don’t rush to antibiotics DOWNLOAD PDF The sinuses are small, hollow spaces ... or teeth. Each year, millions of people use antibiotic drugs to treat sinus problems. However, they usually ...

  14. 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.

  15. Colovesical Fistula After Renal Transplantation: Case Report.

    Science.gov (United States)

    Imafuku, A; Tanaka, K; Marui, Y; Sawa, N; Ubara, Y; Takaichi, K; Ishii, Y; Tomikawa, S

    2015-09-01

    Colovesical fistula is a relatively rare condition that is primarily related to diverticular disease. There are few reports of colovesical fistula after renal transplantation. We report of a 53-year-old man who was diagnosed with colovesical fistula after recurrent urinary tract infection, 5 months after undergoing cadaveric renal transplantation. Laparoscopic partial resection of the sigmoid colon with the use of the Hartmann procedure was performed. Six months after that surgery, there was no evidence of recurrent urinary tract infection and the patient's renal graft function was preserved. Physicians should keep colovesical fistula in mind as a cause of recurrent urinary tract infection in renal transplant recipients, especially in those with a history of diverticular disease.

  16. Sphenoidal fungal sinusitis with intracranial extension An interesting Case Report

    Directory of Open Access Journals (Sweden)

    Balasubramanian Thiagarajan

    2013-08-01

    Full Text Available Isolated sphenoid sinusitis is rather rare. Fungal sinusitis is common in immunocompromised patients. In this case report the authors describe an immunocompetent patient with isolated sphenoid fungal sinusitis with intracranial extension with a review of published literature.Unfavorable location and poor ventilation have been attributed as the probable factors involved in isolated sphenoid sinusitis. Considering the location of sphenoid sinus (close to skull base, optic nerve and great vessels infections involving this sinus is fraught with dangerous complications.

  17. Bronchobiliary Fistula Evaluated with Magnetic Resonance Imaging

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-08-01

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

  18. Vesicoovarian Fistula on an Endometriosis Abscessed Cyst

    OpenAIRE

    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 ...

  19. Aortoenteric Fistula Assocaited with Acute Myocardial Infarcation

    OpenAIRE

    Fingerote, Robert J.; Alan BR Thomson

    1990-01-01

    A 64-year-old male with a prior abdominal aortic graft for lower limb ischemia presented with melena and myocardial infarction. Despite aggressive investigation, an aortoenteric fistula was not diagnosed until after massive gastrointestinal hemorrhage. The patient's myocardial infarction may have heen precipitated by hypotension induced by hemorrhage through the aortoenteric fistula. Patients with prior abdominal aortic graft surgery presenting with gastrointestinal bleeding, abdominal pain o...

  20. 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.

  1. Pilonidal sinus disease - Etiological factors, pathogenesis and clinical features

    Directory of Open Access Journals (Sweden)

    Kazim Duman

    2016-12-01

    Full Text Available and lsquo;Pilonidal sinus' disease, which is most commonly seen in reproductive populations, such as young adults - mostly in males who are in their twenties - is actually a controversial disease in that there is no consensus on its many facets. It is sometimes seen as an infected abscess draining from an opening or a lesion extending to the perineum. It may also present as a draining fistula opening to skin. In terms of etiological factors, various theories (main theories being congenital and acquired have been established since it was first described, no universal understanding achieved. A long and significant post-operative care period with different lengths of recovery depending on the type of operation are quite prevalent with regards to recurrence and complication status. In order to prevent recurrence and improve the quality of life, etiological and predisposing factors as well as clinical features of sacrococcygeal pilonidal disease should be well known, a detailed differential diagnosis should be made, and a suitable and timely intervention should be performed. It was aimed here to explain the etiological factors, pathogenesis and clinical features of the disease that may present with various clinical symptoms. [Arch Clin Exp Surg 2016; 5(4.000: 228-232

  2. CT of the paranasal sinuses is not a valid indicator for sinus surgery in CF patients

    DEFF Research Database (Denmark)

    Rasmussen, Jacob; Aanæs, Kasper; Norling, Rikke;

    2012-01-01

    BACKGROUND: No guidelines comprise when or to what extent sinus surgery should be done in patients with cystic fibrosis (CF) or how a CT scan of the paranasal sinuses should influence the decision. Symptoms of rhinosinusitis and/or eradication of pathogenic bacteria from the sinuses are reasons......: There was no significant correlation between the CT score and detection of pus, pathogenic bacteria or symptoms. Pus and pathogenic bacteria were found in several cases without sinus opacification on the CT scan. Non pathogenic and sterile cultures were also found in sinuses with opacification. CONCLUSIONS: A CT scan...

  3. Role of Osteoplastic Frontal Sinus Obliteration in the Era of Endoscopic Sinus Surgery

    Directory of Open Access Journals (Sweden)

    Joshua B. Silverman

    2012-01-01

    Full Text Available Objective. Determining the indications for osteoplastic frontal sinus obliteration (OFSO for the treatment of inflammatory frontal sinus disease. Study Design. Retrospective case series from a single tertiary care facility. Methods. Thirty-four patients who underwent OFSO for chronic frontal sinusitis ( and frontal sinus mucocele ( comprised our study group. Data reviewed included demographics, history of prior frontal sinus operation(s, imaging, diagnosis, and operative complications. Results. The age range was 19 to 76 years. Seventy percent of patients with chronic frontal sinusitis underwent OFSO as a salvage surgery after previous frontal sinus surgery failures, while 30% underwent OFSO as a primary surgery. For those in whom OFSO was a salvage procedure, the failed surgeries were endoscopic approaches to the frontal sinus (69%, Lynch procedure (12%, and OFSO outside this study period (19%. For patients with frontal sinus mucocele, 72% had OFSO as a first-line surgery. Within the total study population, 15% of patients presented for OFSO with history of prior obliteration, with a range of 3 to 30 years between representations. Conclusions. Osteoplastic frontal sinus obliteration remains a key surgical treatment for chronic inflammatory frontal sinus disease both as a salvage procedure and first-line surgical therapy.

  4. Histoplasma capsulatum sinusitis: case report and review.

    Science.gov (United States)

    Alves, Marcelle D; Pinheiro, Lia; Manica, Denise; Fogliatto, Laura M; Fraga, Christina; Goldani, Luciano Z

    2011-01-01

    Histoplasma capsulatum has not typically been associated with sinusitis in either immunocompetent or immunocompromised hosts. We report a case of sinusitis caused by H. capsulatum in a patient with chronic lymphocytic leukemia and discuss the reported cases of this rare clinical manifestation of histoplasmosis in the medical literature.

  5. GENETIC PREDICTORS OF IDIOPATHIC SICK SINUS SYNDROME

    Directory of Open Access Journals (Sweden)

    A. A. Chernova

    2012-01-01

    Full Text Available Published data demonstrating genetic determination of sick sinus syndrome is presented. The definition of this pathology is presented; the main symptoms are described, as well as genes that influence the development of idiopathic sick sinus syndrome, their polymorphisms and role in disorders of the cardiovascular system.

  6. Genetic aspects of sick sinus syndrome

    Directory of Open Access Journals (Sweden)

    Chernova A.A.

    2013-03-01

    consistent with that of the genotypes of the above genes in the general population of primary sick sinus syndrome patients. The allelic variants of the above genes were not found to be associated with ompensated sick sinus syndrome. Conclusion. The genetic predictors of idiopathic sick sinus syndrome are heterozygous genotypes 44 GA and 4a/4b genes Cx 40 and NOS3 as well as homozygous genotypes in rare allele DD and GG genes ADRA2B and SCN5A. Polymorphic allelic variant 2161C > T (Arg721Trp of MYH6 gene was not revealed in the examined cohort of Krasnoyarsk population. The distribution of the genotypes of the investigated genes in latent sick sinus syndrome patients was found to be consistent with that of the genotypes in the general population of primary sick sinus syndrome patients.

  7. Intra-sinusal third molar: Case report

    Directory of Open Access Journals (Sweden)

    Frederico Sampaio Neves

    2011-01-01

    Full Text Available Ectopic tooth eruption into an area other than the oral cavity is rare. Nasal septum, mandibular condyle, coronoid process and infratemporal fossa space have been reported as frequent locations for ectopic tooth eruption. Ectopic teeth located within the maxillary sinus may be asymptomatic, found only in routine examinations. Headache, sinusitis and nasal obstruction are some of the associated symptoms. The differential diagnosis includes foreign bodies (rhinolith, infections (syphilis and tuberculosis, benign lesions (hemangioma, osteoma, calcifi ed polyp and malign lesions (osteosarcoma. Upper third molars located within the maxillary sinus may be associated with the development of mucocele or dentigerous cyst. The aim of this paper was to describe the case of a 24-year old female patient with an ectopic right upper third molar in the maxillary sinus. A hyperdense area was observed with sinus obliteration, consistent with mucous material.

  8. Tooth in Ethmoid Sinus: A Case Report

    Directory of Open Access Journals (Sweden)

    Tayebe Kazemei

    2009-09-01

    Full Text Available Ectopic eruption of teeth occurs in a variety of locations.Commonly seen in palate and maxillary sinus, they have alsobeen reported in nasal cavity, orbit, mandibular condyle,coronoid process, and facial skin.Here, we report a rare case of recurrent sinusitis caused byectopic tooth in right ethmoid sinus and successful endoscopicremoval of it. The symptoms of the patient disappeared aftersurgery. Such case has not been yet reported in the Englishliterature.Ectopic tooth is an uncommon cause of sinusitis. It shouldbe considered in patients presenting with recurrent sinusitis unresponsiveto medical treatment. Computed tomography of thesinuses is the modality of choice for diagnosis. Endoscopic sinussurgery is the best method for management of such cases.

  9. Report of 2 cases of misdiagnosed vesicouterine fistula.

    Science.gov (United States)

    Petrikovets, Andrey; Lespinasse, Pierre F

    2014-01-01

    Vesicouterine fistula is a rare complication that may occur after multiple cesarean deliveries. The following reports describe cases where vesicouterine fistula was misdiagnosed; one was initially treated for urge incontinence, and the other was treated for stress urinary incontinence.

  10. Gangrenous cystitis: a rare cause of colovesical fistula

    OpenAIRE

    1999-01-01

    A case of gangrenous cystitis presenting as a colovesical fistula in an elderly woman is described. The literature on this rare condition is reviewed.


Keywords: gangrenous cystitis; colovesical fistula

  11. Splenic arteriovenous fistula treated with percutaneous transarterial embolization

    DEFF Research Database (Denmark)

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

    2008-01-01

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

  12. Colo-vesical fistula: Complete healing without surgical intervention

    OpenAIRE

    2014-01-01

    INTRODUCTION Colo-vesical (CV) fistulae are the most common type of fistulae associated with diverticular disease. Surgery remains the mainstay of treatment, without which, CV fistulae rarely achieve complete healing. PRESENTATION OF CASE Herein, we report the case of a 62-year-old man who developed a CV fistula after reversal of Hartmann's procedure (initially for management of diverticular abscess), which healed with conservative management alone. DISCUSSION We discuss possibilities of the ...

  13. ENTEROHEPATIC FISTULA ASSOCIATED WITH LIVER ABSCESS - AN EXTREMELY RARE PRESENTATION

    OpenAIRE

    Vedaraju; Srinivas,; Ashwini; Vijayaraghavachari; Adarsh; Riya Jeeson

    2015-01-01

    Gastrointestinal (GI) fistulas represent abnormal duct like communications between the gut and another epithelial - lined surface , such as another organ system , the skin surface , or elsewhere along the GI tract itself. (1) The development of a GI fistula can markedly increase patient morbidity and mortality , rendering detection of the fistula critical. Imaging often plays a pivotal role in the diagnosis and management of GI fistula....

  14. Reticulo-cutaneous fistula due to the ingestion of a long metallic rod in a cow

    Institute of Scientific and Technical Information of China (English)

    Azari; Omid; Ali; Asghar; Mozaffari

    2014-01-01

    A five-year-old cow was referred to the veterinary faculty hospital for treatment of a swelling mass with a cutaneous fistula at the left lower part of the chest wall,between 7|h till 9th intercostals space.Abdominal pain in palpation of the mass was observed with no abnormality in clinical symptoms.In surgical exploration,skin incision was carried out on the swelling mass and surprisingly a sinus tract with a sharp metallic rod(26 cm length)that continued to the reticulum lumen was identified.Because of unsuccessful attempting to remove of the foreign body,flank laparotomy and rumenotomy was performed.After one month,the cow led to complete recovery.

  15. Reticulo-cutaneous fistula due to the ingestion of a long metallic rod in a cow

    Directory of Open Access Journals (Sweden)

    Azari Omid

    2014-07-01

    Full Text Available A five-year-old cow was referred to the veterinary faculty hospital for treatment of a swelling mass with a cutaneous fistula at the left lower part of the chest wall, between 7th till 9th intercostals space. Abdominal pain in palpation of the mass was observed with no abnormality in clinical symptoms. In surgical exploration, skin incision was carried out on the swelling mass and surprisingly a sinus tract with a sharp metallic rod (26 cm length that continued to the reticulum lumen was identified. Because of unsuccessful attempting to remove of the foreign body, flank laparotomy and rumenotomy was performed. After one month, the cow led to complete recovery.

  16. Urachus Fistula: A Rare First Presentation of Diverticulitis

    Directory of Open Access Journals (Sweden)

    C. Dickhoff

    2008-09-01

    Full Text Available Urachus fistulas are rare, especially in adulthood. In grown-ups urachus fistulas are usually a reflection of Crohn’s disease. We present a patient in whom an urachus fistula was the first presentation of diverticulitis of the sigmoid colon. The need for proper preoperative diagnostic imaging is discussed.

  17. Colovesical fistula resulting from a perforated colonic duplication.

    Science.gov (United States)

    Decter, R M; Kaplan, K M; Eggli, K D; Krummel, T M

    1998-09-01

    Colovesical fistulas in children are most often associated with high anorectal imperforations. Acquired enterovesical fistulas in children only rarely have been reported as a consequence of an inflammatory process. We present a case of an acquired colovesical fistula formed by the erosion of an abscess at the distal end of a colonic duplication in a child who presented with fever of unknown origin.

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

    NARCIS (Netherlands)

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

    1999-01-01

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

  19. Changes in aetiological determinants of urinary fistula

    Institute of Scientific and Technical Information of China (English)

    Prosper E. Gharoro; Chukwunwendu A. Okonkwo

    2009-01-01

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

  20. Endoanal ultrasound in perianal fistulae and abscesses.

    Science.gov (United States)

    Visscher, Arjan Paul; Felt-Bersma, Richelle J F

    2015-06-01

    Endoanal ultrasound is a technique that provides imaging of the anal sphincters and its surrounding structures as well as the pelvic floor. However, endoanal magnetic resonance imaging (MRI) is preferred by most physicians, although costs are higher and demand easily outgrows availability. Endoanal ultrasound is an accurate imaging modality delineating anatomy of both cryptoglandular as well as Crohn perianal fistula and abscess. Endoanal ultrasound is comparable with examination under anesthesia and equally sensitive as endoanal MRI in fistula detection. When fistula tracts or abscesses are located above the puborectal muscle, an additional endoanal MRI should be performed. Preoperative imaging is advocated in recurrent cryptoglandular fistula because a more complex pattern can be expected. Endoanal ultrasound can help avoid missing tracts during surgery, lowering the chance for the fistula to persist or recur. It can easily be performed in an outpatient setting and endosonographic skills are quickly incremented. Costs are low and endoanal ultrasound has the potential to improve outcome of patients with both cryptoglandular and fistulizing Crohn disease; therefore, it values more attention.

  1. Fungal Involvement in Patients with Paranasal Sinusitis

    Directory of Open Access Journals (Sweden)

    P Kordbacheh

    2004-08-01

    Full Text Available Fungal involvement of the paranasal sinuses is frequently observed in the immunocompromised host and it can become lifethreatening if it is not diagnosed. Definitive diagnosis is made by tissue biopsy and culture. In this study biopsy materials of maxillary, ethmoidal and frontal sinuses of 60 patients with clinical manifestation of sinusitis and no response to medical therapy were assessed by mycological and pathological methods for the presence of fungi. Invasive fungal sinusitis was diagnosed in 3 patients and etiologic agents were Candida albicans, Rhizopus sp. and Aspergillus fumigatus. Predisposing factors in these patients were leukemia, diabetes mellitus and previous sinus and polyp surgery, respectively. Allergic fungal sinusitis also was seen in one patient and Alternaria sp. isolated from the biopsy material. Only the patient with allergic form of disease survived but all the patients with invasive form of fungal infection were expired. This clearly underscores the need of early recognition of fungal sinusitis in at risk population in order to start urgent treatment. In this study Nocardia asteroids also was isolated from the biopsy sample in a patient with sinunasal adenocarcinoma.

  2. Current concepts on complications associated with sinus augmentation procedures

    NARCIS (Netherlands)

    Boffano, P.; Forouzanfar, T.

    2014-01-01

    The sinus augmentation, or sinus lift procedure, is an internal augmentation of the maxillary sinus, which is intended to increase the vertical bony dimension in the lateral maxilla to make the placement of dental implants possible. Complication rate associated with maxillary sinus augmentation proc

  3. [Compound odontoma as a cause of chronic maxillary sinusitis].

    Science.gov (United States)

    Crespo Del Hierro, Jorge; Ruiz González, Manuel; Delgado Portela, Margarita; García Del Castillo, Eduardo; Crespo Serrano, Juan

    2008-01-01

    Sinusitis of dental origin is a relatively frequent entity, but the presence of an odontoma in the sinus as a source of this pathology is exceptional. Here we present a case of a young patient who presented chronic maxillary sinusitis over 2 years, originating in an odontoma located in the sinus drainage area.

  4. Association between maxillary sinus pathologies and healthy teeth

    Directory of Open Access Journals (Sweden)

    Gina D. Roque-Torres

    2016-02-01

    Full Text Available ABSTRACT INTRODUCTION: The proximity of the roots to the maxillary sinus can create a variety of risks. OBJECTIVE: To evaluate the relationship between the roots of healthy teeth and the maxillary sinus, as well as the occurrence of sinus pathologies. METHODS: Three radiologists analyzed 109 cone beam computed tomography (CBCT images. The Kappa test was used to assess the intra- and inter-rater agreement. The chi-squared test and prevalence ratio were used to test the hypothesis that roots of healthy teeth in the maxillary sinus favored the occurrence of sinus pathologies ( p = 0.01. RESULTS: Intra- and inter-rater agreement ranged from good to excellent. The chi-squared test demonstrated a statistically significant difference ( p = 0.006 between the tooth roots in diseased maxillary sinuses (6.09% and those in normal sinuses (3.43%. The prevalence ratio test showed a statistically significant higher prevalence of tooth roots in diseased sinuses than in normal sinuses ( p < 0.0001. Roots in the maxillary sinus were 1.82 times more associated with diseased sinuses. CONCLUSION: Dental roots in the maxillary sinus are almost twice as likely to be associated with diseased sinuses than normal sinuses. Healthy teeth whose roots are inside the maxillary sinus may induce an inflammatory response in the sinus membrane. It is suspected that dental procedures may exacerbate the condition.

  5. The Anal Fistula Plug versus the mucosal advancement flap for the treatment of Anorectal Fistula (PLUG trial

    Directory of Open Access Journals (Sweden)

    Janssen Lucas WM

    2008-06-01

    Full Text Available Abstract Background Low transsphincteric fistulas less than 1/3 of the sphincter complex are easy to treat by fistulotomy with a high success rate. High transsphincteric fistulas remain a surgical challenge. Various surgical procedures are available, but recurrence rates of these techniques are disappointingly high. The mucosal flap advancement is considered the gold standard for the treatment of high perianal fistula of cryptoglandular origin by most colorectal surgeons. In the literature a recurrence rate between 0 and 63% is reported for the mucosal flap advancement. Recently Armstrong and colleagues reported on a new biologic anal fistula plug, a bioabsorbable xenograft made of lyophilized porcine intestinal submucosa. Their prospective series of 15 patients with high perianal fistula treated with the anal fistula plug showed promising results. The anal fistula plug trial is designed to compare the anal fistula plug with the mucosal flap advancement in the treatment of high perianal fistula in terms of success rate, continence, postoperative pain, and quality of life. Methods/design The PLUG trial is a randomized controlled multicenter trial. Sixty patients with high perianal fistulas of cryptoglandular origin will be randomized to either the fistula plug or the mucosal advancement flap. Study parameters will be anorectal fistula closure-rate, continence, post-operative pain, and quality of life. Patients will be followed-up at two weeks, four weeks, and 16 weeks. At the final follow-up closure rate is determined by clinical examination by a surgeon blinded for the intervention. Discussion Before broadly implementing the anal fistula plug results of randomized trials using the plug should be awaited. This randomized controlled trial comparing the anal fistula plug and the mucosal advancement flap should provide evidence regarding the effectiveness of the anal fistula plug in the treatment of high perianal fistulas. Trial registration ISRCTN

  6. [Conservative therapy of chronic sinusitis].

    Science.gov (United States)

    Reiss, Michael; Reiss, Gilfe

    2012-01-01

    The chronic rhinosinusitis is defined as chronic inflammation of the nose and nasal sinuses, with or without nasal polyps. Patients suffering from chronic rhinosinusitis report about nasal obstruction and secretion, olfactory impairment, head and facial pain. These symptoms cause also considerable impact on quality of life. Therefore, an adequate rhinological diagnostics as well as therapies are essential. This paper reviews the pharmacologic and non-pharmacologic therapy of chronic rhinosinusitis. First choice of therapy should be topical glucocorticoids. The application of glucocorticoids causes anti-inflammatory and certain curative effects. Hypertonic salt solutions improve nasal symptoms. Long-term therapy with oral macrolides might improve median to severe symptoms of chronic rhinosinusitis without nasal polyps. An additional therapy with antihistamines is possible in patients with an allergy. Adaptive desensitization in patients suffering from analgesic-intolerance associating among other with nasal polyps is currently the single causal therapy. Therefore, frequency of endonasal revision surgery is reduced after desensitization.

  7. [Ectopic molar tooth in the maxillary sinus].

    Science.gov (United States)

    Altun, Hüseyin; Teker, Ayşenur Meriç; Ceran, Murat; Gedikli, Orhan

    2007-01-01

    The development of intranasal ectopic teeth is rare. Although they are more commonly seen in the palate and maxillary sinus, they can also be found in the mandibular condyle, coronoid process, and nasal cavity. A 30-year-old male patient presented with a complaint of headache. Computed tomography of the paranasal sinuses showed a bony mass in the right maxillary sinus wall, 1 cm in size. He did not have any history of maxillofacial trauma or operation. The mass was removed via a Caldwell-Luc procedure. It looked like a tooth. Histopathologic diagnosis was made as ectopic molar tooth. The patient was asymptomatic two weeks after the operation.

  8. Petrosal sinus sampling: technique and rationale.

    Science.gov (United States)

    Miller, D L; Doppman, J L

    1991-01-01

    Bilateral simultaneous sampling of the inferior petrosal sinuses is an extremely sensitive, specific, and accurate test for diagnosing Cushing disease and distinguishing between that entity and the ectopic ACTH syndrome. It is also valuable for lateralizing small hormone-producing adenomas within the pituitary gland. The inferior petrosal sinuses connect the cavernous sinuses with the ipsilateral internal jugular veins. The anatomy of the anastomoses between the inferior petrosal sinus, the internal jugular vein, and the venous plexuses at the base of the skull varies, but it is almost always possible to catheterize the inferior petrosal sinus. In addition, variations in size and anatomy are often present between the two inferior petrosal sinuses in a patient. Advance preparation is required for petrosal sinus sampling. Teamwork is a critical element, and each member of the staff should know what he or she will be doing during the procedure. The samples must be properly labeled, processed, and stored. Specific needles, guide wires, and catheters are recommended for this procedure. The procedure is performed with specific attention to the three areas of potential technical difficulty: catheterization of the common femoral veins, crossing the valve at the base of the left internal jugular vein, and selective catheterization of the inferior petrosal sinuses. There are specific methods for dealing with each of these areas. The sine qua non of correct catheter position in the inferior petrosal sinus is demonstration of reflux of contrast material into the ipsilateral cavernous sinus. Images must always be obtained to document correct catheter position. Special attention must be paid to two points to prevent potential complications: The patient must be given an adequate dose of heparin, and injection of contrast material into the inferior petrosal sinuses and surrounding veins must be done gently and carefully. When the procedure is performed as outlined, both inferior

  9. Management of the entered frontal sinus.

    Science.gov (United States)

    Caroli, Emanuela; Rocchi, Giovanni; D'Andrea, Giancarlo; Delfini, Roberto

    2004-10-01

    The opening of the frontal sinus is a common occurrence in surgical practice. It may involve many surgical disciplines. The complications that may derive from incorrect treatment of an opened frontal sinus are potentially fatal. Unfortunately, the treatment of patients with injured frontal sinus is not uniform and standardized. Here, we describe our technique of treatment. We propose our treatment modality on the basis of our personal experience, which has been excellent in the past 20 years, that is from the time of the technique's introduction and routine application.

  10. Management of anal fistula by ligation of the intersphincteric fistula tract

    DEFF Research Database (Denmark)

    Zirak-Schmidt, Samira; Perdawood, Sharaf

    2014-01-01

    INTRODUCTION: Ligation of the intersphincteric fistula tract (LIFT) is a sphincter-preserving procedure for treatment of anal fistulas described in 2007 by Rojanasakul et al. Several studies have since then assessed the procedure with varied results. This review assesses the relevant literature...... fistula treatment techniques were excluded. Only reports in English were included. Most reports were case studies with no control groups. One report could not be retrieved. RESULTS: A total of 19 original reports were assessed. Details concerning preoperative assessment, antibiotic usage and tract...

  11. 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.

  12. 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.

  13. Successful tubes treatment of esophageal fistula

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

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

  14. Vascular access for hemodialysis: arteriovenous fistula.

    Science.gov (United States)

    Malovrh, Marko

    2005-06-01

    The long-term survival and quality of life of patients on hemodialysis (HD) is dependant on the adequacy of dialysis via an appropriately placed vascular access. The optimal vascular access is unquestionably the autologous arteriovenous fistula (AVF), with the most common method being the conventional radio-cephalic fistula at the wrist. Recent clinical practice guidelines recommend the creation of native fistula or synthetic graft before the start of chronic HD therapy to prevent the need for complication-prone dialysis catheters. This could also have a beneficial effect on the rapidity of worsening kidney failure. A multidisciplinary approach (nephrologists, surgeons, radiologists and nurses) should improve the HD outcome by promoting the use of AVF. An important additional component of this program is the Doppler ultrasound for preoperative vascular mapping. Such an approach may be realized without unsuccessful surgical explorations, with a minimal early failure rate and a high maturation, even in patients with diabetes mellitus.

  15. The effect of sinus surgery with intensive follow-up on pathogenic sinus bacteria in patients with cystic fibrosis

    DEFF Research Database (Denmark)

    Aanaes, Kasper; von Buchwald, Christian; Hjuler, Thomas

    2013-01-01

    Most patients with cystic fibrosis (CF) have chronic rhinosinusitis; their sinuses are often colonized with bacteria that can initiate and maintain deleterious pulmonary infections. Theoretically, eradication of the sinus bacteria should reduce the frequency of lung infections and thereby reduce ...... pulmonary morbidity. This article addressed whether bacteria in CF sinuses are eligible for eradication by sinus surgery and postoperative treatment....

  16. Feasibility of the maxillary sinus ultrasonic study in patients with iatrogenic sinusitis

    Directory of Open Access Journals (Sweden)

    S. D. Varzhapetyan

    2016-03-01

    Full Text Available Objective: to study the effectiveness of ultrasonic diagnostic imaging in the diagnostics of the iatrogenic maxillary sinusitis. Materials and Methods. 68 (100.0% patients of iatrogenic maxillary sinusitis undergone Sonographic Study in B-mode (ultrasonic diagnostic apparatus FCUSON X 500, ATSmod.539 (SIEMENS, USA. For this purpose, we used linear sensors with a working surface of 37 mm long with 7.10 MHz frequency regime. The findings were compared with the results of clinical (rhinoscopy, sinus lavage through perforation, diagnostic puncture and radiological (cone-beam computed tomography examination. The results were recorded according The accuracy of the two-dimensional sonography in the detection of pathological formations (polyps, cysts, foreign bodies, iatrogenic and inflammatory origin in the sinus was detected as lower than in clinical methods. Sensitivity of the two-dimensional sonography was 8.3%, specificity – 95.4% overall accuracy – 64.7%. Informativity of the cone beam tomography in the detection of exudation, effusion and thickening of the sinus mucosa during sinus iatrogenic sinusitis was detected as lower than in sonography. The sensitivity of the two-dimensional sonography in the detection of exudation in the sinus with iatrogenic maxillary sinus was 96.8%, specificity – 91.7% overall accuracy – 94.1%. The sensitivity of the cone beam tomography to thicken (sclerotic changes mucosa was 37.5%, specificity – 92.8%, accuracy – 52.9%. Conclusions. Feasibility of the ultrasound sonography in patients with iatrogenic sinusitis is less than in computer tomography. Maxillary sinuses sonography in addition to CT will improve the quality of the examination in patients with iatrogenic maxillary sinusitis.

  17. Sphenoidal fungal sinusitis with intracranial extension An interesting Case Report

    OpenAIRE

    2013-01-01

    Isolated sphenoid sinusitis is rather rare. Fungal sinusitis is common in immunocompromised patients. In this case report the authors describe an immunocompetent patient with isolated sphenoid fungal sinusitis with intracranial extension with a review of published literature.Unfavorable location and poor ventilation have been attributed as the probable factors involved in isolated sphenoid sinusitis. Considering the location of sphenoid sinus (close to skull base, optic nerve and great vessel...

  18. Effect of Suyuping combined with semiconductor laser irradiation on wound healing after anal fistula surgery

    Institute of Scientific and Technical Information of China (English)

    Min Zhao; Chang-Ye Sang; Zhen-Jun Wang; Yan-Chun Xu

    2016-01-01

    Objective:To explore the effect of Suyuping combined with semiconductor laser irradiation on the wound healing after anal fistula surgery.Methods:A total of 180 patients with anal fistula who were admitted in our hospital from October, 2013 to May, 2015 for surgery were included in the study and randomized into the treatment group and the control group with 90 cases in each group. The patients in the control group were given the conventional surgical debridement dressing, a time a day. On this basis, the patients in the treatment group were given Suyuping smearing on the wound sinus tract combined with semiconductor laser irradiation, a time a day for 10 min, continuous irradiation until wound healing. The postoperative wound swelling fading, wound surface secretion amount, and the clinical efficacy in the two groups were recorded.Results:The wound surface swelling degree and wound pain degree at each timing point after operation in the treatment group were significantly lower than those in the control group (P<0.05). The wound surface area at each timing point after operation in the treatment group was significantly lower than that in the control group (P<0.05). The wound surface secretion amount 6, 9, and 12 days after operation in the treatment group was significantly lower than that in the control group (P<0.05). The total effective rate in the treatment group was significantly higher than that in the control group (P<0.05). The average healing time in the treatment group was significantly faster than that in the control group (P<0.05). Conclusions: Suyuping combined with semiconductor laser irradiation in the treatment of patients after anal fistula can effectively improve the local blood and lymphatic circulation of wound surface, promote the growth of granulation tissues, and contribute the wound healing.

  19. [Acquired coronary-cameral fistula complicated by a ventricular pseudoaneurysm].

    Science.gov (United States)

    Hammami, R; Bosmans, J; Voormolen, M; Vermeulen, T; Salgado, R; Vrints, C

    2013-12-01

    Coronary-cameral fistulas are usually congenital, rarely acquired; the complication of this anomaly with ventricular pseudoaneurysm is exceptional. We report a new case of acquired coronary-cameral fistula, occurred in a patient who had received a bypass graft and who had suffered from angina 1 year after the surgery. On computed tomography coronary angiography, the fistula seems to communicate the first diagonal to a left ventricle pseudoaneurysm. Embolization of the fistula and filling of the pseudoaneurysm by neurocoil were successfully performed. The clinical and angiographic control after 3 months showed symptoms improvement and absence of recanalization of the fistula.

  20. Lymphogranuloma Venereum Presenting as a Rectovaginal Fistula

    Directory of Open Access Journals (Sweden)

    C. M. Lynch

    1999-01-01

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

  1. Aortocaval Fistula in a Behcet's Disease Patient

    Directory of Open Access Journals (Sweden)

    Yusuf Ata

    2009-01-01

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

  2. Conservative Management of a Delayed Neovesicocutaneous Fistula

    Directory of Open Access Journals (Sweden)

    Koichi Kodama

    2014-01-01

    Full Text Available A neovesicocutaneous fistula is a rare complication after orthotopic bladder reconstruction, particularly in the late postoperative period. We report the case of a 59-year-old man who had undergone ileal neobladder construction 17 months previously. He presented with urinary retention concomitant with urinary tract infection due to a neovesicourethral anastomotic stricture. After a combination of transurethral catheter drainage and broad-spectrum antibiotic therapy for 3 weeks, the fistulous tract completely closed. Therefore, conservative treatment may be regarded as a valid option for a delayed neovesicocutaneous fistula.

  3. [A gastropleural fistula can be treated thoracoscopically].

    Science.gov (United States)

    Laugesen, Sofie; Nekrasas, Vytautas; Haahr, Poul Erik

    2014-09-29

    Gastropleural fistula (GPF) is although uncommon a severe and sometimes fatal complication after prior thoracic surgery, trauma or malignancy. Standard therapy has often included major surgery such as laparotomia with gastrectomi. In this case report we present a patient with GPF who underwent thoracoscopia for closure of the fistula. To our knowledge this is the first report of its kind in the Danish and English literature. Thoracoscopic treatment of GPF may be associated with less morbidity and mortality, and should be considered as the initial procedure of choice.

  4. Fistulas carótido cavernosa

    OpenAIRE

    2014-01-01

    Las fistulas carotido-cavernosas son patologías vasculares relativamente infrecuentes que tiene una etiología de mayor frecuencia traumática que espontanea. Su diagnóstico no siempre es sencillo y requiere de conocer la patología para poder tener la sospecha clínica y poder brindar solución de manera rápida y minimizar secuelas. El tratamiento de las fistulas ha mejorado con el tiempo y con el advenimiento de la cirugía endovascular, con esto se han ido descubriendo mejores accesos y mecanism...

  5. Colovesical fistula demonstrated on renal cortical scintigraphy.

    Science.gov (United States)

    Stathaki, Maria; Vamvakas, Lampros; Papadaki, Emmanouela; Papadimitraki, Elisavet; Tsaroucha, Angeliki; Karkavitsas, Nikolaos

    2012-11-01

    A 70-year-old man with a history of weight loss, changes in bowel habits, and hematochezia had rectal adenocarcinoma. He was palliated with diverting colostomy, followed by radiochemotherapy. Bilateral hydronephrosis was found incidentally on lower abdominal CT scan. He underwent 99mTc dimercaptosuccinic acid scan prior to percutaneous nephrostomy tube placement. Apart from the renal cortex, scintigraphy showed activity in the ascending colon continuous to the activity of the bladder. This indicated urine extravasation on account of a colovesical fistula, complicating postoperative radiation treatment. Here we highlight the contribution of renal cortical scintigraphy in the detection of colovesical fistulas.

  6. 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

  7. Intraparenchymal pneumocephalus caused by ethmoid sinus osteoma.

    Science.gov (United States)

    Kamide, Tomoya; Nakada, Mitsutoshi; Hayashi, Yutaka; Hayashi, Yasuhiko; Uchiyama, Naoyuki; Hamada, Jun-Ichiro

    2009-11-01

    We report a 57-year-old man with intraparenchymal pneumocephalus caused by ethmoid sinus osteoma. He had a history of severe allergic rhinitis, which caused him to frequently blow his nose, and he was referred to our hospital with headache and mild left hemiparesis. CT scans revealed a large volume of intraparenchymal air entrapped in the right frontal lobe related to an osteoma in the ethmoid sinus. The osteoma eroded the upper wall of the sinus and extended into the anterior cranial fossa. At operation, we observed that the osteoma had protruded intracranially through the skull base, disrupted the dura and extended into the frontal lobe. To our knowledge, this is the first report of a patient with intraparenchymal pneumocephalus caused by an ethmoid sinus osteoma.

  8. Sphenoid Sinusitis and Migraine-Type Headache

    Directory of Open Access Journals (Sweden)

    J. Gordon Millichap

    2002-02-01

    Full Text Available Three case histories of children (ages 10, 12, and 14 years with isolated sphenoid sinusitis who presented with acute, subacute, and chronic headache symptoms resembling migraine are reported from the University of Texas-Houston Medical School.

  9. Systemic corticosteroid therapy for acute sinusitis

    NARCIS (Netherlands)

    Venekamp, R.P.; Thompson, M.J.; Rovers, M.M.

    2015-01-01

    CLINICAL QUESTION: Are oral or parenteral corticosteroids associated with improved clinical outcomes in patients with acute sinusitis compared with placebo or nonsteroidal anti-inflammatory drugs (NSAIDs)? BOTTOM LINE: Oral corticosteroids combined with antibiotics may be associated with modest bene

  10. Systemic corticosteroid therapy for acute sinusitis

    NARCIS (Netherlands)

    Venekamp, Roderick P.; Thompson, Matthew J.; Rovers, Maroeska M.

    2015-01-01

    CLINICAL QUESTION: Are oral or parenteral corticosteroids associated with improved clinical outcomes in patients with acute sinusitis compared with placebo or nonsteroidal anti-inflammatory drugs (NSAIDs)? BOTTOM LINE: Oral corticosteroids combined with antibioticsmay be associated with modest benef

  11. Frontal sinus recognition for human identification

    Science.gov (United States)

    Falguera, Juan Rogelio; Falguera, Fernanda Pereira Sartori; Marana, Aparecido Nilceu

    2008-03-01

    Many methods based on biometrics such as fingerprint, face, iris, and retina have been proposed for person identification. However, for deceased individuals, such biometric measurements are not available. In such cases, parts of the human skeleton can be used for identification, such as dental records, thorax, vertebrae, shoulder, and frontal sinus. It has been established in prior investigations that the radiographic pattern of frontal sinus is highly variable and unique for every individual. This has stimulated the proposition of measurements of the frontal sinus pattern, obtained from x-ray films, for skeletal identification. This paper presents a frontal sinus recognition method for human identification based on Image Foresting Transform and shape context. Experimental results (ERR = 5,82%) have shown the effectiveness of the proposed method.

  12. Genetics Home Reference: sick sinus syndrome

    Science.gov (United States)

    ... the structure of myosin, which can affect cardiac muscle contraction and increase the likelihood of developing an abnormal heartbeat. More commonly, sick sinus syndrome is caused by other ... such as muscular dystrophy, abnormal inflammation, or a shortage of oxygen ( ...

  13. Radiological findings in biliary fistula and gallstone ileus

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Takaaki Fujii

    2007-10-01

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

  15. Epidemiology and outcome of patients with postoperative abdominal fistula

    Directory of Open Access Journals (Sweden)

    Janaina Wercka

    2016-04-01

    Full Text Available ABSTRACT Objective: to present the epidemiological profile, incidence and outcome of patients who developing postoperative abdominal fistula. Methods: This observational, cross-sectional, prospective study evaluated patients undergoing abdominal surgery. We studied the epidemiological profile, the incidence of postoperative fistulas and their characteristics, the outcome of this complication and the predictors of mortality. Results: The sample consisted of 1,148 patients. The incidence of fistula was 5.5%. There was predominance of biliary fistula (26%, followed by colonic fistulas (22% and stomach (15%. The average time to onset of fistula was 6.3 days. For closure, the average was 25.6 days. The mortality rate of patients with fistula was 25.4%. Predictors of mortality in patients who developed fistula were age over 60 years, presence of comorbidities, fistula closure time more than 19 days, no spontaneous closure of the fistula, malnutrition, sepsis and need for admission to the Intensive Care Unit Conclusion: abdominal postoperative fistulas are still relatively frequent and associated with significant morbidity and mortality.

  16. Spontaneous sphenoid wing meningoencephaloceles with lateral sphenoid sinus extension: the endoscopic transpterygoid approach.

    Science.gov (United States)

    Ajlan, Abdulrazag; Achrol, Achal; Soudry, Ethan; Hwang, Peter H; Harsh, Griffith

    2014-10-01

    Spontaneous meningoencephalocele (SME) of the sphenoid wing is a rare cause of cerebrospinal fluid (CSF) leakage. Surgical closure of the fistula is usually required. The approach taken depends on the location of the defect and the extension of the meningoencephalocele. The endoscopic transpterygoid approach may be useful. We prospectively analyzed the three cases of SME of the sphenoid wing with lateral sphenoid sinus extension treated endoscopically at Stanford over the last 3 years with regard to imaging findings, operative technique, and operative morbidity. In our three cases, the extent of pterygopalatine fossa (PPF) exposure undertaken, complete in one and partial in two, depended on the defect site. Follow-up ranged from 17 to 25 months. The fistula was completely closed in all three cases. Extant literature reports a 97% rate of successful closure (N = 65 of 67, with a mean follow-up of 25 months) and no major complications. Endoscopic transpterygoid repair is a useful, safe alternative to traditional approaches for repair of SME of the sphenoid wing. Its feasibility depends on the site of the defect, which can be identified by preoperative imaging. Larger PPF exposure and postoperative lumbar drainage of CSF can be useful and have a low risk of morbidity.

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

    Directory of Open Access Journals (Sweden)

    Gábor Bognár

    2008-04-01

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

  18. Migrating implant masquerading as acute sinusitis

    OpenAIRE

    2008-01-01

    The author presents a case of migrating miniplate screw presenting as acute on chronic sinusitis. Mini plates have been used in osteosynthesis of the mandible and maxillofacial surgery. In the last decade there has been an increase in the incidence of use of miniplates to stabilise Lefort II and III fractures involving the maxilla. The case report highlights the rare presentation of screw impinging on inferior turbinate in a patient who is a known case of chronic sinusitis presenting as acute...

  19. Radiological evaluation of sinus valsalva rupture

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yul; Park, Jae Hyung; Yeon, Kyung Mo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1984-03-15

    We obtained the following results by reviewing the radiographic findings of 15 cases of Sinus valsalva rupture who were diagnosed surgically at Seoul National University Hospital since 1979. 1. Among distribution was from 15 years to 40 years with the mean age of 24 years. Among the 15 cases, 9 cases were male and 7 were female. 2. Ruptured sinus is right coronary sinus projecting to right ventricle in all 15 cases. Combined diseases are ventricular septal defect in 12 cases, Aortic Valvular heart disease in 4 cases, and narrowing of right ventricular outflow tract in 2 cases, and aneurysmal dilatation of right pulmonary artery in 1 cases. 3. Chest X-ray findings were that of left to right shunt, i.e, cardiomegaly, increased pulmonary vascularity but were normal in 3 cases. 4. Aortography showed sequential leakage of dye from right coronary sinus to right ventricle and finally to pulmonary artery in 9 cases, and in 9 cases of them the leakage is directly to right ventricular outflow tract without filling of sinus portion of the ventricle., i.e., type I. 5. The leakage was well shown in left ventricular diastolic phase and not shown in systolic phase. 6. Ventricular septal defects were not detected definitely in spite of taking left ventriculography. 7. Cine angiography is essential for detecting accurate site, degree and direction of sinus valsalva rupture and other associated cardiac abnormality.

  20. Ligation of intersphincteric fistula tract (LIFT) to treat anal fistula: systematic review and meta-analysis.

    Science.gov (United States)

    Hong, K D; Kang, S; Kalaskar, S; Wexner, S D

    2014-08-01

    Sphincter-preserving approaches to treat anal fistula do not jeopardize continence; however, healing rates are suboptimal. In this context, ligation of the intersphincteric fistula tract (LIFT) can be considered promising offering high success rates and a relatively simple procedure. This review aimed to investigate the outcomes of LIFT to treat anal fistula. We conducted a systematic review of the Pubmed, Web of Science, and Cochrane databases, to retrieve all relevant scientific original articles and scientific abstracts (Web of Science) related to the LIFT procedure for anal fistula between January 2007 and March 2013. The search yielded 24 original articles including 1,110 patients; these included one randomized controlled study, three case control studies, and 20 case series. Most studies included patients with trans-sphincteric or complex fistula, not amenable to fistulotomy. During a pooled mean 10.3 months of follow-up, the mean success, incontinence, intraoperative, and postoperative complication rates were 76.4, 0, 0, and 5.5%, respectively. A sensitivity analysis showed that the impact on success in terms of follow-up duration, study size, and combining other procedures was limited. There was no association between pre-LIFT drainage seton and success of LIFT. Ligation of the intersphincteric fistula tract appears to be an effective and safe treatment for trans-sphincteric or complex anal fistula. Combining other procedures and a pre-LIFT drainage seton does not seem to confer any added benefit in terms of success. However, given the lack of prospective randomized trials, interpretation of these data must be cautious. Further trials are mandatory to identify predictive factors for success, and true effectiveness of the LIFT compared to other sphincter-preserving procedures to treat anal fistula.

  1. 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.

  2. [Urethral Fistula and Scrotal Abscess Associated with Colovesical Fistula Due to the Sigmoid Colon Cancer].

    Science.gov (United States)

    Nakazawa, Shigeaki; Uemura, Motohide; Miyagawa, Yasushi; Tsujimura, Akira; Nonomura, Norio

    2015-09-01

    We report here a rare case of urethral fistula and scrotal abscess associated with colovesical fistula due to sigmoid colon cancer. An 84-year-old male was referred to our hospital complaining of macrohematuria, fecaluria, pneumaturia and micturitional pain. Computed tomography (CT) showed colovesical fistula. Other examinations, including colonoscopy and cystoscopy, did not reveal a clear cause for the colovesical fistula. Only an elevated serum level of the tumor marker CA19-9 suggested the possibility of sigmoid colon cancer. Eleven days after hospitalization, bilateral scrotal contents had swollen rapidly to the size of a goose egg. CT suggested urethral fistula with scrotal abscess formation. Drainage of scrotal abscess and colostomy were performed. Intraoperatively, the fistula of the bulbar urethra was revealed. Because increased serum CA19-9 suggested a diagnosis of sigmoid colon cancer, cystectomy and sigmoid colectomy with right nephrectomy were performed. Pathological examination revealed adenocarcinoma of sigmoid colon with bladder invasion. His condition was improved with rehabilitation 6 months after operation.

  3. Keratocystic odontogenic tumor involving the maxillary sinus: A rare entity

    Directory of Open Access Journals (Sweden)

    Mohammad Asif Kiresur

    2016-01-01

    Full Text Available The keratocystic odontogenic tumor (KCOT is a frequently encountered developmental cyst of the jaws. The occurrence of KCOT in the maxillary sinus is rare. The mucosa of the maxillary sinus is susceptible to infections, allergic diseases, and neoplasm. The anatomic position of maxillary premolar and molar teeth is in close contact with the sinus predispose to spreading of pulp and periodontal infection, odontogenic cyst, and tumors to the sinus. Diagnosis and treating KCOT in maxillary sinus is challenging as treatment has to be rendered for sinusitis because of pathology in the sinus and for KCOT. We report a case of 35-year-old female with KCOT involving the lining of the maxillary sinus and put forward hypotheses for the origin of KCOT in the maxillary sinus.

  4. 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.

  5. Endovascular treatment of hemodialysis arteriovenous fistulas

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  6. Duodenocolic fistula due to safety pin ingestion.

    Science.gov (United States)

    Cay, Ali; Imamoğlu, Mustafa; Sarihan, Haluk; Sayil, Ozgür

    2004-01-01

    The authors describe the case of a 16-month-old boy with benign duodenocolic fistula due to safety pin ingestion who presented with abdominal pain, diarrhea and weight loss. Etiology, symptomatology, diagnosis and management are discussed and the literature is reviewed. Early diagnosis and surgical management are necessary to avoid serious morbidity.

  7. Appearance of a colovesical fistula at cystoscopy

    OpenAIRE

    2015-01-01

    Key Clinical Message Colovesical fistulae typically present with pneumaturia and/or fecaluria. Diverticulitis, inflammatory bowel disease, and malignancies of the colon are the commonest causes. The fistulous tract and adjacent organs are best demonstrated by contrast-enhanced CT scan with rectal contrast or MRI. Biopsy at cystoscopy/colonoscopy is necessary for complete evaluation and treatment planning.

  8. Appearance of a colovesical fistula at cystoscopy.

    Science.gov (United States)

    Aiken, William D; Reid, Gareth; Powell, Leo-Paul

    2015-11-01

    Colovesical fistulae typically present with pneumaturia and/or fecaluria. Diverticulitis, inflammatory bowel disease, and malignancies of the colon are the commonest causes. The fistulous tract and adjacent organs are best demonstrated by contrast-enhanced CT scan with rectal contrast or MRI. Biopsy at cystoscopy/colonoscopy is necessary for complete evaluation and treatment planning.

  9. 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.

  10. 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.

  11. Scimitar syndrome with pulmonary arteriovenous fistulas.

    Science.gov (United States)

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

    1999-10-01

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

  12. [Influence of beta block and autonomic nerve block on the recovery time of the sinus node in sick sinus syndrome and carotid sinus syndrome].

    Science.gov (United States)

    Brignole, M; Sartore, B; Barra, M; Menozzi, C; Monducci, I; Bertulla, A

    1984-10-01

    In order to evaluate the relative role of the automatic nervus system and of the intrinsic electrophysiologic properties on the sinus node function, we measured the corrected sinus node recovery time before and after autonomic nervous system blockade in 24 patients. Fourteen had a sick sinus syndrome, five had a carotid sinus syncope, two had syncope of unknown origin associated with bradycardia. Beta blockade was obtained by infusing metoprolol intravenously at a dosage of 0.2 mg/kg; complete automatic blockade was achieved by further i.v. administration of atropine at a dosage of 0.04 mg/kg. After beta blockade, the corrected sinus node recovery time increased in patients with sick sinus syndrome and intrinsic slow heart rate, whereas it decreased in patients with carotid sinus syncope or with syncope and bradycardia. In patients with sick sinus syndrome and normal intrinsic heart rate the response was variable. A positive direct correlation was found between the changes of the corrected sinus node recovery time induced by beta blockade and those induced by autonomic blockade; that is, both either prolonged or shortened the corrected sinus node recovery time. The changes of the corrected sinus node recovery time after beta blockade alone were inversely correlated with the intrinsic heart rate. We conclude that patients with intrinsic depression of the sinus node have an increased sympathetic tone.

  13. [Sinus lift and dental implantation after endosurgical treatment of odontogenic maxillary sinusitis].

    Science.gov (United States)

    Sysoliatin, S P; Sysoliatin, P G; Palkina, M O; Solop, M V

    2013-01-01

    The long-term results of dental implant placement in patients with the history of odontogenic maxillary sinusitis are assessed in retrospective study. Maxillary sinusotomy and endoscopic surgery procedures are compared in regard to complications risks after subsequent sinus lift and dental implantation, the latter proving to be method of choice in such cases.

  14. Cranialization of the frontal sinus-the final remedy for refractory chronic frontal sinusitis

    NARCIS (Netherlands)

    van Dijk, J. Marc C.; Wagemakers, Michiel; Korsten-Meijer, Astrid G. W.; Buiter, C. T. Kees; van der Laan, Bernard F. A. M.; Mooij, Jan Jakob A.

    2012-01-01

    Object. Chronic sinusitis can be a debilitating disease with significant impact on quality of life. Frontal sinusitis has a relatively low prevalence, but complications can be severe due to its anatomical location. After failure of conservative measures, typically endoscopic procedures are performed

  15. Normal Sinus Rhythm-Sinus Bradycardia is Common in Young Children Post-extracardiac Fontan.

    Science.gov (United States)

    Evans, William N; Acherman, Ruben J; Restrepo, Humberto

    2016-10-01

    We hypothesized that normal sinus rhythm-sinus bradycardia is common in young children following extracardiac Fontan. After excluding patients with sinus pauses, junctional rhythm, tachy-brady syndrome, frequent ectopics, or ectopic atrial rhythm, we found an ambulatory 24-h Holter monitor average heart rate of 78 ± 12 beats per minute (bpm) in 33 post-extracardiac Fontan children with a median age of 6 years (5-10). A 24-h average heart rate of 78 ± 12 bpm is statistically significantly lower than a 24-h average heart rate value of 90 ± 10 bpm derived from a similarly aged control population (p < 0.01). We conclude that after excluding those with significant arrhythmias, normal sinus rhythm-sinus bradycardia is common in children post-extracardiac Fontan.

  16. Laparoscopic Resection of Chronic Sigmoid Diverticulitis with Fistula

    Science.gov (United States)

    Abbass, Mohammad A.; Tsay, Anna T.

    2013-01-01

    Background and Objectives: A growing number of operations for sigmoid diverticulitis are being done laparoscopically. There is a paucity of data on the outcome of laparoscopy for sigmoid diverticulitis complicated by colonic fistula. The aim of this study was to compare the results of laparoscopic resection of sigmoid diverticulitis with and without colonic fistula. Methods: A retrospective review was conducted of all patients who underwent laparoscopic resection of sigmoid diverticulitis complicated by fistula at a single tertiary care institution over a 7-year period. Comparison was made with a group of patients who underwent resection for diverticulitis without fistula during the same study period. Results: Forty-two patients were analyzed (group 1: diverticular fistula, group 2: no fistula). The median age was similar (49 vs. 50 years, P = .68). A chronic abscess was present in 24% of patients in group 1 and 10% in group 2 (P = .40). Fistula types were colovesical (71%), colovaginal (19%), and colocutaneous (10%). Operation types were sigmoidectomy (57% vs. 81%) and anterior resection (43% vs. 19%) in groups 1 and 2, respectively (P = .18). Ureteral catheters were used more frequently in group 1 (67% vs. 33% [P = .06]). No difference was noted in operative time, blood loss, conversion rate, length of stay, overall complications, wound infection rate, readmission rate, reoperation rate, and mortality. All patients healed without fistula recurrence. Conclusions: Patients with sigmoid diverticulitis with fistula can be successfully treated with laparoscopic excision, with similar outcomes for patients without fistula. PMID:24398208

  17. Sisters of the sinuses: cetacean air sacs.

    Science.gov (United States)

    Reidenberg, Joy S; Laitman, Jeffrey T

    2008-11-01

    This overview assesses some distinguishing features of the cetacean (whale, dolphin, porpoise) air sac system that may relate to the anatomy and function of the paranasal sinuses in terrestrial mammals. The cetacean respiratory tract has been modified through evolution to accommodate living in water. Lack of paranasal sinuses in modern cetaceans may be a diving adaptation. Bone-enclosed air chambers are detrimental, as their rigid walls may fracture during descent/ascent due to contracting/re-expanding air volumes. Flexible-walled "sinuses" (extracranial diverticula) are a logical adaptation to diving. Odontocetes (toothed whales) exhibit several pairs of paranasal air sacs. Although fossil evidence indicates that paranasal sinuses occur in archaeocetes (ancestors/relatives of living cetaceans), it is not known whether the paranasal sacs derive from these sinuses. Sac pigmentation indicates that they derived from invaginations of the integument. Unlike sinuses, paranasal sacs are not circumferentially enclosed in bone, and therefore can accommodate air volume changes that accompany diving pressure changes. Paired pterygoid sacs, located ventrally along the cetacean skull, connect the pharynx and middle ear cavities. Mysticetes (baleen whales) have a large midline laryngeal sac. Although cetacean air sacs do not appear to be homologous to paranasal sinuses, they may serve some analogous respiratory, vocal, or structural functions. For example, these sacs may participate in gas exchange, thermoregulation, resonance, and skeletal pneumatization. In addition, they may subserve unique aquatic functions, such as increasing inspiratory volume, mitigating pressure-induced volume change, air shunting to reduce respiratory dead space, and facilitating underwater sound production and transmission.

  18. [Non-puncture treatment of sinusitis in nasal septal defects].

    Science.gov (United States)

    Shilenkova, V V; Markov, G I; Shilenkov, A A

    1994-01-01

    The [symbol: see text] sinus-catheter was used to treat purulent sinusitis with septal perforation or defective septum of the sinuses. The procedure described implies simultaneous introduction of two sinus-catheters the functioning channels of which unite into one output by means of T-joint. The method has been successfully tried in the treatment of exudative and aggravated chronic purulent hemisinusitis (6 cases). The authors hold that communication between nasal sinuses is not a contraindication for sinus-catheter application. This fact widely extends potentialities of its use.

  19. Cholesterol Granuloma of the Frontal Sinus: A Case Report

    Science.gov (United States)

    Marco, Manola; Ida, Casorelli; Francesco Luigi, Pietrafesa; Giampiero, Mottola; Domenico, Lacerenza; Giuseppe, Battiloro; Giuseppe, Patitucci; Giulia Anna Carmen, Vita

    2012-01-01

    Cholesterol granulomas are common in the mastoid antrum and air cells of the temporal bone. In the paranasal sinuses, especially in the frontal sinus, they have occasionally been mentioned in the literature. The pathogenesis is unknown, but the majority of the authors support the concept of airway obstruction in the cells well pneumatised of temporal bone and paranasal sinuses. The authors report a case of cholesterol granuloma of the frontal sinus treated with radical surgical techniques, and they also recommend an endoscopic approach to frontal sinus to restore or enlarge the nose-frontal canal and promote drainage and ventilation of the frontal sinus. PMID:23150840

  20. Cholesterol Granuloma of the Frontal Sinus: A Case Report

    Directory of Open Access Journals (Sweden)

    Manola Marco

    2012-01-01

    Full Text Available Cholesterol granulomas are common in the mastoid antrum and air cells of the temporal bone. In the paranasal sinuses, especially in the frontal sinus, they have occasionally been mentioned in the literature. The pathogenesis is unknown, but the majority of the authors support the concept of airway obstruction in the cells well pneumatised of temporal bone and paranasal sinuses. The authors report a case of cholesterol granuloma of the frontal sinus treated with radical surgical techniques, and they also recommend an endoscopic approach to frontal sinus to restore or enlarge the nose-frontal canal and promote drainage and ventilation of the frontal sinus.

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

    DEFF Research Database (Denmark)

    Schroeder, T; Kristensen, J K

    1983-01-01

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

  2. HISTOPATHOLOGICAL CHARACTERISTICS OF LYMPH NODE SINUS CONTAINING BLOOD

    Institute of Scientific and Technical Information of China (English)

    YIN Tong; JI Xiao-long

    2001-01-01

    This study is to find out the histopathological characteristics of lymph node sinus containing blood. Routine autopsy was carried out in the randomly selected 102 patients(among them,100 patients died of various diseases, and 2 of non-diseased causes),their superficial lymph nodes locating in the bilateral neck, axilla, inguina, thorax and abdomen were sampled. Haematoxylin-eosin staining was performed on 10% formalin-fixed and paraffin-embedded lymph node tissue sections(5μm).The histological characteristics of the lymph node sinuses containing blood were observed under light microscope. Among the 1362 lymph nodes sampled from the 100 autopsies, lymph sinuses containing blood were found in 809 lymph nodes sampled from 91 cases, but couldn't be seen in the lymph nodes sampled from the non-diseased cases. According to histology, five kinds of lymph sinuses containing blood were found:vascular-opening sinus, blood-deficient sinus, erythrophago-sinus, blood-abundant sinus, and vascular-formative sinus. It is concluded that in the state of disease, the phenomenon of blood in the lymph sinus is not uncommon. Blood could possibly enter into lymph sinus through lymphatic-venous communications between the veins and sinuses in the node. Lymph circulation and blood circulation could communicate with each other in the lymph sinus.

  3. Cholecystocolonic fistula mimicking acute cholecystitis diagnosed unequivocally by computed tomography.

    Science.gov (United States)

    Chick, Jeffrey Forris Beecham; Chauhan, Nikunj Rashmikant; Paulson, Vera Ashley; Adduci, Alexander J

    2013-12-01

    Cholecystocolonic fistula is an uncommon potential complication of cholecystitis found intraoperatively in 0.06-0.14 % of patients undergoing cholecystectomy and 0.1-0.5 % of autopsy series. Although cholecystocolonic fistula is the second most common cholecystoenteric fistula, second only to cholecystoduodenal fistula, it is diagnosed preoperatively in only 7.9 % of patients. Failure to preoperatively diagnose cholecystocolonic fistula places surgeons in precarious positions, as they may be forced to convert a seemingly routine cholecystectomy to a more sophisticated procedure coupled with adhesiolysis, colonic suturing, or colonic resection. We report a young patient who presented to the emergency department with complaints indicative of acute cholecystitis; however, preoperative ultrasound was suggestive of a cholecystoenteric fistula. Computed tomography and pathology were pathognomonic with clear visualization of the cholecystocolonic fistulous tract.

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

    DEFF Research Database (Denmark)

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

    1996-01-01

    PURPOSE: The purpose of this study was to assess the impact of arteriovenous fistulas combined with varying degrees of stenosis on distal bypass hemodynamics and Doppler spectral parameters. METHODS: In an in vitro flow model bypass stenoses causing 30%, 55%, and 70% diameter reduction were induced...... 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...... Doppler spectra obtained 10 cm downstream of the fistula. All measurements were carried out with open and clamped fistula. RESULTS: At 30% diameter reducing stenosis opening of the fistula induced a 12% systolic pressure drop across the stenosis but had no adverse effect on the Doppler waveform parameters...

  5. Closure of oroantral fistula with rotational palatal flap technique

    Directory of Open Access Journals (Sweden)

    David B. Kamadjaja

    2007-03-01

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

  6. Tentorial artery embolization in tentorial dural arteriovenous fistulas

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-10-15

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

  7. [Fistulas of the lower urinary tract in children].

    Science.gov (United States)

    Tonegatti, Luca; Scarpa, Maria-Grazia; Goruppi, Ilaria; Olenik, Damiana; Rigamonti, Waifro

    2015-01-01

    A lower urinary tract fistula consist in an abnormal connection between bladder, urethra and adjacent abdominal organs or skin. There are several types of urinary fistulas in paediatric age and they may be congenital or acquired. Etiology may be due to embriological defects, infectious processes, malignant tumours, pelvic irradiation as well as complications following surgical procedures, especially postsurgical repair of hypospadia or epispadia. Clinical presentation depends on the type of fistula and diagnosis is based on signs, symptoms and radiological or endoscopic examinations. We performed PubMed research using terms such as lower urinary fistulae, urology and paediatrics and we consulted medical texts. We reviewed selected articles and used the relevant ones to perform our study concentrating on classification, diagnosis and treatment of different types of fistulas. Paediatric lower urinary fistulas are an uncommon pathology, but the knowledge of their etiology and classification is important to recognise them and lead the physician to an appropriate treatment, which is surgical in most cases.

  8. Asymptomatic Cholecystocolonic Fistula: A Diagnostic and Therapeutic Dilemma

    Directory of Open Access Journals (Sweden)

    Nicola Antonacci

    2013-01-01

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

  9. Severe bleeding after sinus floor elevation using the transcrestal technique

    DEFF Research Database (Denmark)

    Jensen, Simon Storgard; Eriksen, Jacob; Schiodt, Morten

    2012-01-01

    To present a rare but clinically significant complication to sinus floor elevation (SFE) using the transcrestal technique.......To present a rare but clinically significant complication to sinus floor elevation (SFE) using the transcrestal technique....

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

    OpenAIRE

    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...

  11. Endovascular treatment for bilateral vertebral arteriovenous fistulas in neurofibromatosis 1.

    Science.gov (United States)

    Siddhartha, W; Chavhan, Govind B; Shrivastava, Manish; Limaye, Uday S

    2003-12-01

    We report a rare case of a 36-year-old woman with neurofibromatosis 1 (NF1) with bilateral vertebro-vertebral arteriovenous fistulas. The patient presented with quadriparesis and had neck pain. Angiography revealed vertebral arteriovenous fistulas bilaterally with dilated epidural venous plexuses compressing the cervical cord resulting in quadriparesis. Endovascular treatment using coils and balloons resulted in successful occlusion of both fistulas. At 6-months postembolization, the patient had improved significantly and is now able to walk with support.

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

    Science.gov (United States)

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

    2010-08-01

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

  13. A rare upper gastrointestinal system bleeding case: Aortoesophageal fistula

    OpenAIRE

    AYYILDIZ, Talat; Nas, Ömer Fatih; YILDIRIM, Çınar; Dolar, Enver; Gurel, Selim

    2014-01-01

    Aortoesophageal fistula is a rare condition with fatal prognosis. It is one of the life-threatining causes of massive upper gastrointestinal bleeding. With this case report, we will discuss an instance of a fatal aortoesophageal fistula in a patient to whom was implanted a stent due to an aorta aneurysm. In endoscopic examination blood clot on the mouth of the fistula was visualized. J. Exp. Clin. Med., 2014; 31:51-53

  14. Early Recognition of H-Type Tracheoesophageal Fistula

    Directory of Open Access Journals (Sweden)

    Muhammad Riazulhaq

    2012-02-01

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

  15. Idiopathic intracranial hypertension and transverse sinus stenoses

    DEFF Research Database (Denmark)

    Skyrman, Simon; Fytagoridis, Anders; Andresen, Morten

    2013-01-01

    An 18-year-old woman was diagnosed with idiopathic intracranial hypertension (IIH) and bilateral transverse sinus stenoses (TSS), after presenting with papilledema and decreased visual acuity. Lumbar puncture revealed an opening pressure of >60 cm H2O. MRI showed bilateral TSS believed to be asso......An 18-year-old woman was diagnosed with idiopathic intracranial hypertension (IIH) and bilateral transverse sinus stenoses (TSS), after presenting with papilledema and decreased visual acuity. Lumbar puncture revealed an opening pressure of >60 cm H2O. MRI showed bilateral TSS believed...... to be associated with the IIH. Initial treatment consisted of symptom relief by a temporary lumbar drain for cerebrospinal fluid (CSF) diversion, while the pros and cons of a more permanent solution by insertion of a ventriculoperitoneal shunt (VPS) or bilateral transverse sinus stent was discussed. A VPS...

  16. [Neuro-ophthalmological complications of sinusitis].

    Science.gov (United States)

    Tatuene, Joseph Kamtchum; Pollak, Pierre

    2013-10-01

    Sinusitis is a frequent and very often under-diagnosed condition. Despite the constantly increasing number of antibiotics with improved efficacy, prevention of its complications remains difficult. The prevalence of these complications is estimated at 3.7%. Their clinical presentation is highly variable making the diagnosis difficult and thereby increasing mortality. In this article, historical, epidemiological, pathophysiological, clinical and therapeutic aspects of neuro-ophthalmological complications of sinusitis are reviewed. For didactic reasons, the various complications have been divided into extra-axial, intra-axial, vascular, and orbital. Specific paragraph have been devoted to sinusitis-related bone complications and pain syndromes. It's however obvious that various more or less complex associations of these complications can be seen in daily practice.

  17. Mechanisms in adverse reactions to food. The sinuses

    DEFF Research Database (Denmark)

    Høst, A

    1995-01-01

    Food allergy is an extremely rare cause of chronic sinusitis. Mucosal inflammation in chronic sinusitis is rarely caused by allergic reactions to foods but rather viral infections in the upper respiratory tract.......Food allergy is an extremely rare cause of chronic sinusitis. Mucosal inflammation in chronic sinusitis is rarely caused by allergic reactions to foods but rather viral infections in the upper respiratory tract....

  18. A Rare Diabetic Autonomic Neuropathy: Carotid Sinus Hypersensitivity

    Directory of Open Access Journals (Sweden)

    Ahmet Kaya

    2016-03-01

    Full Text Available Carotid sinus hypersensitivity is a common cause of fainting and falls in the elderly, and can be diagnosed by carotid sinus massage. We present a 67-year-old diabetic man who was admitted with hyperglycemia. During thyroid examination, clouding of consciousness occurred with unilateral palpation. Asystole was documented for 4.8 seconds and suspected for 7 seconds upon carotid sinus massage. A cardioverter defibrillator was implanted. Carotid sinus hypersensitivity should be kept in mind when examining diabetic patients.

  19. Obstetric fistula in low and middle income countries.

    Science.gov (United States)

    Capes, Tracy; Ascher-Walsh, Charles; Abdoulaye, Idrissa; Brodman, Michael

    2011-01-01

    Vesicovaginal fistula secondary to obstructed labor continues to be an all-too-common occurrence in underdeveloped nations throughout Africa and Asia. Vesicovaginal fistula remains largely an overlooked problem in developing nations as it affects the most marginalized members of society: young, poor, illiterate women who live in remote areas. The formation of obstetric fistula is a result of complex interactions of social, biologic, and economic influences. The key underlying causes of fistula are the combination of a lack of functional emergency obstetric care, poverty, illiteracy, and low status of women. In order to prevent fistula, some strategies include creation of governmental policy aimed toward reducing maternal mortality/morbidity and increasing availability of skilled obstetric care, as well as attempts to increase awareness about its prevention and treatment among policymakers, service providers, and communities. Whereas prevention will require the widespread development of infrastructure within these developing countries, treatment of fistula is an act which can be done "in the now." Treatment and subsequent reintegration of fistula patients requires a team of specialists including surgeons, nurses, midwives, and social workers, which is largely unavailable in developing countries. However, there is increasing support for training of fistula surgeons through standardized programs as well as establishment of rehabilitation centers in many nations. The eradication of fistula is dependent upon building programs that target both prevention and treatment.

  20. [Congenital broncho-biliary fistula: a case report].

    Science.gov (United States)

    Pérez, Cinthia G; Reusmann, Aixa

    2016-10-01

    Congenital tracheo-or-bronchobiliary fistula or congenital he-patopulmonary fistula is a rare malformation with high morbidity and mortality if the diagnosis is not made early. The tracheo-or-bronchobiliary fistula is a communication between the respiratory (trachea or bronchus) and biliary tract. To date, only 35 cases have been published worldwide. We report a case of a neonate with right pneumonia and bilious fluid in the endotracheal tube. Diagnosis was made using bronchoscopy with fluoroscopy. Videothoracoscopy was used to remove the bronchobiliary fistula. Subsequently, a left he-patectomy with Roux-en-Y biliary-digestive anastomosis was performed as bile ductus hypoplasia was present.

  1. Volume Flow in Arteriovenous Fistulas Using Vector Velocity Ultrasound

    DEFF Research Database (Denmark)

    Hansen, Peter Møller; Olesen, Jacob Bjerring; Pihl, Michael Johannes;

    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...

  2. Surgical procedure for coronary artery ectasia associated with saccular fistula.

    Science.gov (United States)

    Murakami, Masanori; Gohra, Hidenori; Yagi, Takeshi; Jinbou, Mitsutaka; Kobayashi, Toshiro; Saito, Satoshi; Takahashi, Tsuyoshi; Shiomi, Kotaro; Ono, Siro; Hamano, Kimikazu

    2014-09-01

    Echocardiography of a 60 year-old woman with a three-year history of heart murmur revealed a coronary artery fistula. Coronary angiography indicated right coronary artery ectasia and fistula. The pulmonary-to-systemic blood flow ratio was 1.4, and left-to-right shunt, 29%. On follow-up, infective endocarditis of the tricuspid valve had developed and was treated using antibiotics. The right coronary artery was dilated along its length and was saccular at the distal aspect. At this point, a fistula also connected by the left anterior descending and left circumflex arteries drained into the right ventricle. Fistula closure and reduction aneurysmectomy were performed.

  3. Congenital bronchoesophageal fistula in an adult: A case report

    Institute of Scientific and Technical Information of China (English)

    Lei Su; Xiu-Qin Wei; Xiu-Yi Zhi; Qing-Sheng Xu; Ting Ma

    2007-01-01

    Bronchoesophageal fistulas are usually diagnosed in the neonatal period. As such, the condition is rare in adults.We present a case of a congenital bronchoesophageal fistula in a 62-year-old man with the complaint of severe bouts of cough and choking after swallowing liquid. His workup included a barium esophagogram that revealed a fistula between the esophagus and a right lower lobe bronchus. The diagnosis should be considered in certain individuals with suggestive symptomatology and unexplained respiratory pathology. The fistula was divided and resected, The patient had an uneventful recovery.

  4. Orbicularis oris musculomucosal flap for anterior palatal fistula

    Directory of Open Access Journals (Sweden)

    Tiwari V

    2006-01-01

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

  5. 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.

  6. Covered metallic stents for the palliation of colovesical fistula.

    Science.gov (United States)

    Ahmad, Mukhtar; Nice, Colin; Katory, Mark

    2010-09-01

    Colovesical fistula is a distressing condition that is usually managed surgically. For some patients in whom surgery is not feasible, covered colonic stents offer palliation. We present two challenging cases with contrasting outcomes. The first case is a colovesical fistula secondary to malignancy with a successful outcome after stenting and the second a complex diverticular fistula with a poor outcome. From our limited experience, it is a useful technique but careful patient selection is essential to its safe application. There is little published experience of the use of these stents for colovesical fistula.

  7. Genetic aspects of sick sinus syndrome

    OpenAIRE

    Chernova A.A.; Nikulina S.Yu.; Tret’yakova S.S.; Voyevoda M.I.; Maksimov V.N.; Chernov V.N.

    2013-01-01

    Aim. To study the association between polymorphic allelic variants of the alpha-2В-adrenoreceptor gene (ADRA2B), endothelial nitric oxide synthase gene (NOS3), connexin protein gene 40 (Cx40), cardiac myosin heavy chain gene (MYH6), and voltage-gated sodium channels gene (SCN5A) and development of the idiopathic sick sinus syndrome. Methods. 14 probands with primary symptoms of sick sinus syndrome and their 110 relatives of the I–III degree kinship were examined. At the Berzon City Clinical H...

  8. Pilonidal sinus (Nadi vrana): A case study

    OpenAIRE

    2010-01-01

    Pilonidal sinus (PNS) occurs in the cleavage between the buttocks (natal cleft) and can cause discomfort, embarrassment and absence from work for thousands of young people (mostly men) annually. The incidence of the disease is calculated to be 26 per 100,000 people. It occurs 2.2 times more often in men than in women. Age at presentation is 21 years for men and 19 years for women this case report describes a 22-year-old man with pilonidal sinus who was treated with ksharasutra.

  9. Pilonidal sinus (Nadi vrana): A case study.

    Science.gov (United States)

    Shinde, Pradeep; Toshikhane, Hemant

    2010-07-01

    Pilonidal sinus (PNS) occurs in the cleavage between the buttocks (natal cleft) and can cause discomfort, embarrassment and absence from work for thousands of young people (mostly men) annually. The incidence of the disease is calculated to be 26 per 100,000 people. It occurs 2.2 times more often in men than in women. Age at presentation is 21 years for men and 19 years for women this case report describes a 22-year-old man with pilonidal sinus who was treated with ksharasutra.

  10. Thoracic sinuses in HIV a diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Pai V

    2003-01-01

    Full Text Available A male aged 57 years with multiple discharging sinuses on both sides of chest, multiple ulcers on the back, painful ankylosis of right shoulder since 2 months. Chest examination showed reduced expansion and decreased breath sounds on right side. Large boggy swelling on right hemithorax with multiple discharging sinuses was seen. VDRL was reactive in high dilutions and he was also ELISA - HIV positive. X-ray of chest showed few opacities in right lung field. A provisional diagnosis of Gumma - Syphilis/Tuberculous was considered. Sensorineural deafness was also present.

  11. Thoracic sinuses in HIV a diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Pai V

    2003-03-01

    Full Text Available A male aged 57 years with multiple discharging sinuses on both sides of chest, multiple ulcers on the back, painful ankylosis of right shoulder since 2 months. Chest examination showed reduced expansion and decreased breath sounds on right side. Large boggy swelling on right hemithorax with multiple discharging sinuses was seen. VDRL was reactive in high dilutions and he was also ELISA - HIV positive. X-ray of chest showed few opacities in right lung field. A provisional diagnosis of Gumma - Syphilis/Tuberculous was considered. Sensorineural deafness was also present.

  12. [Anorexia with sinus bradycardia: a case report].

    Science.gov (United States)

    Wang, Fang-fang; Xu, Ling; Chen, Bao-xia; Cui, Ming; Zhang, Yuan

    2016-02-18

    As anorexia patients always go to the psychiatric clinic, little is concerned about the occurrence of sinus bradycardia in these patients for cardiologists and psychiatrists. The aim of this paper is to discuss the relationship between anorexia and sinus bradycardia, and the feature analysis, differential diagnosis and therapeutic principles of this type of sinus bradycardia. We report a case of sinus bradycardia in an anorexia patient with the clinical manifestations, laboratory exams, auxiliary exams, therapeutic methods, and her prognosis, who was admitted to Peking University Third Hospital recently. The patient was a 19-year-old female, who had the manifestation of anorexia. She lost obvious weight in a short time (about 15 kg in 6 months), and her body mass index was 14.8 kg/m(2). The patient felt apparent palpitation, chest depression and short breath, without dizziness, amaurosis or unconsciousness. Vitals on presentation were notable for hypotension, and bradycardia. The initial exam was significant for emaciation, but without lethargy or lower extremity edema. The electrocardiogram showed sinus bradycardia with her heart rate being 32 beats per minute. The laboratory work -up revealed her normal blood routine, electrolytes and liver function. But in her thyroid function test, the free thyroid (FT) hormones 3 was 0.91 ng/L (2.3-4.2 ng/L),and FT4 was 8.2 ng/L (8.9-18.0 ng/L), which were all lower; yet the thyroid stimulating hormone (TSH) was normal 1.48 IU/mL (0.55-4.78 IU/mL). Ultrasound revealed her normal thyroid. Anorexia is an eating disorder characterized by extremely low body weight, fear of gaining weight or distorted perception of body image, and amenorrhea. Anorexia patients who lose weight apparently in short time enhance the excitability of the parasympathetic nerve, and inhibit the sympathetic nerve which lead to the appearance of sinus bradycardia, and functional abnormalities of multiple systems such as hypothyroidism. But this kind of sinus

  13. Fistulas carótido cavernosa

    Directory of Open Access Journals (Sweden)

    Gerardo Lang Serrano

    2014-03-01

    Full Text Available Las fistulas carotido-cavernosas son patologías vasculares relativamente infrecuentes que tiene una etiología de mayor frecuencia traumática que espontanea. Su diagnóstico no siempre es sencillo y requiere de conocer la patología para poder tener la sospecha clínica y poder brindar solución de manera rápida y minimizar secuelas. El tratamiento de las fistulas ha mejorado con el tiempo y con el advenimiento de la cirugía endovascular, con esto se han ido descubriendo mejores accesos y mecanismos para tratarlo, como lo es el abordaje por la vena oftálmica superior. Sin embargo esto no siempre es posible debido a la variaciones anatómicas que en ella se encuentran, pero cuando se logra tiene resultado cosméticos y funcionales muy adecuados.

  14. Coronary fistula resembling patent ductus arteriosus

    Directory of Open Access Journals (Sweden)

    Sgarbieri Ricardo Nilsson

    2003-01-01

    Full Text Available A 14-year-old girl, presenting with heart failure and a continuous murmur, similar to that of a patent arterial duct, was investigated using echocardiogram and cardiac catheterization revealing a left to right shunt throught a coronary artery fistulae between the first septal branch and the right ventricular outflow tract. The patient was submitted to surgery, occluding the anomalous branch by the suturing of its orifice in the right ventricular outflow tract, under cardiopulmonary bypass. After the operation, cardiac catheterization revealed complete occlusion of the fistula without any residual shunt or compromise to the coronary circulation. In seven years of follow-up the patient is completely free of symptoms.

  15. Percutaneous transarterial embolization of extrahepatic arteroportal fistula

    Institute of Scientific and Technical Information of China (English)

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

    2006-01-01

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

  16. Tubular Colonic Duplication Presenting as Rectovestibular Fistula.

    Science.gov (United States)

    Karkera, Parag J; Bendre, Pradnya; D'souza, Flavia; Ramchandra, Mukunda; Nage, Amol; Palse, Nitin

    2015-09-01

    Complete colonic duplication is a very rare congenital anomaly that may have different presentations according to its location and size. Complete colonic duplication can occur in about 15% of all gastrointestinal duplications. Double termination of tubular colonic duplication in the perineum is even more uncommon. We present a case of a Y-shaped tubular colonic duplication which presented with a rectovestibular fistula and a normal anus. Radiological evaluation and initial exploration for sigmoidostomy revealed duplicated colons with a common vascular supply. Endorectal mucosal resection of theduplicated distal segment till the colostomy site with division of the septum of the proximal segment and colostomy closure proved curative without compromise of the continence mechanism. Tubular colonic duplication should always be ruled out when a diagnosis of perineal canal is considered in cases of vestibular fistula alongwith a normal anus.

  17. An unusual case of pancreatic fistula.

    Science.gov (United States)

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

    2013-03-21

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

  18. 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.

  19. Colovesical fistula presenting as Listeria monocytogenes bacteraemia.

    Science.gov (United States)

    Hobbs, Mark

    2015-03-31

    We present a case of colovesical fistula presenting with a clinical syndrome of urosepsis subsequently demonstrated to be due to Listeria monocytogenes bacteraemia. The patient had a history of previous rectal cancer with a low anterior resection and a covering ileostomy that had been reversed 6 months prior to this presentation. L. monocytogenes was also isolated among mixed enteric organisms on urine culture. There were no symptoms or signs of acute gastrointestinal listeriosis or meningoencephalitis. This unusual scenario prompted concern regarding the possibility of communication between bowel and bladder, which was subsequently confirmed with CT and a contrast enema. The patient recovered well with intravenous amoxicillin and to date has declined surgical management of his colovesical fistula. This case illustrates the importance of considering bowel pathology when enteric organisms such as Listeria are isolated from unusual sites.

  20. Treatment of anal fistula and abscess.

    Science.gov (United States)

    Pigot, F

    2015-04-01

    The glands of Hermann and Desfosses, located in the thickness of the anal canal, drain into the canal at the dentate line. Infection of these anal glands is responsible for the formation of abscesses and/or fistulas. When this presents as an abscess, emergency drainage of the infected cavity is required. At the stage of fistula, treatment has two sometimes conflicting objectives: effective drainage and preservation of continence. These two opposing constraints explain the existence of two therapeutic concepts. On one hand the laying-open of the fistulous tract (fistulotomy) in one or several operative sessions remains the treatment of choice because of its high cure rates. On the other hand surgical closure with tract ligation or obturation with biological components preserves sphincter function but suffers from a higher failure rate.

  1. Role of diaphragm in pancreaticopleural fistula

    Institute of Scientific and Technical Information of China (English)

    Anestis P Ninos; Stephanos K Pierrakakis

    2011-01-01

    A pancreatic pleural effusion may result from a pan-creatopleural fistula. We herein discuss two interest-ing issues in a similar case report of a pleural effusion caused after splenectomy, which was recently pub-lished in the World Journal of Gastroenterology . Pan-creatic exudate passes directly through a natural hia-tus in the diaphragm or by direct penetration through the dome of the diaphragm from a neighboring sub-diaphragmatic 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 recom-mended in that article as the management of choice. Although this may be an option in selected frail pa-tients, 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.

  2. Current concepts of anatomy and electrophysiology of the sinus node.

    Science.gov (United States)

    Murphy, Cliona; Lazzara, Ralph

    2016-06-01

    The sinoatrial node, or sinus node, of humans is the principal pacemaker of the heart. Over the last century, studies have unraveled the complex molecular architecture of the sinus node and the expression of unique ion channels within its specialized myocytes. Aim of this review is to describe the embriology, the anatomy, the histology and the electrophisiology of the sinus node.

  3. Different types of fungal sinusitis occurring concurrently: implications for therapy.

    Science.gov (United States)

    Rupa, V; Thomas, Meera

    2013-02-01

    The purpose of this study is to describe the clinical and histopathological features, management and outcome of a series of patients with simultaneous occurrence of invasive and non-invasive fungal sinusitis (mixed fungal sinusitis). The histopathological records of patients with fungal sinusitis seen over the last 6 years were reviewed. The clinical, histopathological, treatment and follow up details of all cases with mixed fungal sinusitis were noted. Six cases of mixed fungal sinusitis with concurrent occurrence of chronic granulomatous fungal sinusitis and allergic fungal sinusitis (AFS) were seen during the study period. Most (83.3 %) had bilateral disease. All patients had undergone prior endoscopic sinus surgery at least once within the previous 2 years. Histopathological features showed predominance of invasive disease in half the patients. Except for one patient who did not report for follow up, all patients with predominant chronic granulomatous fungal sinusitis received systemic antifungal therapy and inhaled steroids. Those with predominant features of AFS received oral and inhaled steroids. Five patients with mixed fungal sinusitis who had follow up ranging from 6 months to 5 years were disease free following treatment. Mixed fungal sinusitis should be recognized by the surgeon and pathologist as a separate category of fungal sinusitis whose treatment depends on accurate histological diagnosis. A good outcome may be expected with appropriate therapy.

  4. Sinusitis associated with nasogastric intubation in 3 horses.

    Science.gov (United States)

    Nieto, Jorge E; Yamout, Sawsan; Dechant, Julie E

    2014-06-01

    Sinusitis has not been reported as a complication of long-term nasogastric intubation in horses. We describe 3 horses that developed nosocomial sinusitis following abdominal surgery with associated perioperative nasogastric intubation. Sinusitis was suspected by the presence of malodorous discharge and confirmed by percussion, upper airway endoscopy, radiographs (n = 3), and bacterial culture (n = 1).

  5. [Age associated clinical features of odontogenic maxillary sinusitis].

    Science.gov (United States)

    Iordanishvili, A K; Nikitenko, V V; Balin, D V

    2013-01-01

    Detailed analysis of odontogenic maxillary sinusitis clinical course allowed identifying clinical features of the disease specific for elderly and senile patients. The paper describes the peculiarities of odontogenic maxillary sinusitis in elderly and senile patients including those having oroantral sinus tract.

  6. [Odontogenic maxillary sinusitis in elderly and old age].

    Science.gov (United States)

    Nikitenko, V V; Iordanishvili, A K; Ryzhak, G A

    2013-01-01

    On the basis of a detailed analysis of the clinical picture of odontogenic maxillary sinusitis the peculiarities of its flow in elderly and senile patients are demonstrated. The causes of odontogenic inflammation of the maxillary sinuses, the clinical features of inflammation of the maxillary sinus in older age groups, including those with oroantral communication are shown.

  7. Medical image of the week: tracheoesophageal fistula

    Directory of Open Access Journals (Sweden)

    Wong C

    2013-06-01

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

  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. 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.

  10. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-03-15

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

  12. Management and outcomes of colovesical fistula repair.

    Science.gov (United States)

    Lynn, Elizabeth T; Ranasinghe, Nalin E; Dallas, Kai B; Divino, Celia M

    2012-05-01

    This large retrospective study presents the largest colovesical fistula (CVF) series to date. We report on recurrence risk factors and patient satisfaction based on quality of life after CVF repair. Approval was obtained from The Mount Sinai School of Medicine Institutional Review Board, and a retrospective review was performed from 2003 to 2010 involving 72 consecutive patients who underwent a colovesical fistula repair. The CVF recurrence rate was 11 per cent. Ten percent of our patients who had a history of radiation therapy were at a significantly higher risk of developing a recurrence. Noted recurrence rates were significantly higher in advanced bladder repairs compared with simple repair (P = 0.022). The modified (Gastrointestinal Quality of Life Index) surveys showed overall patient satisfaction score was 3.6, out of a maximum score of 4, regardless of the type of repair or any postoperative complications. Our study found the CVF recurrence rate to be 11 per cent. Patients at higher risk of recurrence include those needing advanced bladder repair, those with "complex" CVF, and those whose fistulas involve the urethra. Patient satisfaction was found to be more closely linked to the resolution of CVF symptoms, irrespective of the type of repair performed or development of postoperative complications.

  13. [Abscess, fistula and occlusion of colonic diverticulosis].

    Science.gov (United States)

    Bouillot, J L

    1995-04-15

    Diverticular disease is generally benign but may be serious in case of septic complications. The most common complication of acute diverticulitis is development of an abscess which can be located around the colon or in the pelvis. The diagnosis can be clinically suspected in case of non-response to medical management of severe acute diverticulitis. Confirmation is obtained by conventional radiographic examinations and computerized tomography. This condition can be safely treated by percutaneous catheter drainage associated to antibiotics followed by an elective delayed single-stage operation without colostomy. Fistula occurs in 20% of the patients who undergo surgery for diverticular disease. Colovesical fistula is the most common type of spontaneous internal fistula. Routine evaluation may raise the suspicion of complication. Surgical management requires colonic resection and primary anastomosis. Complete obstruction secondary to diverticular disease is uncommon and generally resolves with conservative management. However, some degree of ileus is frequent secondary to inflammatory changes of diverticulitis but should imperatively be differentiated from ileus observed in case of generalized peritonitis.

  14. Coronary artery to left ventricle fistula

    Directory of Open Access Journals (Sweden)

    Kumar Vivek

    2005-11-01

    Full Text Available Abstract Background Coronary cameral fistulas are an uncommon entity, the etiology of which may be congenital or traumatic. They involve abnormal termination of a coronary artery, usually the right coronary, into a cardiac chamber, usually the right ventricle. Case Presentation We describe a case of female patient with severe aortic stenosis and interventricular septal hypertrophy that underwent bioprosthetic aortic valve replacement with concomitant septal myectomy. On subsequent follow-up an abnormal flow traversing the septum into the left ventricle was identified and Doppler interrogation demonstrated a continuous flow, with a predominantly diastolic component, consistent with coronary arterial flow. Conclusion The literature on coronary cameral fistulas is reviewed and the etiology of the diagnostic findings discussed. In our patient, a coronary artery to left ventricle fistula was the most likely explanation secondary to trauma to the septal perforator artery during myectomy. Since the patient was asymptomatic at the time of diagnosis no intervention was recommended and has done well on follow-up.

  15. Compression of the posterior fossa venous sinuses by epidural hemorrhage simulating venous sinus thrombosis: CT and MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Singh, Sumit; Ramakrishnaiah, Raghu H.; Hegde, Shilpa V.; Glasier, Charles M. [University of Arkansas for Medical Sciences, Pediatric Radiology, Little Rock, AR (United States)

    2016-01-15

    Posterior fossa dural venous sinus thrombus is a well-described complication of head trauma, especially when fracture crosses the dural sinus grooves or in association with epidural hemorrhage. We have found that post-traumatic posterior fossa epidural hematoma compressing a dural venous sinus can mimic dural venous thrombus. To discuss the CT and MRI findings of posterior fossa epidural hemorrhages simulating sinus thrombosis, to make radiologists aware of this important imaging pitfall. We describe radiologic findings in four children in whom a posterior fossa epidural hemorrhage mimicked dural venous sinus thrombus. Routine CT head and CT venography were obtained on Toshiba volume and helical CT scanners. MRI and MR venography were performed on a Philips scanner. In all cases there was medial displacement and compression of the posterior fossa dural venous sinuses without intraluminal thrombosis. The epidural hemorrhage was seen tracking along sinus grooves in the occipital bone, peeling the dura containing the sinuses from the calvarium and compressing the sinus, simulating thrombosis on axial CT views. Both venous sinus thrombosis and posterior fossa epidural hemorrhages in children are well-described complications of head trauma. Posterior fossa epidural hemorrhage can mimic a sinus thrombus by compressing and displacing the sinuses. It is important to recognize this pitfall because treatment of a suspected thrombus with anticoagulation can worsen epidural hemorrhage. (orig.)

  16. The incidence of maxillary sinus membrane perforation during endoscopically assessed crestal sinus floor elevation: a pilot study.

    Science.gov (United States)

    Garbacea, Antoanela; Lozada, Jaime L; Church, Christopher A; Al-Ardah, Aladdin J; Seiberling, Kristin A; Naylor, W Patrick; Chen, Jung-Wei

    2012-08-01

    Transcrestal sinus membrane elevation is a surgical procedure performed to increase the bone volume in the maxillary sinus cavity. Because of visual limitations, the potential for maxillary sinus membrane perforations may be greater than with the lateral approach technique. The aim of this study was to macroscopically investigate ex vivo the occurrence of sinus membrane perforation during surgery using 3 transcrestal sinus floor elevation methods. Twenty fresh human cadaver heads, with 40 intact sinuses, were used for simultaneous sinus membrane elevation, placement of graft material, and dental implants. Real-time sinus endoscopy, periapical digital radiographs, and cone-beam computerized tomography (CBCT) images were subsequently used to evaluate the outcome of each surgical procedure. Perforation rates for each of the 3 techniques were then compared using a significance level of P sinus endoscope noted a higher frequency of perforations at the time of implant placement as compared with instrumentation or graft insertion, the difference was not statistically significant (P = .04). The CBCT readings were judged to be more accurate for identifying evidence of sinus perforations than the periapical radiographs when compared with the direct visualization with the endoscope. This pilot study demonstrated that a sinus membrane perforation can occur at any time during the sinus lift procedure, independent of the surgical method used.

  17. [Congenital left sinus of Valsalva aneurysm].

    Science.gov (United States)

    Simões, M V; Figueira, R R; Barbato, D; Miziara, H L

    1991-01-01

    Two cases of left sinus of Valsalva congenital aneurysm (SVCA), incidentally found are described. The authors call attention on rarity of them, and present new concepts about their morphogenesis and incidence. They also suggested a higher incidence of asymptomatic and undiagnosed cases of SVCA should be considered.

  18. Acute otitis media and acute bacterial sinusitis.

    Science.gov (United States)

    Wald, Ellen R

    2011-05-01

    Acute otitis media and acute bacterial sinusitis are 2 of the most common indications for antimicrobial agents in children. Together, they are responsible for billions of dollars of health care expenditures. The pathogenesis of the 2 conditions is identical. In the majority of children with each condition, a preceding viral upper respiratory tract infection predisposes to the development of the acute bacterial complication. It has been shown that viral upper respiratory tract infection predisposes to the development of acute otitis media in 37% of cases. Currently, precise microbiologic diagnosis of acute otitis media and acute bacterial sinusitis requires performance of tympanocentesis in the former and sinus aspiration in the latter. The identification of a virus from the nasopharynx in either case does not obviate the need for antimicrobial therapy. Furthermore, nasal and nasopharyngeal swabs are not useful in predicting the results of culture of the middle ear or paranasal sinus. However, it is possible that a combination of information regarding nasopharyngeal colonization with bacteria and infection with specific viruses may inform treatment decisions in the future.

  19. Orbital Complications of Sinusitis A Review

    Directory of Open Access Journals (Sweden)

    Balasubramanian Thiagarajan

    2014-08-01

    Full Text Available Abstract: Introduction: Despite availability of excellent antibiotics, orbital complications’ following sinusitis is rather common. With the emergence of fungal sinusitis orbital involvement by the disease is getting frequent. Prevalence of life style disorders like diabetes mellitus has added to the woes. This article attempts to review the entire gamut of orbital complications following sinus infections. Aim: This study aims at analyzing orbital complications following sinusitis at Government Stanley Medical College Hospital during the period 2009 – 2013. Study design: Retrospective study Methodology: Cases with rhinosinusitis treated in our Institution during the period 2009-2013 were taken up for analysis. 112 patients were chosen for the study. Their case records were analyzed. CT scan images taken during the time of admission were also evaluated. Patients with orbitalcomplications following rhinosinusitis were included. Chandler’s classification was used to categorize the stage of disease. Results: 112 patients were included in the study. 76 Male patients 36 Female patients 26 patients developed orbital complications Number of male patients with orbital complication – 22 Number of female patients with orbital complication – 4 Number of patients who died due to complications - 2 Conclusion: High degree of suspicion, early diagnosis and aggressive medical management of Chandler’s categories I and II will go a long way in preventing irreparable damage to vision. All our patients were managed initially with parenteral antibiotics. Patients who do not show improvement even after 4 days of antibiotic therapy were taken up for surgical management.

  20. Sinusitis from Nontuberculous Mycobacteria in Tap Water

    Centers for Disease Control (CDC) Podcasts

    2012-12-21

    Dr. Wellington S. Tichenor. Associate Clinical Professor of Medicine at New York Medical College and in private practice in Manhattan, New York, discusses his investigation of sinusitis from nontuberculous mycobacteria in tap water.  Created: 12/21/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 12/31/2012.

  1. Osteoma of the skull base and sinuses

    NARCIS (Netherlands)

    C. Georgalas; J. Goudakos; W.J. Fokkens

    2011-01-01

    Osteomata of the frontal and ethmoid sinuses have traditionally been surgically removed via external approaches. However, endoscopic techniques have increasingly been used for the surgical management of selected cases. Advances in visualization and instrumentation, as well as the excellent access pr

  2. [Sinus-node recovery time in the sick-sinus syndrome (author's transl)].

    Science.gov (United States)

    Delius, W; Wirtzfeld, A; Sebening, H; Blömer, H

    1975-11-01

    Sinus-node recovery times were measured, before and after atropine administration, in 21 patients with the clinical diagnosis of sick-sinus syndrome. The results were compared with those reported by other workers. It is concluded that sinus-node recovery times of more than 1 400 ms are most likely due to sinus-node damage (sick-sinus syndrome); normal recovery times are rare in such patients. The diagnosis of the syndrome is strengthened if the recovery time remains abnormally long even after atropine. Further useful diagnostic information can be obtained from the total stimulation phase (duration until restoration of the basic rhythm), this being overall longer in patients with the syndrome than in normal subjects. The increased incidence of A-V nodal rhythms before restoration of the basic rhythm is another indication of organic damage to the sinus node, especially if it also occurs after atropine. The significance of a recovery time which is prolonged before but normal after atropine is less clear: a raised sensitivity to vagotonic influences may be the determining factor here.

  3. Sinus node function after autonomic blockade in normals and in sick sinus syndrome.

    Science.gov (United States)

    Sethi, K K; Jaishankar, S; Balachander, J; Bahl, V K; Gupta, M P

    1984-06-01

    Electrophysiologic studies were performed in 10 normals and 33 patients with sick sinus syndrome before and after total autonomic blockade with propranolol and atropine. In normals both corrected sinus node recovery time (SNRT) and sinoatrial conduction time (SACT) decreased significantly after autonomic blockade. In patients with sick sinus syndrome the corrected SNRT was abnormal (greater than 450 msec) in 16 (48.5%) cases before and 25 (76%) cases (greater than 285 msec) after autonomic ablation (P less than 0.02). Thirteen of 21 patients (62%) with normal intrinsic heart rate and all 12 cases with abnormally low intrinsic rate after autonomic blockade had abnormal corrected SNRT (greater than 285 msec). Mean SACT measured in 19 patients also shortened significantly following pharmacologic denervation. During control it was prolonged (greater than 226 msec) in 8 patients (44%). After autonomic blockade 2 of 13 patients with normal intrinsic heart rate and 3 of 6 with low intrinsic rate showed abnormal SACT (greater than 151 msec). The data suggest that the majority (76%) of patients with sick sinus syndrome have intrinsic abnormality of sinus node automaticity while in a minority (24%) disturbed autonomic regulation is the pathogenetic mechanism. Patients with normal intrinsic heart rate usually have normal intrinsic SACT, while a significant proportion of those with low intrinsic rate have abnormal perinodal conduction. Subjects with abnormal intrinsic heart rate have more severe disturbances of sinus node function than those with normal intrinsic rate.

  4. Post Repeat Lower Segment Caesarean Section Cervicovesical Fistula

    Directory of Open Access Journals (Sweden)

    Vidya A.Thobbi

    2008-12-01

    Full Text Available A 35 year old female patient G2P1L1 with previous LSCS with 9 months amenorrhea with labor pains was admitted and caesarean section was done for cephalo – pelvic disproportion with foetal distress. Patient developed cervico-vesical fistula which was successfully repaired by total abdominal hysterectomy and fistula was repaired using peritoneal flap .

  5. Formation of a vesicovaginal fistula in a pig model

    DEFF Research Database (Denmark)

    Lindberg, Jennifer; Rickardsson, Emilie; Andersen, Margrethe

    2015-01-01

    Objective: To establish an animal model of a vesicovaginal fistula that can later be used in the development of new treatment modalities. Materials and methods: Six female pigs of Landrace/Yorkshire breed were used. Vesicotomy was performed through open surgery. An standardized incision between t...... be an effective and cheap way to create a fistula between the bladder and vagina....

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

    Science.gov (United States)

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

    2005-01-01

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

  7. Repair of large palatal fistula using tongue flap

    Directory of Open Access Journals (Sweden)

    Fejjal Nawfal

    2014-01-01

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

  8. [Giant cervical angioma caused by "malignant" arteriovenous fistulae].

    Science.gov (United States)

    Palou, J; Mir y Mir, L

    1992-01-01

    A case of angioma by malignant AV fistula (described by F. Martorell in 1970) is reported. Such kind of fistulas have usually a lethal course. The case reported underwent a surgical correction, and after a following of 10 years, no major complications have been reported.

  9. Analysis of related risk factors for pancreatic fistula after pancreaticoduodenectomy

    Institute of Scientific and Technical Information of China (English)

    Qi-Song Yu; He-Chao Huang; Feng Ding; Xin-Bo Wang

    2016-01-01

    Objective:To explore the related risk factors for pancreatic fistula after pancreaticoduodenectomy to provide a theoretical evidence for effectively preventing the occurrence of pancreatic fistula.Methods:A total of 100 patients who were admitted in our hospital from January, 2012 to January, 2015 and had performed pancreaticoduodenectomy were included in the study. The related risk factors for developing pancreatic fistula were collected for single factor and Logistic multi-factor analysis.Results:Among the included patients, 16 had pancreatic fistula, and the total occurrence rate was 16% (16/100). The single-factor analysis showed that the upper abdominal operation history, preoperative bilirubin, pancreatic texture, pancreatic duct diameter, intraoperative amount of bleeding, postoperative hemoglobin, and application of somatostatin after operation were the risk factors for developing pancreatic fistula (P<0.05). The multi-factor analysis showed that the upper abdominal operation history, the soft pancreatic texture, small pancreatic duct diameter, and low postoperative hemoglobin were the dependent risk factors for developing pancreatic fistula (OR=4.162, 6.104, 5.613, 4.034,P<0.05).Conclusions:The occurrence of pancreatic fistula after pancreaticoduodenectomy is closely associated with the upper abdominal operation history, the soft pancreatic texture, small pancreatic duct diameter, and low postoperative hemoglobin; therefore, effective measures should be taken to reduce the occurrence of pancreatic fistula according to the patients’own conditions.

  10. Stent-graft repair of a recurrent popliteal arteriovenous fistula

    NARCIS (Netherlands)

    Tielliu, IFJ; Verhoeven, ELG; Prins, TR; van Det, M; van den Dungen, JJAM

    2002-01-01

    Purpose: To describe the successful endovascular treatment of a popliteal arteriovenous fistula with a stent-graft. Case Report: A 54-year-old man was referred to our hospital with a distal popliteal arteriovenous fistula following an arthroscopic meniscectomy 6 years earlier. Three surgical attempt

  11. Nail penetrating trauma:a rare cause of vesicovaginal fistula

    Institute of Scientific and Technical Information of China (English)

    Mohammad Asl Zare; Ali Kamalati; Saeed Esmailnia

    2014-01-01

    Vesicovaginal fistula (VVF) may be caused by prolonged obstructed labor, gynecologic, urologic, or other pelvic surgery, malignancy, radiation, infection and trauma. Here we report a case of VVF caused by nail penetrating trauma in a young woman with genital bleeding after first intercourse. This is a rare etiology of VVF. We also explain the operative technique used to repair the fistula.

  12. 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.

  13. 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.

  14. Treatment of ureterovaginal fistula using a Memokath stent

    DEFF Research Database (Denmark)

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

    2014-01-01

    Ureterovaginal fistula (UVF) is a challenging problem for patients and doctors, especially in patients who have been treated by radiation for malignancy. UVF may occur in conjunction with surgeries involving the uterus. A success rate of 70-100% has been reported for fistula repair with the best...

  15. Endovascular management of intracranial pial arterio-venous fistulas.

    Science.gov (United States)

    Limaye, U S; Siddhartha, W; Shrivastav, M; Anand, S; Ghatge, S

    2004-03-01

    From 1996-2002 we treated 5 consecutive cases of pial fistula. There were 3 patients with a single hole-single channel pial fistula and two patients had a complex pial fistula. Three patients presented with intracerebral hematoma and had a focal neurological deficit. One patient presented with history of seizures and 1 patient had headache. The results of the treatment were analyzed both clinically and angiographically. The follow-up period ranged from 6 months to 6 years. All fistulas were treated with concentrated glue. The glue cast included the distal part of the feeding artery, A-V connection and the proximal part of the vein. Post-embolisation angiography showed complete occlusion of two single-hole fistulas and one complex pial A-V fistula and near total occlusion of one single-hole and one complex pial A-V fistula. Four patients had excellent clinical outcome. One patient with single-hole fistula had a hemorrhagic venous infarct resulting in transient hemiparesis.

  16. 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.

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

    Science.gov (United States)

    Wang, Xia; Xu, Yaosheng

    2015-12-01

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

  18. Pro-inflammatory cytokines in cryptoglandular anal fistulas

    NARCIS (Netherlands)

    van Onkelen, R. S.; Gosselink, M. P.; van Meurs, M.; Melief, M. J.; Schouten, W. R.; Laman, J. D.

    2016-01-01

    Sphincter-preserving procedures for the treatment of transsphincteric fistulas fail in at least one out of every three patients. It has been suggested that failure is due to ongoing disease in the remaining fistula tract. Cytokines play an important role in inflammation. At present, biologicals targ

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

    Science.gov (United States)

    Cosman, B C

    1998-07-01

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

  20. Historical Perspectives in the Care of Patients with Enterocutaneous Fistula

    Science.gov (United States)

    2010-09-01

    KEYWORDS: Enterocutaneous fistulas, historical review Objectives: On completion of this article the reader should understand the evolution of care of the...and proton-pump inhibitors can decrease fistula effluent, prevent stress- induced gastritis , and reduce electrolyte losses, but have not been