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At least 73 records · Page 4Linked to original sources
PubMed1993

[Transcatheter embolization of ascending aorto-pulmonary fistula combined with coronary arteriovenous fistula].

We encountered a patient with a coronary arteriovenous fistula accompanied by an ascending aortopulmonary fistula, a rare malformation. The patient was a 42-year-old female complaining of exertional dyspnea and chest pain at rest. She noticed dyspnea while going up and down the stairs, and chest pain at rest at the age of about 40 years. While she was being treated for hypertension, a cardiac murmur was detected. She was admitted to our hospital for close examination. Coronary angiography (CAG) showed a coronary arteriovenous fistula that branches from the left anterior descending branch and forms an aneurysm, running to the trunk of the pulmonary artery. On March 28, 1989, ligation of the fistula was performed. Postoperative CAG demonstrated an ascending aorto-pulmonary fistula that flowed to an aneurysm adjacent to the pulmonary artery. On November 29, transcatheter embolization was performed. She was discharged 7 days after embolization without complications. She is now being treated on an outpatient basis, and the symptoms in her chest have disappeared. Transcatheter embolization used in this patient may also be applicable in the treatment for coronary arteriovenous fistulae.

Adult↗
PubMed1994

Rectal perforation, rectocutaneous fistula formation, and enterocutaneous fistula formation after pelvic trauma in a dog.

This report describes the management of rectal perforation, incision infection, implant failure, sepsis, osteonecrosis, and enterocutaneous fistula formation in a 3-year-old Yorkshire Terrier that was hit by a car. Rectal perforation from displaced pelvic fractures was suspected because of drainage from the incision, and clinical signs, and blood test results indicative of sepsis. Ilial and acetabular osteonecrosis from wound infection were treated with hemipelvectomy without pelvic limb amputation, and full limb function was regained. Primary repair of the rectal perforation and use of a muscle flap were unsuccessful, and a rectocutaneous fistula developed, but the rectum healed after colostomy for fecal diversion. An enterocutaneous fistula subsequently developed at the rectocutaneous fistula site, resulting in weight loss and continued drainage from the incision. Primary closure of the jejunal stoma, appropriate wound management, and nutritional support by enteral feeding resulted in eventual second-intention healing of the fistula and incision.

Animals↗
PubMed2005

[Arterio-venous fistula of cavernous sinus. A comparison of iatrogenic direct fistula with low flow dura shunt syndrome].

PURPOSE: Comparison of symptoms of the low-flow dura shunt syndrome as a small arterial anomaly in the cavernous sinus with the direct, traumatic originated internal carotid artery fistula. MATERIAL AND METHODS: The clinical case report for two patients. The first case with a direct cavernous sinus fistula was diagnosed using angiography and the patient was treated with a detachable balloon catheter through the inferior petrousal sinus. The second case after the diagnosis was followed up with doppler sonography. RESULTS: The first case developed the direct cavernous sinus fistula after second thrombarteriotomy of the right internal carotid stenosis. The diagnosis, by typical clinical symptoms, was confirmed through the cavernous sinus angiogram with enlarged superior and inferior ophthalmic veins. The drainage was accomplished through the inferior petrousal sinus and the intercavernous sinus with accompanying signs of cortical drainage. All clinical symptoms, except for the abducens nerve palsy and the incomplete oculomotor nerve palsy, were reduced after neurosurgical occlusion of the fistula. The second case with the low-flow dura shunt syndrome was symptomatic by hypertension crisis and some spontaneous reduction was noticed. CONCLUSIONS: The iatrogenic direct cavernous sinus fistula is seldom but a very dangerous vital complication of the internal carotid arterial stenosis surgery and must be immediately closed through the endovascular embolisation therapy. The low-flow dura shunt syndrome may be in 50% occluded spontaneously.

Aged↗
PubMed1998

[Sealing esophagobronchial fistulae: better results with self expanding stents than with an esophagobronchial fistula].

OBJECTIVE: To compare the results of plastic endoprostheses and of self expanding stents in patients with an esophagobronchial fistula. DESIGN: Retrospective, descriptive. SETTING: Nederlands Kanker Instituut/Antoni van Leeuwenhoek Ziekenhuis, Amsterdam, the Netherlands. METHOD: Forty-two patients with an esophagobronchial fistula caused by a malignant tumour in the oesophagus, lungs or mediastinum were fitted with an endoprosthesis during the period 1 January 1991-31 August 1995. Use was made initially of a plastic endoprosthesis with a special tulip funnel (n = 24), later of a coated self expanding stent (n = 18). In seven patients, the fistula had been the first manifestation of the tumour; in 35, a recurrence after earlier treatment was involved. The initial characteristics (sex, age, diagnosis, earlier therapy, signs and symptoms) were the same in both groups. RESULTS: Dilatation immediately before insertion of a plastic endoprosthesis was necessary in 23 patients (96%); such dilatation was necessary in four of the patients (22%) fitted with a self expanding stent. Complete sealing of the fistula was achieved in 19 (79%) and 15 (83%) patients, respectively. Reoperations were necessary in eight (33%) and three (17%) patients. Early major complications occurred in four (17%) and two (11%) patients. CONCLUSION: The selfexpanding stent was faster and easier to insert than a plastic endoprosthesis, and effective in sealing an oesophagobronchial fistula.

Bronchial Fistula↗
PubMed2005

Treatment of fistulas-in-ano with fibrin sealant in combination with intra-adhesive antibiotics and/or surgical closure of the internal fistula opening.

PURPOSE: The treatment of fistulas-in-ano with fibrin sealant injection has been moderately successful. Failures can be caused by persistent infection within the tract or early expulsion of the clot. In an attempt to improve the success rate, we examined three modifications of the sealant procedure: the addition of cefoxitin to the sealant, surgical closure of the primary opening, or both. METHODS: A prospective, randomized, clinical trial was performed in which patients were treated with Tisseel-VH fibrin sealant according to previously published procedures. In addition, patients were randomized to receive intra-adhesive cefoxitin, surgical closure of the primary opening, or both modifications. Cefoxitin, 100 mg, was added to the sealant for patients randomized to receive intra-adhesive antibiotics. For the appropriate patients, the primary fistula opening was closed with a 3-0 absorbable suture. If fistulas failed to heal, patients were offered a single retreatment with sealant. RESULTS: Twenty-four patients were treated in the cefoxitin arm, 25 in the closure arm, and 26 in the combined arm. Median duration of fistulas was 12 months. Patients were followed for a mean of 27 months postoperatively. There was no postoperative incontinence or complications related to the sealant itself. Initial healing rates were 21 percent in the cefoxitin arm, 40 percent in the closure arm, and 31 percent in the combined arm (P = 0.35). One of five patients in the cefoxitin arm, one of seven patients in the closure arm, and one of six patients in the combined arm were successfully retreated; final healing rates were 25, 44, and 35 percent respectively (P = 0.38). CONCLUSIONS: Treatment of fistula-in-ano with fibrin sealant with closure of the internal opening was somewhat more successful than sealant with cefoxitin or the combination, however this did not achieve statistical significance. None of the three modifications were more successful than historic controls at our institution treated with sealant alone. Therefore, the addition of intra-adhesive cefoxitin, closure of the internal opening, or both are not recommended modifications of the fibrin sealant procedure.

Adult↗
PubMed1994

Bicoronary-pulmonary fistulae with coexistent mitral valve prolapse: a case report and literature review of coronary-pulmonary fistula.

Bicoronary-pulmonary artery fistulae are rare congenital coronary artery fistulae. We report the case of a 57-year-old man who presented with biventricular failure and angina pectoris. At angiography the coronary arteries were normal, but bicoronary-pulmonary fistulae were noted; severe mitral regurgitation secondary to mitral valve prolapse was also present. At right heart catheterization the calculated left to right shunt was 2.1. Fistula ligation and repair of both mitral and tricuspid valves was undertaken. The literature regarding coronary-pulmonary fistula is also reviewed.

Arterio-Arterial Fistula↗
PubMed1991

[One-stage surgery of high trans- and supra-sphincter anal fistula using primary fistulectomy and occlusion of the internal fistula ostium. A prospective study of 169 patients].

In a prospective study on 169 patients with a so-called high fistula-in-ano (147 transsphincteric, 22 suprasphincteric) the value of a sphincter-saving operation technique was assessed. This technique consists of one-stage fistulectomy as well as of drainage of the intersphincteric space by internal sphincterotomy. The site of the former primary orifice of the fistula is adapted by multiple peranally performed single stitches. The perianal part of the wound is left to heal by second intention. Post-operatively, 19 cases of suture leakage occurred (9.5% with the transsphincteric and 23% with the suprasphincteric fistula, resp.). 32 patients (19%) had to have repeated surgery because of recurrent abscess or fistula or because of suture leakage (mean follow-up 3.2 years). Anal manometry was carried out preoperatively as well as postoperatively. It revealed a decrease in anal resting and squeezing pressure of 10 to 40% with a mean about 30%. Of the patients who had not been operated on previously, an impairment of continence developed in 15% postoperatively. This percentage rose up to 40% according to the rising number of previous fistula operations. The main problem in these cases was soiling. Total anorectal incontinence for formed stool did not occur.

Adolescent↗
PubMed1990

[Blood flow measurement in arteriovenous fistula. Comparison of 2 ultrasonic methods, direct and indirect by compression of the fistula].

Measuring blood flow in arteriovenous fistulae in patients under chronic dialysis is of interest to evaluate the repercussions of the fistula on the heart. The apparently simplest method is direct measurement of the mean blood flow velocity by the pulsed doppler technique and ot the cross-section area by ultrasonography, the product of these two values being the blood flow rate. Another method has been proposed, which consists of measuring the cardiac output before and after compression of the fistula, the difference between the two values being supposed to represent the blood flow rate in the fistula. A comparative study of these two methods was conducted in 17 patients aged from 2 to 21 years (mean: 14 years). The direct method gave a figure of 475 ml.min-1.m-2 (SD = 240), while the figure obtained with the indirect method was 471 ml.min-1.m-2 (SD = 227); the difference was statistically not significant. In terms of concept, however, the indirect method is open to much more severe criticism than the direct method, and whenever possible the latter should be preferred when measuring blood flow in arteriovenous fistulae.

Adolescent↗
PubMed1989

[A case of bilateral coronary artery to pulmonary artery fistulas associated with hepatic arteriovenous fistula].

A 55-year-old man, previously treated for primary hypothyroidism, was admitted for evaluation of atypical chest pain. On physical examination, the pulse rate was 60 and blood pressure was 132/84 mmHg. Heart sounds were normal and no murmur was heard. Abdominal palpation showed no abnormal finding, and bruit was not heard. The electrocardiogram was normal and stress-induced ischemia was not found. The chest X-ray showed no sign of pulmonary hyperaemia or mass lesion, and central shadow was normal (CTR = 44%). During right heart catheterization, the pressures were normal in the cardiac chambers, pulmonary artery, and wedge position. A significant increase in oxygen saturation was disclosed at pulmonary artery level (10%) and the upper site of the inferior vena cava (22%). Coronary arteriography found coronary artery fistulas from the left main trunk, the left anterior descending artery, the left circumflex, and the right coronary artery to the pulmonary trunk. The left and right ventriculograms were normal. The digital subtraction angiography of celiac artery showed hepatic arteriovenous fistula. Ultrasonography and computed tomography found no mass lesion of the liver. Since combination of the bilateral coronary artery with pulmonary artery fistula, and hepatic arteriovenous fistula is very rare, the present case is worth noting for the investigation of the pathogenesis of congenital arteriovenous fistulas.

Arterio-Arterial Fistula↗
PubMedDate not supplied

[Extraoral odontogenic fistulas: a classification and a differential diagnosis from other type head and neck fistulas].

The majority of extraoral facial fistulas are of odontogenic origin. Although the differential diagnosis of draining lesions should include various types of skin infection, infected tumour, specific infections, failed wound healing, foreign body, salivary gland fistula, sebaceous cysts and developmental cysts and fistulas. This report documents a group of patients with extraoral draining skin lesions and illustrates that their diagnosis is very important because clinically they can resemble many pathologic entities. One hundred and twenty-eight cases of extraoral fistulas are presented in this paper. This study aims to analyse a number of fistula cases so as to give a clear idea about relative frequency of etiology and to attract to some cases of non odontogenic etiology.

Dental Fistula↗
PubMed1993

Transition of renal arteriovenous fistula to arteriocalyceal fistula during embolization.

Selective and superselective renal embolization is a generally accepted technique for treating traumatic or iatrogenic renal arteriovenous fistulas or arteriocalyceal fistulas. Only a minority are pure arteriocalyceal fistulas. During embolization, an arteriovenous fistula may become a frankly bleeding arteriocalyceal fistula, causing massive haematuria and necessitating further embolization.

Aged↗
PubMed1977

Surgical closure of left coronary artery-left ventricular fistula: the second case reported in the literature and a review of the five previously reported cases of coronary artery fistula terminating in the left ventricle.

Surgical closure of a left coronary artery-left ventricular fistula in a 44-year-old black man is reported. The fistula was discovered by coronary arteriography after the patient was admitted to the hospital complaining of recurrent chest pain. The fistula was closed with cardiopulmonary bypass, ischemic arrest, and hypothermia, and there was an uneventful postoperative recovery. The previously reported five cases of fistulas terminating in the left ventricle that were closed surgically are reviewed. Four of these cases originated in the right coronary artery and one in the left coronary artery. Three of the six patients were symptomatic at the time of discovery of the lesion. Cardiopulmonary bypass was necessary in five of the six cases. One patient died in the postoperative period from intractable hemorrhage. It is recommended that coronary artery fistulas by closed upon establishment of the diagnosis because of the sequelae if they are allowed to remain open; these include premature atherosclerosis, aneurysmal dilatation of the coronary artery, and congestive heart failure.

Adult↗
PubMedDate not supplied

[Posttraumatic carotid-cavernous fistula: diagnosis and treatment--exemplified by a patient with a fistula following a blunt head injury].

Carotid-cavernous fistula is a rare posttraumatic complication. The authors described the patient in which a blunt cranial injury caused the carotid-cavernous fistula. In diagnosing the fistula Doppler examination proved very helpful. It showed the vein-arterial flow in the ophthalmic artery on the fistula side. The arteriography of the common carotid artery fully confirmed the diagnosis. Successful treatment was achieved by means of percutaneous endovascular balloonization of the fistula ring.

Arteriovenous Fistula↗
PubMed2000

[Role of somatostatins in the preventin of pancreatic fistulae and the treatment of digestive fistulae].

Somatostatin and analogues exert an extraordinary range of inhibitory effects which eventually may have a variety of therapeutic applications. Treatment of intestinal and pancreatic fistula are the main targets in general and digestive surgery. The perioperative and prophylactic application of somatostatin or octreotide in patients who undergo major pancreatic surgery reduces the postoperative complication rate. This prevention seems indicated following Whipple procedure in patients with soft pancreatic tissue. The efficacy of somatostatin or analogues in the treatment of intestinal or pancreatic fistulae is still in debate. Fistula output frequently decreases but closure rate, healing time and complications rate are not reduced. The treatment and care of patients with high output fistulae may be simplified by somatostatin or analogues if a positive effect on output is obvious in the first days of treatment.

Hormones↗
PubMed1989

[Use of omental pedicle flap for the prevention of bronchopleural fistula after surgery: an unsuccessful case in a management of bronchopleural fistula].

We report a case of bronchopleural fistula after preoperative neo-adjuvant chemotherapy for advanced lung cancer. A 55-year-old man admitted to our institution and was diagnosed to have advanced lung cancer. Right pneumonectomy was carried out after chemotherapy. Parietal pleura and the right main bronchus were thick because of severe fibrosis due to chemotherapy. On the 16th postoperative day, bronchopleural fistula was found. After drainage, further resection of bronchial stump and wrapping with omentum was carried out. However, he died of pneumonia due to repeated bronchopleural fistula. Since this experience, we use omental wrapping procedure in patients undergoing surgery for the hilar type lung cancer after chemotherapy, and conclude that omental wrapping is useful for prevention of bronchopleural fistula.

Bronchial Fistula↗
PubMedDate not supplied

[Contribution of arteriography to diagnosis of secondary arterio-digestive fistulas. Intestinal haemorrhage due to ilio-ileal fistula, a complication in vascular reconstruction (author's transl)].

The authors describe a case of secondary ilio-ileal fistula revealed by an intestinal haemorrhage which occurred ten years after vascular reconstruction. They stress the importance of arteriography which shows up the pseudo-aneurysm causing the fistularisation and vascular contrast material escaping into the digestive lumen. A complete review of the literature on arterio-colonic fistulas, and more particularly, ileo-ileal fistulas, shows that they usually express themselves clinically in the form of digestive haemorrhages occurring generally after vascular graft and after a variable lapse of time. The association of digestive haemorrhage and a previous vascular reconstruction should suggest the diagnosis of arterio-digestive fistula and should lead to early angiography to enable coherent surgical strategy to be put into operation.

Aged↗
PubMed1984

Choledochoduodenal fistula and choledocholithiasis: treatment by endoscopic enlargement of the choledochoduodenal fistula.

Choledochoduodenal fistula is an uncommon complication of choledocholithiasis. Five patients with this entity were treated by endoscopic enlargement of the choledochoduodenal fistula without complication. Choledochoduodenal fistula complicating choledocholithiasis seem to arise either from stone erosion through the bile duct into the duodenum or as a complication of vigorous instrumentation at the time of common duct exploration. In patients in whom endoscopic sphincterotomy cannot be performed because of inability to cannulate the ampullary orifice, endoscopic enlargement of the choledochoduodenal fistula can be performed safely.

Aged↗
PubMed1982

Pilonidal fistulas mimicking fistulas-in-ano.

Four pilonidal fistulas which were initially diagnosed as fistulas-in-ano are reported. Only one perianal pilonidal fistula and four perineal pilonidal sinuses have previously been reported. It is suggested that they are more common than the literature suggests and should be excluded when patients present with symptoms of fistula-in-ano.

Adult↗