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At least 91 records · Page 5Linked to original sources
PubMed2005

Temporary transgastric fistula occlusion as salvage procedure in neonates with esophageal atresia with wide distal fistula and moderate to severe pneumonia.

A method to achieve distal fistula occlusion by inflating the balloon of a catheter placed at the gastroesophageal junction via a transgastric route was tried in seven consecutive neonates with esophageal atresia and wide distal fistula. Due to associated moderate or severe pneumonia, these infants were at poor anesthetic risk for the definitive repair. The procedure was done under local anesthesia with mild sedation and took an average of half an hour for completion. Another feeding tube was negotiated through another gastrotomy across the pylorus to allow early enteral feeds. Temporary transgastric fistula occlusion (TTFO) allowed better ventilation of the hypocompliant lungs (by increasing resistance at the fistulous end), prevented lung injury due to aspiration of the refluxing gastric juices, and facilitated optimal ventilation by preventing epigastric distension. All study subjects survived this procedure except for one of our earlier study subjects who died of massive pneumothorax that was a procedure-related complication. None of the remaining subjects required mechanical ventilation either after TTFO or after the definitive esophageal repair that was carried out 5-7 days subsequent to TTFO, except for one other neonate with right lung aplasia who began deteriorating 48 h after thoracotomy and died of cardiac failure. There were no anastomosis-related problems among the survivors over a 12-month follow-up. The gratifying results of our study prompt us to suggest that this procedure deserves attention, and its role should be explored for salvaging neonates with type C esophageal atresia with wide fistula and pneumonia in developing countries with few neonatal intensive care services.

Balloon Occlusion↗
PubMed2006

Dutch survey of coronary artery fistulas in adults: congenital solitary fistulas.

AIMS: Congenital coronary artery fistulas are frequently identified in adult and pediatric populations and they have been associated with various clinical and morphological features. The purpose of this study was to define the clinical and coronary angiographic morphological characteristics of adult patients with congenital solitary CAFs in the Dutch Registry. METHODS AND RESULTS: Fifty-one patients with angiographically documented CAFs were reviewed for clinical evaluation, used non-invasive and invasive diagnostic tools and treatment modalities. Unilateral CAFs were predominant (80%) and 84% of the patients were symptomatic. The most common presenting symptom was angina pectoris (57%). Angina pectoris was present in a quarter of the patients in the absence of coronary artery disease (CAD). Significant CAD was present in 49% of the patients. Twenty-nine percent of the CAFs showed aneurysmal formation, underlying their potential hazard of rupture. Myocardial infarction occurred in 18% of the patients. In 27% of CAFs multiplicity of the origin was found and nearly all fistulas were tortuous (97%). Treatment modalities were conservative medical in 70%, percutaneous transluminal embolisation in 5% and surgical ligation in 25% of the cases. Multiple micro-fistulas from the coronary arteries to the left ventricle were excluded from the study. CONCLUSION: In this national survey series, congenital solitary CAFs can be presented with typical angina pectoris in the absence of obstructive CAD. Fistula-related coronary artery was infrequently involved in the development of ipsilateral myocardial infarction. Tortuousity and multiplicity of the CAFs may determine, for the individual patient, the choice of the currently available treatment modalities.

Adult↗
PubMedDate not supplied

Coronary-pulmonary artery fistula associated with right heart failure: successful closure of fistula with a graft stent.

Coronary artery fistula constitutes a rare congenital anomaly. The reported incidence of this anomaly ranges from 0.1% to 0.2% of the population undergoing coronary angiography. Coronary-pulmonary artery fistula is an extremely rare congenital anomaly of the coronary artery. Its real incidence is unknown. The authors report a case of coronary-pulmonary artery fistula that caused right heart failure in a 77-year-old woman. The fistula, arising from a proximal portion of the circumflex artery to the pulmonary artery, was sealed successfully using a Jostent (polytetrafluoroethylene-covered graft stent).

Aged↗
PubMed1976

[The fistula of the first branchial cleft A critical presentation of its pathogenesis and its clinical and surgical problems. A description of one case combined with a fistula auris congenita (author's transl)].

A case of congenital fistula of the first branchial cleft (Ohr-Hals-Fistel) is presented. Based on the previously published cases the anatomical and clinical aspects of the disease are summed up. Pathogenesis is discussed on the underlying principles of embryological basic research, centering on Hochstetter's "Entwicklungsgeschichte der Ohrmuschel und des äusseren Gehörganges des Menschen" (1948), a publication that is hardly known. Some hypotheses on the genesis of the fistula of the first branchial cleft are criticised and a new hypothesis is developed to the effect that the fistula is caused by a disturbance in the development of the external ear channel. A few critical remarks are added concerning the discussion on the genesis of fistula auris congenita.

Branchial Region↗
PubMedDate not supplied

[Spontaneous right primary iliac arteriovenous fistula and an unrecognized aorto-caval fistula located above an aneurysm].

A patient admitted for treatment of an aorto-iliac aneurism presented himself with swelling of the lower extremities and a low grade bruit over the abdomen continuous throughout systole and diastole. Aortography demonstrated the presence of a suspected ilio-caval fistula. Surgical treatment consisted of closure of the fistula and vascular replacement with an appropriate aorto-bifemoral prosthesis. Large statistics report an incidence of aortocaval fistula up to 4% in association with rupturing aortic aneurisms. The grave clinical signs and aortography confirm the diagnosis. Some of those may obstruct themselves spontaneously only to reopen at the time of operation as in the case reported. The greatest peroperatory problems with closure of those fistulae are pulmonary emboli by air and aneurismal contents. In our first case a temporary caval clip was placed as a part in the management of the lesion.

Aged↗
PubMed1994

[Pulmonary arteriovenous fistula with Rendu-Osler-Weber disease and its HLA typing--a review and report of 87 cases of fistula].

Seven cases with pulmonary arteriovenous fistula (PAVF) in our hospital were reviewed on clinical data and HLA antigens. Furthermore, 80 reported cases of PAVF in Japan were summarized about the association with Rendu-Osler-Weber disease (Osler disease). Thirty-six (41%) of the total 87 cases had Osler disease. Fistulas were single in 46 cases and multiple in 41; unilateral in 56 and bilateral in 31. Operations were performed in 61 cases, embolizations in 8 and no therapy in 18. The frequency of the bilateral fistulas and multiple ones was significantly higher in cases with Osler disease (n = 36) than in those without Osler disease (n = 51) (p < 0.025). In our 7 cases, 6 had Osler disease. Aggregation of platelets was decreased in one case. Contralateral fistulas were recurred in another case 8 years after surgery. Three cases with Osler disease had the HLA halotype A26Bw6Bw61 which did not coincide with that in previous reports. We concluded that various HLA halotypes might exist in Osler disease.

Adolescent↗
PubMed1990

[Surgical treatment of benign tracheoesophageal fistula and bronchoesophageal fistula in the adults].

This article deals with experiences of surgical treatment of benign tracheoesophageal fistula and bronchoesophageal fistula in seven adults. Among them 2 cases were congenital, 2 cases were infective and 3 cases were traumatic. There were 5 males and 2 females. Their average age ranged from 24 to 53 years. The modes of operation were as follows: (1) resection of fistula, and repairing of leak in 3 cases; (2) pneumonectomy and repairing of leak in 2 cases; (3) esophagectomy through right thoracotomy and cervical reconstruction of the retrosternal esophagogastrostomy was performed in one case; (4) repairing of leak with pedicled esophagus wall in one case. Follow-up shows that the surgical treatment gives satisfactory results in these patients.

Adult↗
PubMed2006

Creating arteriovenous fistulas in 132 consecutive patients: exploiting the proximal radial artery arteriovenous fistula: reliable, safe, and simple forearm and upper arm hemodialysis access.

HYPOTHESIS: Dialysis by native arteriovenous fistula (NAVF) clearly offers lower infection rates, fewer procedures, and lower mortality risk compared with access by catheter or graft, in addition to lower cost. However, NAVFs are utilized for vascular access in only 30% of hemodialysis patients in the United States. Wrist NAVFs are not feasible or successful in many patients and upper arm brachial artery NAVFs may be impractical or lead to additional procedures or complications. Careful preoperative evaluation of all options for NAVF construction including the proximal radial artery (PRA) as an arterial inflow site will find most, if not all, patients to be candidates for successful NAVFs. DESIGN: Retrospective review of consecutive operations for hemodialysis access preformed by an individual surgeon from May 2003 to November 2004. SETTING: Two university-affiliated tertiary medical centers. PATIENTS: All patients underwent preoperative ultrasound evaluation by the operating surgeon. A wrist fistula was first choice for access when success was predicted by ultrasound and physical examination. The second choice, and most common operation, was a PRA NAVF with distal forearm (retrograde) flow established by disrupting the initial venous valve using a vessel probe. RESULTS: One hundred thirty-two patients aged 11 to 90 years (mean = 61) were reviewed. Sixty-eight patients had diabetes and 61 were female. Thirty-four had previous failed access surgery. Native arteriovenous fistulas were created in all patients. No grafts were used. A PRA NAVF was utilized in 105 operations. Overall (assisted) patency was 97%, with a mean follow-up of 11 months. Importantly, there were no infections or hospitalizations due to the NAVF access operations. CONCLUSIONS: No grafts were used in this series of 132 consecutive patients. The PRA NAVF was the most common operation and an important addition to wrist, brachial, and transposition fistulas. Proximal radial artery NAVFs increase the opportunity for construction of successful NAVFs and are reliable, safe, and simple procedures with access sites often available in both the forearm and in the upper arm.

Adolescent↗
PubMedDate not supplied

Collateralization of the palmar arch by a failing radiocephalic fistula: an underappreciated complication of Cimino fistula anatomy.

Stenosis at the anastomosis of an arteriovenous dialysis fistula can cause fistula failure due to venous thrombosis. Three cases are presented in which anastomotic stenosis in radiocephalic fistulas resulted in radial artery occlusion with collateralization of ulnar artery flow across the palmar arch. Hand ischemia did not occur, and reductions in fistula efficiency were clinically subtle. Urea kinetics were compromised, and a characteristic palmar bruit was heard.

Adult↗
PubMedDate not supplied

Long-term outcomes of a fistula initiative: sustaining "fistula culture".

From 1998 to 2003, a low cost fistula initiative at Allegheny General Hospital increased the rate of AV fistulas from 32% to 72%. We present an additional 25 months of vascular access data, with stratification of results by gender and long-term patient survival data. These data show the self-sustaining nature of 'fistula culture' in an urban hemodialysis unit, and the survival benefits that result from increased fistula rates.

Arteriovenous Shunt, Surgical↗
PubMedDate not supplied

Bovine artegraft arteriovenous fistulas for hemodialysis in one-hundred patients after "conventional" arteriovenous fistulas failed.

The use of the Bovine artegraft for creation of arteriovenous fistulas in the hemodialysis patients was first carried out in the midsummer of 1971. Since that time, there has been considerable material reported in the use of this substitute as an access for hemodialysis. In this article information gained from an ongoing study of the first 100 patients in chronic hemodialysis who had Bovine artegraft arteriovenous fistulas was reviewed. The indications for operation, the standard technique, the results, the complications, and the future plans for study of the physiology and hemodynamics of this type of fistula are described. The Bovine artegraft, AV fistula can be created successfully in a high percentage of patients, offers ease of needle placement, and effective dialysis with very little complication.

Adolescent↗
PubMed1998

Presacral neuroenteric fistula presenting with meningitis and vaginal fistula: a case report.

Neuroenteric fistulas are rare congenital malformations arising from a persistent connection between the embryonic neural and intestinal tissues; they are extremely rare in the lumbosacral area. Neuroenteric fistulas should be suspected whenever children present with anaerobic meningitis in the absence of brain abscesses or respiratory infections. This patient is the first patient who presented with a presacral cyst that separately connected to the nervous system and the vagina. It is thought that the rape of this 12-year-old patient resulted in soilage of the spinal fluid through dual fistulae, causing anaerobic meningitis without an abscess.

Child↗
PubMed1989

[Percutaneous drainage of fistula-associated abscesses and biliary fistulas].

33 abdominal abscesses associated with fistulae in 31 patients were treated by percutaneous drainage. 19 of these patients had had surgery immediately preceding the drainage. In 64% the percutaneous drainage led to a diagnosis of an internal fistula. Additional therapeutic measures, because of the fistula, were necessary in 45% (operation, biliary drainage, repositioning of catheter). The average duration of drainage was 29 days. 77% of those abscesses which could be drained were treated successfully. Mortality in the entire series was 19%.

Abdomen↗
PubMed1992

[Esophago-thoracic fistula after pneumonectomy and long-term main bronchus stump fistula].

A woman patient admitted for treatment, who had reached the age of 65 years, had a previous history of an open pulmonary tuberculosis in 1946 that had been treated at that time by means of collapsotherapy and phrenico-exeresis. Pleuropneumonectomy was performed in 1976 because of a residual cavity of a thoracic empyema. Since 1978 the patient suffered from a fistula of the bronchus treated by postural therapy without achieving a cure. In 1989 a fistula formed between oesophagus and pneumonectomy cavity. Clinically this was associated with an increasing reduction of performance and a suddenly ineffective postural drainage, resulting in triphasic and eventually fatal aspiration. Histology revealed a suppurative inflammation in the fistular channel and a slight superficial Candida colonisation of the pneumonectomy cavity, of the fistular channel and of adjacent mucous glands of the oesophagus. Formation of the fistula was probably due to a small traction diverticulum followed by perforation because of obstructed oesophageal passage due to scarified distortions.

Aged↗
PubMed1989

Hematemesis due to fistula between aorta and esophagus and later to fistula between left common carotid artery and esophagus. Case report.

A case of massive hematemesis due to an aortoesophageal fistula is presented. The diagnosis was made intraoperatively. The patient died 39 days postoperatively of an additional, previously unidentified fistula between the left common carotid artery and the esophagus. This fistula combination does not seem to have been reported previously.

Aortic Diseases↗
PubMed1979

[Esophago-tracheal fistula and ano-cutaneous fistula in a newborn (author's transl)].

Esophago-tracheal fistulas are rare malformations in which the frequency of associated defects is not yet well known. This is the reason for the description of a case of oesophago-tracheal fistula and ano-cutaneous fistula in a female newborn. Special attention is also paid to the problem of diagnostic difficulties, which were here resolved by oesophagoscopy accompanied by positive pressure ventilation through a tracheal tube.

Female↗
PubMed1987

Management of chronic ulcerative colitis and rectovaginal fistula by simultaneous ileal pouch construction and fistula closure. Report of a case.

Persistent rectovaginal fistulas occurring with ulcerative colitis are unusual manifestations that complicate surgical or medical treatment of the primary disease. Prior to the development of ileal pouch procedures, many cases were traditionally managed with a total colectomy and permanent ileostomy. The authors are aware of no previous study using concurrent fistula repair combined with ileal pouch construction to manage this complex problem. The successful simultaneous repair of a chronic rectovaginal fistula with ileal pouch reconstruction in a patient with intractable ulcerative colitis is reported.

Adult↗