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Healed enteroportal fistula as a complication of liver transplantation.

The development of a fistula between the intestinal tract and the portal vein has been reported as a complication of trauma, inflammation, and surgical intervention. It has not, however, been specifically reported in a patient who has undergone orthotopic liver transplantation. We recently had the opportunity to study a patient who sustained this rare complication.

Female↗

[Use of biological antiseptic tampon (BAT) for treatment of infected wounds and fistulas after abdominal surgery].

In the paper, based on the experience with the treatment of 42 patients having extensive purulent wounds and fistulas, the use of a biologial antiseptic tampon (BAT) for treatment of persistantly unhealing wounds and fistulas after various abdominal operations is discussed. The mechanism of BAT therapeutic effect, the method of its application and the results of treatment are described.

Abdomen↗

Spontaneous duodenal-caval fistula with embolization of intestinal contents.

We describe the second example of a duodenal-caval fistula in a patient with peptic ulcer disease. This condition was complicated by embolization of intestinal contents to the lung, with abundant intravascular mucin. This is the first histological documentation of intravascular mucin apart from amniotic fluid embolism. It is well known that mucin may activate coagulation. We propose that intravascular mucin activated the coagulation cascade in our patient, causing disseminated intravascular coagulation and adult respiratory distress syndrome.

Adult↗

SURGICAL MANAGEMENT OF REGIONAL ENTERITIS.

The present-day concepts concerning the surgical management of regional enteritis are reviewed and the multitude of problems that may arise in surgical treatment are discussed. The primary treatment of regional enteritis remains medical. Surgical intervention is necessary only for the complications of intractability, obstruction, fistula, abscess formation, anal and rectal complications, massive hemorrhage and perforation. To ensure the best possible results, medical treatment should continue after surgery. A perfect operation for this disease does not exist. Operations for regional enteritis can now be performed with a mortality rate of less than 2%, and although the recurrence rate following surgery averages approximately 30%, the disease is well controlled in the majority of patients with medical and/or surgical treatment.

Appendectomy↗