11/275. Epidural blood patch under fluoroscopic control: non-surgical treatment of lumbar cerebrospinal fluid fistula following implantation of an intrathecal pump system.The treatment of lumbar cerebrospinal fluid fistula in the presence of an intrathecal catheter is known to be difficult. Open revision surgery is recommended in the literature, although the rate of recurrence is high. The epidural blood patch technique is well established as a successful treatment for post-dural-puncture headaches. Recent work about the distribution of the injected blood and theoretical considerations about the mechanism of action make this method suitable for the occlusion of spinal leakage even in the presence of an intrathecal catheter. In this note technical details are given for a successful therapy of lumbar cerebrospinal fluid fistula including the right positioning of the opening of the needle (cerebrospinal fluid can be expected intrathecally and epidurally) by injection of contrast medium first for myelography then for epidurography. In this procedure the (epidural) distribution of autologous blood can be indirectly controlled by compression of the dural sac. The method is easy to perform, and the possible risks are small.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
12/275. Management of a patient with hepatic-thoracic-pelvic and omental hydatid cysts and post-operative bilio-cutaneous fistula: a case report.In humans, most hydatid cysts occur in the liver and 75% of these are single. Our patient was a 31 year-old male. His magnetic resonance imaging (MR) showed one cyst (15 x 20 cm) in the right lobe and three cysts (5 x 6 cm, 8 x 6 cm, and 5 x 5 cm) in the left lobe of the liver, two cysts (4 x 5 cm and 5 x 5 cm) on the greater omentum, and two cysts (15 x 10 and 10 x 10 cm) in the pelvis. The abdomen was entered first by a bilateral subcostal incision and then by a Phennenstiel incision. Partial cystectomy capitonnage was done on the liver cysts; the cysts on the omentum were excised, and the pelvic cysts were enucleated. The cyst in the right lobe of the liver was in communication with a thoracic cyst. An air leak developed from the thoracic cyst which had underwater drainage and bile drainage from the drain in the cavity of the right lobe cyst. Sphincterotomy was done on the seventh post-operative day by endoscopic retrograde cholangiopancreatography (ERCP). No significant effect on mean bile output from the fistula occurred. octreotide therapy was initiated, but due to abdominal pain and gas bloating the patient felt and could not tolerate, it was stopped on the fourth day; besides, it had no decreasing effect on bile output during the 4 days. Because air and bile leak continued and he had bile stained sputum, he was operated on on post-operative day 18. By right thoracotomy, the cavity and the leaking branches were closed. By right subcostal incision, cholecystectomy and T-tube drainage of the choledochus were done. On post-operative day 30, he was sent home with the T-tube and the drain in the cavity. After 3 months post-operatively, a second T-tube cholangiography was done, and a narrowing in the distal right hepatic duct and a minimal narrowing in the distal left hepatic duct were exposed. Balloon dilatation was done by way of a T-tube. bile drainage ceased. There was no collection in the cavity in follow-up CT scanning, so the drain in the cavity, and the drainage catheter in the right hepatic duct were extracted. Evaluation of the biliary ductal system is important in bilio-cutaneous fistulas, and balloon dilatation is very effective in fistulas due to narrowing of the ducts.- - - - - - - - - - ranking = 1.1666666666667keywords = fistula (Clic here for more details about this article) |
13/275. mycobacterium xenopi infection of a 50-year-old oil plombage complicated by bronchopleural and pleurocutaneous fistulas.We report the rare combination of simultaneous bronchopleural and pleurocutaneous fistulas 50 years after oil plombage, together with infection of both the plombage and the contralateral lung with mycobacterium xenopi. Our case documents imaging patterns of complex fistula formation and subsequent infection resulting from oil plombage. Our case also emphasizes the infectious potential of mycobacterium xenopi.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
14/275. Vesicocutaneous fistula 23 years after hip arthroplasty. A case report.Vesicocutaneous fistula after total hip replacement is a very rare but severe complication, which can appear months or years after operation. Intrapelvic cement (methylmethacrilate) spilling, loosening and dislocation of the prosthesis and infection are believed to be the cause of fistula formation. Only 4 cases of this kind of fistula have been reported in the literature. A new case of vesicocutaneous fistula is presented. The fistula developed 23 years after arthroplasty mainly because of hip-joint infection. urinary tract symptoms caused by urinary infection appeared only few months earlier.- - - - - - - - - - ranking = 18.03728909465keywords = urinary, fistula (Clic here for more details about this article) |
15/275. Closure of an oropharyngocutaneous fistula in an irradiated patient. A case report.A case of oropharyngocutaneous fistula is presented in a preoperatively irradiated patient. A double-layer closure, using a modified Owens flap, was used to obtain a satisfactory result.- - - - - - - - - - ranking = 0.83333333333333keywords = fistula (Clic here for more details about this article) |
16/275. Congenital colocutaneous fistula as presenting sign of prenatally closed gastroschisis.MATERIALS AND methods: An infant was born with a congenital colocutaneous fistula to the right of the base of the umbilicus, along with distal small bowel atresia. RESULTS: These findings produced a unique presentation of a prenatally closed gastroschisis with absorption of the extruded intestine. CONCLUSION: This child, like all five previously reported infants with prenatally closed gastroschisis, died from complications of short-gut syndrome.- - - - - - - - - - ranking = 0.83333333333333keywords = fistula (Clic here for more details about this article) |
17/275. Therapeutic embolization and surgical excision of haemophilic pseudotumour.Haemophilic pseudotumour is a rare complication of haemophilia. Few cases of iliac haemophilic pseudotumour have been reported in the literature. These tumours can act as a focus for infection and cause cutaneous fistulas. When they present perforations and infections of endogenous origin their course is usually fatal. Suitable treatment has been investigated on numerous occasions, most of the literature agreeing that the only curative treatment is surgical resection. We present a case of haemophilic pseudotumour of the iliac and caecum with cutaneous fistulas, with a septic process of endogenous origin. It was treated with surgical resection after performing arterial embolization to reduce the vascularization of the pseudotumour, thereby reducing its size and the risk of bleeding complications during surgery.- - - - - - - - - - ranking = 0.33333333333333keywords = fistula (Clic here for more details about this article) |
18/275. Transthoracic fistula with erosion of the ascending aorta along an IMA-protecting graft.Internal mammary artery (IMA) graft protection with nonbiodegradable material, such as polytetrafluorethylene (PTFE), is recognized as an effective means for preventing overexuberant adhesion development as well as injury of retrosternally crossing arterial grafts in the event of resternotomy and should enable better identification of the IMA graft. It is still uncertain whether the use of PTFE material is suitable for diabetic patients with complete arterial revascularization due to potential infectious complications. We report on a young diabetic patient after arterial T-grafting due to severe coronary disease and readmission with wound infection and retrosternal fistula formation 8 months after operation.- - - - - - - - - - ranking = 0.83333333333333keywords = fistula (Clic here for more details about this article) |
19/275. aorta-cutaneous fistula as a rare complication of localized chronic mediastinitis.A 35-year-old man was admitted 5 years after congenital heart surgery complicated by staphylococcus aureus and a cutaneous fistula located at the left fourth intercostal space. He was febrile (40 degrees C), suffering from sternal pain and suppuration from the old fistula. During examination arterial blood suddenly discharged from the fistula, so that surgery was immediately instituted. An infected Dacron tube implanting on the ascending aorta for a central aorto-pulmonary shunt was at the origin of a false aneurysm: this had led to the repeat formation of an aorta-cutaneous fistula and outbreak of external bleeding.- - - - - - - - - - ranking = 1.3333333333333keywords = fistula (Clic here for more details about this article) |
20/275. Congenital cheek fistula: a report of three cases.Three cases of the rare condition of congenital cheek fistulae are presented. These differ from preauricular fistulae in terms of their location and the direction in which the fistula is lying. Each cheek fistula seemed to be situated along the line of the junction between the mandibular and maxillary processes of the first branchial arch.- - - - - - - - - - ranking = 1.3333333333333keywords = fistula (Clic here for more details about this article) |
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