Cases reported "Esophageal Fistula"

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11/30. Esophagoatrial fistula with previous pericarditis complicating esophageal ulceration. Report of two cases and a review of the literature.

    Sixteen cases of nontraumatic left atrial-esophageal fistulas have been reported previously. These fistulas usually result from chronic peptic esophagitis or cancer. The diagnosis is suggested by the triad of chronic dysphagia, hematemesis, and acute neurologic signs. There may be cardiac manifestations such as pericarditis, atrial fibrillation, or shock. An unusual feature of these fistulas is systemic embolization of food, air, or septic necrotic debris which may result in sudden central nervous system symptoms. All reported cases resulted in death due to hemorrhage, although there was often a variable time interval between the onset of hematemesis and the patient's death. The authors report two additional cases in which an episode of pericarditis preceded fistula development. Based on these 18 cases, the spectrum of esophagoatrial fistulas is reviewed, as well as the signs which may herald fistula development.
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ranking = 1
keywords = esophagitis
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12/30. Sudden death from perforation of a benign oesophageal ulcer into a major blood vessel.

    Two cases of sudden death due to perforation of a benign oesophageal ulcer into a major blood vessel are reported. In one man, anaemia and aspiration pneumonitis dominated the clinical picture. He had an oesophageal stricture and a chronic peptic ulcer associated with an incarcerated hiatus hernia. death was due to haemorrhage caused by perforation of the ulcer into the thoracic aorta. The second patient presented with confusion and falls, backache and indigestion. She had a hiatus hernia and a large benign chronic oesophageal ulcer. death was due to perforation of the ulcer into the left pulmonary vein. The cases are presented for their rarity, to illustrate the complex and late presentation of problems in geriatric medicine, and as a reminder that reflux oesophagitis can be dangerous.
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ranking = 1.0027544668321
keywords = esophagitis, reflux
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13/30. Tuberculous esophagitis with aortic aneurysm fistula.

    A patient with treated pulmonary tuberculosis and a thoracic aortic aneurysm was seen with a one-month history of dysphagia. barium swallow revealed a mass in the lower esophagus and extravasation of contrast material into the mediastinum. endoscopy and biopsy specimens showed acid-fast organisms. The patient was treated with antituberculous drug therapy but bled massively from the gastrointestinal tract and died. autopsy revealed an aortoesophageal fistula at the level of the thoracic aneurysm. Histopathological study confirmed that this rare tuberculous lesion of the esophagus caused the fistula.
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ranking = 4
keywords = esophagitis
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14/30. Right atrial-esophageal fistula and hydropneumopericardium after esophageal dilation.

    Esophagoatrial fistula formation is a rare and heretofore fatal event. A patient presented with esophageal reflux and stricture that later developed into a right atrial-esophageal fistula during biweekly esophageal dilation. Clinical recognition and surgical therapy led to a successful outcome. There were several unique features of this case, including fistulous connection to the right rather than the left atrium, concomitant hydropneumopericardium and esophagoatrial fistula, occurrence during esophageal dilation and surgical cure.
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ranking = 0.0027544668321368
keywords = reflux
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15/30. Esophageal-atrial fistula.

    We report an unusual case of an esophageal-atrial fistula in a patient with CREST (calcinosis, Raynaud's phenomenon, esophagitis, sclerodactyly, telangiectasia) variant of scleroderma. An ulcer in Barrett's esophagus perforated into the left atrium and led to systemic embolization and cerebral abscess. A review of similar reports of esophageal-atrial fistula reveals a symptom complex that includes chronic esophageal pathology, gastrointestinal bleeding, and neurological signs. An antemortem diagnosis has never been made.
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ranking = 1
keywords = esophagitis
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16/30. Tuberculous esophagitis with erosion into aortic aneurysm.

    An 87-year-old woman with a known atherosclerotic thoracic aneurysm died suddenly from a massive esophageal hemorrhage. Prior to death, tuberculous esophagitis was diagnosed by biopsy. At autopsy, a fistulous tract was found extending from the esophagus to the aortic aneurysm; this fistula proved to be the site of fatal hemorrhage. The tract was surrounded by a granulomatous inflammatory reaction, in which acid-fast bacilli were found. To our knowledge, this is the first reported case of tuberculous esophagitis extending to an aortic aneurysm resulting in hemorrhage and death.
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ranking = 6
keywords = esophagitis
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17/30. Esophageal-atrial perforation due to recurrent esophagitis 18 years after esophageal bypass surgery.

    A 62-year-old man presented with a grand mal seizure, progressive abdominal distention, and refractory hypotension 18 years after colonic bypass of a benign stricture of the low middle third of the esophagus. He died 3 hours after admission to the hospital. The patient had a history of liniment ingestion in childhood plus a long history of dysphagia and substernal pain. autopsy disclosed a large ulcer of the anterior wall of the distal esophagus, which had eroded through the posterior wall of the left atrium. Histologic examination revealed chronic esophagitis with fibrous obliteration of the esophageal wall, pericardium, and left atrial myocardium near the site of perforation. Foreign material was present within small arteries of multiple viscera, and in several of these fragments transverse striations were demonstrated. Esophageal-atrial perforation is a rare but fatal complication of chronic esophageal ulceration. The clinical and pathological features of this and previously reported cases of nontraumatic esophageal-atrial perforation are reviewed.
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ranking = 5
keywords = esophagitis
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18/30. esophageal perforation in a neonate associated with gastroesophageal reflux.

    This is the first report of a neonate with esophageal perforation in whom an association of gastroesophageal reflux (GER) was detected by esophagraphy and esophageal ph monitoring. The patient was successfully treated for both esophageal perforation of GER by thoracic drainage and fundoplication. In this patient, GER seemed a likely cause of esophageal perforation.
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ranking = 0.013772334160684
keywords = reflux
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19/30. Crohn's disease of the esophagus.

    In 1932 Crohn, Ginzburg, and Oppenheimer described a distinct pathologic and clinical entity characterized by a chronic inflammatory process of unknown etiology involving the terminal ileum. Since then, Crohn's disease has been recognized in all portions of the alimentary canal from mouth to anus. Crohn's disease of the esophagus is a rare process. Such a patient is reported with a review of the literature. A review of the English literature reveals reports of 20 patients with Crohn's disease of the esophagus. One-third of these patients had regional enteritis requiring resection. Esophageal stricture, stenosis, or fistula were frequent complications requiring resection. Regional esophagitis is difficult to distinguish from carcinoma, frequently leads to esophagitis, and is associated with a higher mortality rate than Crohn's disease in other portions of the alimentary tract.
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ranking = 2
keywords = esophagitis
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20/30. Esophagopericardial fistula in a scleroderma patient with peptic esophagitis.

    esophageal perforation from peptic ulceration is rare. A patient with scleroderma who had an esophagopericardial fistula caused by peptic esophagitis is described. The fistula mimicked an acute myocardial infarction.
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ranking = 5
keywords = esophagitis
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