Cases reported "Fistula"

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1/171. Haemosuccus pancreaticus: a clinical challenge.

    BACKGROUND: Haemosuccus pancreaticus is a rare complication of pancreatitis. It is a diagnostic problem for even the most astute clinician and a challenge for the expert endoscopist. We report a 25-year-old male patient who had all the features usually seen in haemosuccus pancreaticus patients: recurrent obscure upper gastrointestinal bleeding, pancreatitis, pseudocyst formation, ductal disruption, fistula and pancreatic ascites. The patient was treated by subtotal pancreatectomy, splenectomy and drainage of the pseudocyst. Although pancreatic duct communication with the surrounding vasculature could not be ascertained, we strongly believe the patient had haemosuccus pancreaticus because, over a follow-up period of 3 years, the patient was not only ascites free, but did not experience any further upper gastrointestinal bleeding. We believe that in evaluating patients with recurrent obscure gastrointestinal bleeding, one should always remember that the pancreas is a part of the gastrointestinal tract and, like other organs, is prone to blood loss.
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2/171. A previously unreported surgical technique utilizing five different grafting materials to successfully achieve simultaneous alveolar regeneration and closure of a large oronasal defect.

    This case report describes the successful surgical and restorative management of an unusual cyst-granuloma combination that had expanded to perforate the labial and nasal parts of the maxillary bone. Enucleation and curettage of the lesions resulted in a large oronasal communication that presented a reconstructive challenge. Five different graft and/or barrier materials were used to close the oral and nasal openings and to regenerate the alveolus for implant placement and for aesthetic prosthetic restoration.
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3/171. Congenital malformation of the inner ear associated with recurrent meningitis.

    Congenital deformities of the labyrinth of the inner ear can be associated with meningitis and varying degrees of hearing loss or deafness. A recurrence of meningitis is due to the development of a fistulous communication between the subarachnoid space and the middle ear cavity, and can prove lethal. An illustrative case of a 4-year-old Japanese girl with bilateral severe hearing loss, recurrent meningitis and malformations of the inner ear and stapes footplate is presented. Removal of the stapes during tympanotomy provoked a gush of cerebrospinal fluid. The defect was repaired successfully, and there has been no further episodes of meningitis to date.
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4/171. Two cases of seminal vesicle fistula.

    Two cases of fistulation into the seminal vesicles are described. One related to Crohn's disease and the other following surgery for carcinoma of the rectum. Both cases were diagnosed by CT sinography. This technique is described and is recommended when attempting to demonstrate the internal communications of difficult perineal fistulae when standard techniques of fistulography fail.
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5/171. Thoracoscopic surgery and pleurodesis for pleuroperitoneal communication in patients on continuous ambulatory peritoneal dialysis.

    Two patients on continuous ambulatory peritoneal dialysis (CAPD) developed right massive hydrothorax and were diagnosed as having pleuroperitoneal communication. Thoracoscopic surgery and pleurodesis were performed. It showed that one was caused by multiple flaws in the diaphragm and that the other was attributable to multiple blebs in the diaphragmatic dome. After the procedure, both of them had no recurrence of hydrothorax and underwent CAPD safely. We recommend thoracoscopic surgery and pleurodesis as the first choice of therapeutic methods for pleuroperitoneal communication.
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6/171. Multiple spontaneously occurring coronary artery-left ventricular communications: a case report.

    A search of the literature revealed that spontaneous coronary artery-left ventricular communications have only rarely been reported. These fistulae are frequently associated with angina pectoris which has been attributed to a ventricular steal phenomenon. The patient described herein presented with angina pectoris and was found to have multiple coronary arterioventricular communications without significant coronary atherosclerosis.
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7/171. Colosalpingeal fistula: a rare complication of colonic diverticular disease.

    Diverticular disease is a common condition in Western countries. The formation of inflammatory fistulae, usually from sigmoid colon to bladder or vagina, can be a feature of complicated cases of the disorder and is normally an indication for surgical intervention. We present a case of colosalpingeal fistulation occurring secondary to diverticulitis, a complication which, to our knowledge, has not been previously reported in the radiological literature. As in this instance, the initial clinical presentation of this problem can often be non-specific, with localising symptoms occurring later. In our case, barium enema examination allowed good demonstration of the fistulous communication before the more specific symptoms were clinically apparent.
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8/171. Bronchoperitoneal fistula secondary to chronic klebsiella pneumoniae subphrenic abscess.

    We treated a case of bronchoperitoneal fistula secondary to a klebsiella pneumoniae subphrenic abscess. This fistulous communication and the surgical procedure used to treat it are described.
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9/171. Congenital pleuroperitoneal communication in a patient with pseudomyxoma peritonei.

    BACKGROUND AND OBJECTIVES: pseudomyxoma peritonei syndrome is a rare disease arising from a perforated appendiceal adenoma. The syndrome is characterized by progressive accumulation of mucinous ascites and tumor within the peritoneal cavity. Direct extension of pseudomyxoma peritonei to the pleural cavity is uncommon and has been associated with surgical penetration of the diaphragm at the time of cytoreduction. methods: We review the case of a patient who presented with mucoid peritoneal and pleural fluid consistent with spontaneous pleural spread of pseudomyxoma peritonei. RESULTS: Surgical exploration confirmed direct pleuroperitoneal communication by macroscopic diaphragmatic fenestration. CONCLUSIONS: This is a rare phenomenon. We outline a therapeutic approach to be applied when pleural involvement is suspected in patients with pseudomyxoma peritonei syndrome.
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10/171. Iatrogenic main pulmonary artery-left atrial fistula in a child.

    A 14-month-old boy who underwent operation for ventricular septal defect patch closure and debanding of the pulmonary artery presented with arterial desaturation in the early postoperative period. angiography confirmed the echocardiographic findings of hemodynamically significant main pulmonary artery-left atrial fistula. This communication was successfully closed surgically.
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