Cases reported "Fistula"

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1/8. vocal cord paralysis and oesophago-broncho-aortic fistula complicating foreign body-induced oesophageal perforation.

    A 61 year old man died after presenting with a 24 h history of haematemesis and haemoptysis, and one year history of hoarseness of voice. Post-mortem examination showed a dental plate eroding through the mid-oesophagus into a bronchus and into the descending arch of the aorta, with scarring suggestive of old perforation. An organized haematoma also involved the left recurrent laryngeal nerve. Vocal cord paralysis may be a manifestation of foreign body-induced oesophageal perforation, which can lead to death from an oesophago-broncho-aortic fistula. Both complications of oesophageal perforation from a foreign body have not to our knowledge been previously reported.
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ranking = 1
keywords = haematemesis
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2/8. Fatal haematemesis in childhood associated with aorto-oesophageal fistula.

    A case of fatal haematemesis associated with a non-traumatic, non-tuberculous aorto-oesophageal fistula in a 9-year-old Nigerian boy is presented. autopsy revealed two inflamed and ulcerated mild-oesophageal pulsion diverticula, one of which had eroded into the right pleura as a sinus track. The second diverticulum had perforated and caused mediastinitis and eventually aorto-oesophageal fistula which led to the fatal haematemesis. A mild chest injury is seen as a precipitating factor of the haematemesis and not the initiator of the pathology.
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ranking = 7
keywords = haematemesis
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3/8. Aortoduodenal fistula revisited.

    Two new cases of primary aortoduodenal fistula (ADF), one associated with an arteriosclerotic aneurysm and the other without, are presented and 4 cases of primary ADF without aneurysm published between 1972 and 1985 are reviewed. The anatomic relationship of the distal part of the duodenum to the infrarenal segment of the aorta, arteriosclerosis, mechanical trauma, infection and sepsis are prominent factors in the pathogenesis of ADF irrespective of its type. Intermittent haematemesis and/or melaena are the main presenting symptoms in all variants of ADF and awareness of the existence of this condition is essential for its early detection. Upper gastrointestinal endoscopy including examination of the distal part of the duodenum and explorative laparotomy are important tools in the preoperative diagnostic workup specially in primary ADF without previous knowledge of the presence of an aneurysm.
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ranking = 1
keywords = haematemesis
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4/8. Fatal haematemesis arising from benign oesophagoatrial fistula.

    An 86 year old woman with a Barrett's oesophagus, a benign oesophageal stricture, and a benign ulcer developed an oesophagoatrial fistula. As in previously reported cases, she died after a massive haematemesis.
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ranking = 5
keywords = haematemesis
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5/8. Left ventriculo-colic fistula--a late complication of colonic interposition for the oesophagus.

    An 18 year old man developed recurrent haematemesis 12 years after colonic interposition for corrosive injury to the oesophagus. A colonic ulcer close to the cologastric anastomosis appeared to have fistulated into the cavity of the left ventricle. This so far unreported complication needs to be considered when patients who have had coloesophageal substitution present with gastrointestinal bleeding.
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ranking = 1
keywords = haematemesis
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6/8. Fatal haematemesis from an aorto-oesophageal fistula of obscure aetiology: a case report.

    endoscopy, aortography and laparotomy failed to demonstrate a high aorto-oesophageal fistula of obscure aetiology in a woman presenting with haematemesis. Recognition of Chiari's triad: mid-thoracic pain, sentinel arterial haemorrhage, and final exsanguination after a symptom-free interval, and therapeutic embolization as a mode of therapy, are discussed.
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ranking = 5
keywords = haematemesis
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7/8. Aorto-colonic fistula as a late complication of colon interposition for oesophageal atresia.

    A 22-year-old man developed severe haematemesis 21 years after colon interposition for long-gap oesophageal atresia. A fistula, from an anastomotic ulcer to the descending thoracic aorta, was discovered and treated successfully by surgical resection. This previously unreported complication highlights the need for the prevention of peptic complications following oesophageal replacement in children.
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ranking = 1
keywords = haematemesis
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8/8. Aortoduodenal fistula.

    A primary aortoduodenal fistula is usually associated with an atherosclerotic aortic aneurysm, and a secondary fistula with a leaking anastomotic aortic suture line. Two examples of each are reported. The typical features of a primary fistula are haematemesis or melaena, pain, and a pulsatile abdominal mass; the features of a secondary fistula are haematemesis and melaena with a past history of aortic resection. The initial haemorrhage is rarely fatal: a lag period allows urgent laparotomy. The fistula is diagnosed by dissection of the fourth part of the duodenum from the aorta. The treatment is closure of the duodenum, and resection of an aneurysm if present. Reconstruction is by a graft anastomosed to the aorta proximal to the fistula, if the area is clean, or by an extra anatomical bypass, if the area is heavily contaminated.
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ranking = 2
keywords = haematemesis
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