Cases reported "Gastric Fistula"

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1/20. Successful surgical treatment of aortogastric fistula after an esophagectomy and subsequent endovascular graft placement: report of a case.

    An aortogastric fistula is a rare but fatal complication after an esophagectomy and intrathoracic esophagogastric anastomosis. A 54-year-old man underwent an esophageal resection due to carcinoma in his lower esophagus. The alimentary tract continuity was restored by intrathoracic esophagogastric anastomosis. Forty-six days later, he suffered a massive hematemesis due to an aortogastric fistula which had formed at the esophagogastric suture line. The fistula was surgically obliterated twice, but each operation was followed by pseudoaneurysm formation. The patient was finally successfully treated with an endovascular stent graft placement. This is the first report of a patient surviving after developing this complication.
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2/20. Gastric tube-to-tracheal fistula closed with a latissimus dorsi myocutaneous flap.

    A gastric tube-to-airway fistula is a very rare complication after esophageal reconstruction. A patient with a gastric tube-to-tracheal fistula that developed more than 9 years after surgery for cancer of the cervical esophagus was treated with transposition of a pedicled latissimus dorsi myocutaneous flap. Careful perioperative respiratory management helped save the patient's life.
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3/20. A rare complication of surgical management for esophageal tumor: a non neoplastic belated fistula between stomach and main right bronchus.

    The fistula between stomach and bronchus after surgery for cancer of the esophagus is a rare occurrence. We describe a gastric non neoplastic ulceration that arose late after six years from an esophagectomy, with an end-side cervical esophagogastrostomy, for a spino-cellular carcinoma. After the partial failure of surgical technique, of the endoscopic treatment and for the bad general conditions of patient we decided to treat the fistula by transluminal drainage. This technique involved a progressive resolution of the fistula, becoming, nowadays, in our division, the preferred treatment for these kinds of postoperative complications.
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keywords = esophagus
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4/20. A new variant of esophageal atresia with distal tracheo-antral fistula associated with congenital intrathoracic stomach and situs inversus.

    esophageal atresia (EA) with distal tracheoesophageal fistula (TEF) is the most common anatomic pattern within congenital anomalies of the esophagus. Also, more than 50% of the infants with esophageal atresia have other congenital malformations. To our knowledge, this is the first case report of EA with distal tracheo-antral fistula associated with congenital intrathoracic stomach and situs inversus (SI).
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5/20. Bronchogastric fistula successfully treated with the insertion of a covered bronchial stent.

    We present what we believe to be the first case of a bronchogastric fistula successfully treated with a plastic-covered metallic bronchial stent. This developed 5 years after a transhiatal oesophagectomy with gastric pull-up for carcinoma of the oesophagus. The successful outcome in this case suggests that this method of treatment should be considered in patients in whom this post-operative complication cannot be managed easily by other means.
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keywords = esophagus
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6/20. Communicating bronchopulmonary foregut malformations: classification and embryogenesis.

    Communicating bronchopulmonary foregut malformations (CBPFMs) are characterized by a fistula between an isolated portion of respiratory tissue (ie, a lung, a lung lobe, or a segment) and esophagus or stomach. We combine our 30-year (1959 to 1989) experience of 6 cases with 51 reported patients to propose a CBPFM classification supported by a proposed embryogenesis theory. Group I (16%): anomaly is associated with esophageal atresia and tracheoesophageal fistula. Group II (33%): one lung originates from the lower esophagus. Group III (46%): an isolated anatomic lung lobe or segment communicates with the esophagus or stomach. Group IV (5%): A portion of the normal bronchial system communicates with the esophagus. The portion of the lung served by the communicating bronchus receives systemic blood supply. The right and left lung sacs curve dorsally to embrace the lower esophagus during normal lung development. At this stage a part of the lung bud joins the esophagus. This segment then breaks away from the main pulmonary anlage to form a CBPFM. CBPFMs should be considered in the workup of infants with respiratory distress and/or recurrent pneumonias. patients with suspected pulmonary sequestration should undergo contrast studies to exclude a gastrointestinal communication.
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keywords = esophagus
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7/20. peptic ulcer-induced acute aortogastric fistula occurring 7 years after a pharyngogastrostomy following a resection for carcinoma of the esophagus: report of a case.

    A 46-year-old woman underwent a pharyngogastrostomy, following a laryngoesophagectomy for esophageal carcinoma. Although she had been disease-free for 7 years, she subsequently was admitted to undergo a workup due to fever along with chest and back pain. A few days after admission, the patient suddenly vomited a large volume of blood and went into shock. Bleeding was stopped with a Sengstaken-Blakemore tube, and an emergency thoracotomy was performed. A fistula between the thoracic aorta and an ulcer of the gastric tube was identified. We decided to close the aortic lesion directly because the adhesions were extremely dense and her blood circulation was poor. One week later, we resected the thoracic part of the gastric tube, debrided the fistula, and wrapped the aortic lesion with a patch. However, on the 18th postoperative day, she developed massive hematemesis due to rupture of an infected pseudoaneurysm in the thoracic aorta and died.
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keywords = esophagus
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8/20. Benign gastro-bronchial fistula - an uncommon complication of esophagectomy: case report.

    BACKGROUND: Gastro-bronchial fistula (GBF) is a rare and devastating complication following esophagectomy. Making the correct diagnosis is difficult and there is no agreement on the treatment for this rare condition. CASE PRESENTATION: We report the case of a 56-year-old man who presented with features of repeated aspiration and chest infections six years following an esophagectomy for Barrett's esophagus. Despite extensive investigations the cause of symptoms was difficult to determine. The correct diagnosis of fistula from stomach to right main stem bronchus was made at bronchoscopy under general anesthesia. After ruling out local recurrence of cancer, a successful primary repair was carried out by resection of fistula and direct repair of gastric conduit and bronchus. He is well after 6 months of treatment. CONCLUSION: Late development of gastro-bronchial fistula is a rare complication of esophageal resection that may be difficult to diagnose.Surgical resection and direct closure is the treatment of choice, although the method of treatment should be tailored according to the anatomy of the fistula and the patient's condition.
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ranking = 1
keywords = esophagus
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9/20. Gastropericardial fistula and candida kruzei pericarditis following laparoscopic Nissen fundoplication (gastropericardial fistula).

    We report a case of gastropericardial fistula and candida kruzei pericarditis one year after laparoscopic Nissen fundoplication. Chest X-ray and CT revealed pneumopericardium. barium swallow, UGI, endoscopy, and bronchoscopy were negative. Pericardial exploration was performed through a sternotomy. Intraoperative fistulogram revealed a tract into the stomach. A midline abdominal incision allowed identification of the slipped Nissen, resection of the fistula tract, and subsequent re-do fundoplication. The patient was treated with amphotericin and remains symptom-free 10 months after her operation. We recommend both sternotomy and midline abdominal incisions to explore and access the pericardium, stomach, esophagus, and diaphragm.
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keywords = esophagus
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10/20. Bronchopulmonary foregut malformations. A unifying etiological concept.

    Two cases of congenital bronchopulmonary foregut malformation are reported and another 27 cases reviewed and the findings analyzed. The left lower lobe and the entire right lung are the most common locations of pulmonary involvement. The distal portion of the esophagus or cardioesophageal junction was the most common site of communication (83%). The majority of the patients (60%) presented in the first eight months of life, and the incidence in females was nearly twice that in males. Chronic cough, recurrent pneumonias and respiratory distress were the most common clinical findings, whereas two patients were totally asymptomatic. The esophagogram was the single most useful diagnostic procedure (82%). The microscopic structure of the congenital fistula resembled esophagus, bronchus or both. Surgical treatment was curative in most instances. Sime deaths occurred prior to corrective surgery, whereas the postoperative deaths in most instances were related to severe associated congenital anomalies. We believe a common embryologic pathogenesis leads to the formation of a variety of bronchopulmonary foregut malformations. These bronchopulmonary foregut malformations include intralobar and extralobar sequestrations, pulmonary sequestration with patent, or involuted--partial or complete--gastroesophageal communication, esophageal or gastric diverticula, and esophageal or bronchogenic duplication cysts.
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keywords = esophagus
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