Cases reported "Sigmoid Diseases"

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1/60. Bowel entrapment within pelvic fractures: a case report and review of the literature.

    Bowel entrapment within a pelvic fracture is a rarely reported but potentially fatal complication. diagnosis is often delayed due to difficulty in differentiating entrapment from the more common adynamic ileus. Computed tomography of the abdomen and pelvis with enteric contrast can be useful in making the diagnosis. We report an unusual case of bowel entrapment within a pelvic fracture presenting as a colocutaneous fistula in a patient with no prior symptoms that suggested a bowel injury. This report expands the realm of presentation of this rare occult bowel injury.
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ranking = 1
keywords = fistula
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2/60. Ovarian carcinoma with fistula formation to the sigmoid colon and ileum: report of a case.

    We describe herein an extremely rare case of clear cell type ovarian carcinoma resulting in fistula formation into the colon and intestine. The patient was a 61-year-old woman in whom a large tumor with extravasation from the sigmoid colon was found by barium enema examination. The tumor was preoperatively diagnosed as left ovarian cancer by angiography which showed the tumor feeder arising from the left ovarian and uterine arteries.
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ranking = 5
keywords = fistula
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3/60. Primary aortosigmoid fistula treated by descending thoracic aortofemoral bypass.

    Primary aortoenteric fistula is a rare disease with a fatal outcome unless it is diagnosed accurately and treated surgically. We present an elderly patient with primary aortosigmoid fistula confirmed by endoscopy. Descending thoracic aortofemoral bypass was performed and the aortoiliac aneurysm and sigmoid colon were then resected in continuity. The patient maintains a good quality of life 6 years after the operation with good graft patency and no sign of graft infection.
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ranking = 6
keywords = fistula
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4/60. Colovesical fistula an unusual complication of cytotoxic therapy in a case of non-Hodgkin's lymphoma.

    A 65-year old man, a known case of non-Hodgkin's lymphoma of base of the tongue and epiglottis presented with complaints of pneumaturia and faecaluria. He had received the first cycle of cytotoxic therapy (CHOP-regimen). At the end of the cycle he developed febrile neutropenia (circulating granulocyte count <1500/mm3). Cystogram showed air in the bladder area and a fistulous communication to a cavity behind the bladder. CT-scan showed air in the bladder, a fistulous communication between the sigmoid colon and bladder along with an intervening small abscess cavity. On exploration a fistulous communication between the sigmoid and bladder along with an intervening small abscess cavity was found. Resection of involved portion of sigmoid and end to end anastomosis along with a diverting colostomy was done. The bladder was closed in two layers with an omental interposition between it and the sigmoid along with a suprapubic cystostomy. The histopathology demonstrated only inflammatory response without any evidence of malignancy or diverticular disease.
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ranking = 4
keywords = fistula
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5/60. Coexisting aortocolic and aortovesical fistulae in an abdominal aortic aneurysm: report of a case.

    Aortoenteric fistula is a rare complication in abdominal aortic aneurysms (AAA), and an aortovesical fistula is even more rare. This is a report of a case of aortocolic and aortovesical fistulae in a 64-year-old man with AAA who was treated with an aortobiiliac bypass, a primary repair of the fistulated bladder, and a sigmoid colostomy.
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ranking = 8
keywords = fistula
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6/60. Sigmoidoduodenal fistula as a rare complication of colonic carcinoma: report of a case.

    We report a very unusual case of malignant sigmoidoduodenal communication. To the best of our knowledge, this is the first documentation of this entity in the English language literature. A 76-year-old man presented with weakness, severe weight loss, foul-smelling eructations, anemia, constipation, and episodes of diarrhea. A sigmoidoduodenal fistula was found by barium enema, and a diagnosis of ulcerative colonic adenocarcinoma was made from the colonoscopy findings. Thus, we performed sigmoid colectomy with resection of the fistula and the involved anterior wall of the third duodenal part, followed by primary closure of the duodenal defect. Histological examination confirmed a Dukes' B (Stage II - T(4)N(0)M(0)) colonic adenocarcinoma, and the excision margins of the resected duodenal specimen were clear. We gave adjuvant chemotherapy with 5-fluorouracil and leucovorin. The patient is still alive and disease-free, 2 years postoperatively.
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ranking = 6
keywords = fistula
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7/60. Enterovesical fistula caused by inflammatory bowel diseases.

    Enterovesical fistula caused by inflammatory bowel diseases is a rare disorder. Two male patients with recurrent cystitis had sigmoid colon diverticulitis causing enterovesical fistula. One female patient with Crohn's disease developed enterovesical fistula with abdominal and urinary symptoms. In each patient, a barium enema revealed causative bowel diseases. The precise diagnosis of enterovesical fistula was made either by cystography or cystoscopy. One-stage resection of the inflamed bowel with fistula and affected the bladder wall was proved to be an effective treatment for these three patients, while a long term follow up is specifically necessary in the patient with Crohn's disease.
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ranking = 9
keywords = fistula
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8/60. empyema resulting from a true colopleural fistula complicating a perforated sigmoid diverticulum.

    Empyemas developing after traumatic rupture of intraabdominal organs have been previously reported. We report a case of a true nontraumatic colopleural fistula following surgery for spontaneous rupture of a sigmoid diverticulum. The diagnosis was suspected by the presence of an air-containing tract seen in a computerized tomogram of chest and abdomen and was established with a contrast study. The empyema cavity was initially drained, followed by a laparotomy and fistulectomy with primary large bowel anastomosis and loop ileostomy. Although rare, colopleural fistulas present a diagnostic challenge and delayed management can lead to increased morbidity.
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ranking = 6
keywords = fistula
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9/60. Late sequelae of hysterectomy and diverticulosis: colovaginal fistulae.

    Three cases of colovaginal fistulae were recently diagnosed and treated. Colovaginal fistulae are not commonly reported and their diagnosis may be difficult to make. Our cases presented with a complaint of vaginal discharge, history of hysterectomy, and diagnosis of diverticulosis. The diagnosis and treatment of colovaginal fistulae are discussed.
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ranking = 7
keywords = fistula
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10/60. Unusual presentations of aorto-enteric fistula.

    BACKGROUND: Aorto-enteric fistula is rare but can result in exsanguination without timely surgery or endovascular stent placement. methods: Four cases of aorto-enteric fistula were reviewed in which the presentation was unusual and diagnosis difficult. OBSERVATIONS: The first patient had an aorto-sigmoid fistula in the setting of an aorto-bi-femoral graft. Two patients had a primary aorto-enteric fistula, one to the stomach from a suprarenal aortic aneurysm, and the other, to the duodenum in the setting of retroperitoneal spread of renal cancer. The aortoduodenal fistula recurred in the 4th patient within 3 months of surgical repair; this patient is the only one who survived long term. CONCLUSIONS: When presentation is atypical, the diagnosis of aorto-enteric fistula can be extremely difficult. Because investigative studies are not consistently useful in making a definitive pre-operative diagnosis, a strong index of clinical suspicion and a willingness to consider surgical exploration are essential for timely and successful management.
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ranking = 10
keywords = fistula
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