11/374. Gracilis transposition in complicated perianal fistula and unhealed perineal wounds in Crohn's disease.OBJECTIVE: To assess the efficacy of transposition of gracilis muscle in the treatment of chronic recurrent fistulas and unhealed perineal wounds after proctectomy in patients with Crohn's disease. DESIGN: Retrospective study. SETTING: Academic clinic, united states. SUBJECTS: 7 patients with Crohn's disease: 3 had unhealed perineal wounds and persistent sinuses; 2 had had several attempts to repair rectovaginal fistulas; 1 had a rectourethral fistula; and 1 a pouch vaginal fistula. INTERVENTION: Transposition of the gracilis muscle. MAIN OUTCOME MEASURE: Healing. RESULTS: Mean follow up was 18 months (range 3-30). All patients operated on for unhealed perineal wounds had healed completely within 3-6 months. The patients with a rectovaginal fistula and a rectourethral fistula had both healed by 1 month postoperatively. Two fistulas recurred, and the small pouch-vaginal fistula remained but was asymptomatic. CONCLUSIONS: Transposition of the gracilis is a viable option for the treatment of persistent sinus and unhealed perineal wound after proctectomy for Crohn's disease. It could also be an option before proctectomy for patients with other types of Crohn's-related or complicated fistulas for whom other treatments have failed. A larger series will be required before a definite conclusion can be drawn.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
12/374. A case of cancerous familial adenomatous polyposis in urinary bladder due to migration of colonic mucosa through rectovesical fistula.The patient was a 50-yr-old man who had undergone low anterior resection for rectal cancer at the age of 24 yr in 1966. At that time, gastric and colonic polyposis were indicated. Postoperative anastomotic dehiscence occurred and, by 1985, a rectovesical fistula had formed. In 1986, when the patient was 44 yr old, he was examined at our hospital for constriction of the rectum due to the rectovesical fistula. Abdominoperineal excision of rectum and surgical closure of the fistula were performed, and the patient was kept under observation because of a diagnosis of familial adenomatous polyposis. In 1988, when the patient was 46 yr old, early ascending colon cancer was discovered and total colectomy was performed. Then, in December, 1991, gross hematuria was found. Further examination revealed a tumor on the posterior wall of the urinary bladder lumen, and biopsy showed adenocarcinoma. Pelvic recurrence of the rectal cancer was diagnosed, and total pelvic exenteration was performed. There were no distant metastases; histologically, the tumor of the bladder was thought to be due to colonic mucosa of familial adenomatous polyposis that had migrated to the bladder lumen via the rectovesical fistula and had become cancerous.- - - - - - - - - - ranking = 10598.547086099keywords = urinary, fistula (Clic here for more details about this article) |
13/374. Rare case of left-sided ureteroduodenal fistula.BACKGROUND/AIMS: Ureteroduodenal fistulas are rare and only 11 cases have been reported in the literature since 1918. diagnosis requires careful observation of symptoms. methods: The case presented demonstrates a 68-year-old female with left-sided ureteroduodenal fistula confirmed by CT scan. A duodenal fistula was localized and an atrophic left kidney was identified and repaired. RESULTS: Nephroureterectomy was performed and an omental patch was used for the repair. No complications were encountered during the postoperative course. CONCLUSIONS: Recurrent chronic urinary tract infection, pyuria and hematuria can indicate this rare disease. Early testing and detection can improve the chances of renal preservation.- - - - - - - - - - ranking = 2120.1248018351keywords = urinary, fistula (Clic here for more details about this article) |
14/374. Ureterovaginal fistula following laparoscopic-assisted vaginal hysterectomy--a case report with review of literature.The authors present a case of ureterovaginal fistula following laparoscopy-assisted vaginal hysterectomy, which was successfully managed by ureteroneocystostomy with bladder psoas hitch.- - - - - - - - - - ranking = 0.38461538461538keywords = fistula (Clic here for more details about this article) |
15/374. Congenital urethrocutaneous fistula.Congenital urethral fistula is an extremely rare but easily manageable anomaly that may be confused with hypospadias. This is a case description of a congenital fistula of the anterior urethra. awareness of the entity will avoid complications.- - - - - - - - - - ranking = 0.46153846153846keywords = fistula (Clic here for more details about this article) |
16/374. Nephroenteric fistula treated with fulguration of the fistulous tract.We report the management of a nephroenteric fistula with percutaneous fulguration in a patient with recurrent pyelonephritis and urolithiasis. A nephrostogram at 6 weeks and retrograde pyelogram at 18 weeks after fulguration showed no evidence of a recurrent fistula. We believe this to be the first reported case of a nephroenteric fistula treated successfully with fulguration.- - - - - - - - - - ranking = 0.53846153846154keywords = fistula (Clic here for more details about this article) |
17/374. Urethrocutaneous fistula due to a retained ring of condom.Hidden foreign bodies have been described as a rare cause of both strangulation of the glans penis and urethrocutaneous fistula. We present the case of a 30-year-old man who developed a urethrocutaneous fistula and penile shaft necrosis after a condom broke during intercourse. Neither the patient nor several physicians could identify the retained ring of condom, which had been buried under newly epithelialized skin. He underwent removal of the foreign body under general anesthesia, followed 5 months later by a formal urethrocutaneous fistula repair.- - - - - - - - - - ranking = 0.53846153846154keywords = fistula (Clic here for more details about this article) |
18/374. Repair of traumatic urethral fistula and huge tissue defect with Lehoczky's island flap.A 20-years-old male patient suffered pelvic bone fracture and a penetrating urethral injury through the perineum due to a car accident. The injury and the unsuccessful reconstruction resulted in a large perineal tissue defect, urethral fistula, and dislocation of the anus close to the fistula. The authors performed a successful reconstruction; closure of the urethral fistula, sinking of the anus to its proper place, and substitution of the missing skin and subcutaneous tissue with Lehoczky's flap. The flap with its good blood supply and mass of tissue repaired the defect and promoted the rapid, functionally and cosmetically excellent result.- - - - - - - - - - ranking = 0.53846153846154keywords = fistula (Clic here for more details about this article) |
19/374. Cutaneous nephrocolonic fistula as a consequence of a kidney stone.We report an unusual case of cutaneous nephrocolonic fistula caused by a renal calculus with perirenal infection. The diagnosis was made by fistulography and computed tomography, after which nephrectomy and resection of the descending colon were successful. We also review the literature on cutaneous nephrocolonic fistulas.- - - - - - - - - - ranking = 0.46153846153846keywords = fistula (Clic here for more details about this article) |
20/374. Congenital urethrocutaneous fistula.BACKGROUND: A 3-year-old boy visited our hospital for aberrance of urination. He had a fistula on his ventral penile shaft. Our diagnosis was congenital urethrocutaneous fistula. methods/RESULTS: We performed one-stage repair transverse preputial onlay island flap urethroplasty. Postoperatively, the patient was voiding comfortably with no recurrence of fistula. CONCLUSIONS: Congenital urethrocutaneous fistula is rare. Eighteen cases of congenital urethrocutaneous fistula have been reported previously. We consider the etiology of congenital urethrocutaneous fistula as a deficiency of the urethral plate and fusion of urethral folds.- - - - - - - - - - ranking = 0.76923076923077keywords = fistula (Clic here for more details about this article) |
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