Cutaneous Fistula
Fistula
Arteriovenous Fistula
Intestinal Fistula
Bronchial Fistula
Vascular Fistula
Rectal Fistula
Urinary Fistula
Esophageal Fistula
Biliary Fistula
Cardiocutaneous fistula. (1/133)
Infection of the Teflon pledgets on the heart suture line after left ventricular aneurysm repair, presenting late with a fistulous tract connecting the heart with the skin (cardiocutaneous fistula) is an uncommon but potentially serious condition. The case is reported of a 73 year old man who developed a cardiocutaneous fistula extending through the left hemidiaphragm and draining at the abdominal wall, which developed six years after left ventricular aneurysmectomy. Following radiographic evaluation, which established the diagnosis, the Teflon pledgets and fistulous tract were successfully surgically removed. Prompt diagnosis depends on a high index of suspicion. Eradication of infection requires excision of infected material, which must be planned on an individual basis. (+info)Infliximab for the treatment of fistulas in patients with Crohn's disease. (2/133)
BACKGROUND: Enterocutaneous fistulas are a serious complication of Crohn's disease and are difficult to treat. Infliximab, a chimeric monoclonal antibody to tumor necrosis factor alpha, has recently been developed as a treatment for Crohn's disease. We conducted a randomized, multicenter, double-blind, placebo-controlled trial of infliximab for the treatment of fistulas in patients with Crohn's disease. METHODS: The study included 94 adult patients who had draining abdominal or perianal fistulas of at least three months' duration as a complication of Crohn's disease. Patients were randomly assigned to receive one of three treatments: placebo (31 patients), 5 mg of infliximab per kilogram of body weight (31 patients), or 10 mg of infliximab per kilogram (32 patients); all three were to be administered intravenously at weeks 0, 2, and 6. The primary end point was a reduction of 50 percent or more from base line in the number of draining fistulas observed at two or more consecutive study visits. A secondary end point was the closure of all fistulas. RESULTS: Sixty-eight percent of the patients who received 5 mg of infliximab per kilogram and 56 percent of those who received 10 mg per kilogram achieved the primary end point, as compared with 26 percent of the patients in the placebo group (P=0.002 and P=0.02, respectively). In addition, 55 percent of the patients assigned to receive 5 mg of infliximab per kilogram and 38 percent of those assigned to 10 mg per kilogram had closure of all fistulas, as compared with 13 percent of the patients assigned to placebo (P=0.001 and P=0.04, respectively). The median length of time during which the fistulas remained closed was three months. More than 60 percent of patients in all the groups had adverse events. For patients treated with infliximab, the most common were headache, abscess, upper respiratory tract infection, and fatigue. CONCLUSIONS: Infliximab is an efficacious treatment for fistulas in patients with Crohn's disease. (+info)Thyroglossal duct cysts: sonographic appearances in adults. (3/133)
BACKGROUND AND PURPOSE: Previous reports have suggested that thyroglossal duct cysts (TDCs) appear on sonograms as well-defined cystic masses with thin walls and posterior enhancement. In our experience, however, TDCs have a variable sonographic appearance. We report our findings in 40 patients with TDCs and document the variability of sonographic patterns. METHODS: All patients in whom the diagnosis of TDC was made clinically (by at least two head and neck surgeons) and sonography detected a cystic mass related to the hyoid bone were included in this study. Sonograms of 40 patients with TDCs were reviewed. The features evaluated were the location, internal echogenicity, posterior enhancement, presence of septa, solid component, and fistulous tract. The echo pattern was not compared with the biopsy results. RESULTS: Four patterns of TDCs were identified: anechoic (28%), homogeneously hypoechoic with internal debris (18%), pseudosolid (28%), and heterogeneous (28%). The majority showed posterior enhancement (88%), were midline (63%), and infrahyoid in location (83%). Only half of all TDCs showed a typical thin wall. CONCLUSION: On sonograms, TDCs in adults are not simple cysts, as previously suggested, but have a complex pattern ranging from a typical anechoic to a pseudosolid appearance. (+info)Hydrogen peroxide enhanced ultrasound- fistulography in the assessment of enterocutaneous fistulas complicating Crohn's disease. (4/133)
BACKGROUND/AIMS: Proper management of enterocutaneous fistulas complicating Crohn's disease largely depends on the anatomical characteristics of the sinus tracks as well as the coexistence of complications such as abscesses and distal bowel stenosis. The aim of this prospective study was to evaluate the accuracy of a new technique (hydrogen peroxide enhanced ultrasound (US)-fistulography) compared with conventional x ray fistulogram and/or surgical findings in the detection of Crohn's disease associated enterocutaneous fistulas. METHODS: Patients with known Crohn's disease and a suspicion of enterocutaneous fistulas were prospectively studied with this novel technique, conventional x ray fistulogram, and barium radiography as well as with computed tomography whenever an abdominal abscess was suspected at US. In those undergoing surgery, intraoperative findings were also compared. RESULTS: Seventeen of 502 (3.4%) consecutive patients with Crohn's disease seen over a ten month period had associated enterocutaneous fistulas and were enrolled. Hydrogen peroxide enhanced US-fistulography visualised the extent and configuration of fistula in all cases: 13 patients had a fistula arising from the ileum and two from the sigmoid colon, whereas in two there was no evidence of communication with intestinal loops; in contrast, conventional x ray fistulography missed a correct definition of the fistulous branches or communication with intestinal loops in 50% (4/8) and 36% (4/11) of patients respectively; barium radiography showed fistulas in two cases only. The presence of abscesses along or close to the sinus track, as well as the coexistence of intestinal stenosis, was correctly detected at US in all patients. CONCLUSIONS: Hydrogen peroxide enhanced US-fistulography could be considered the diagnostic procedure of choice in Crohn's disease associated enterocutaneous fistulas, as it is at least as accurate, simple, and safe as conventional x ray fistulogram, does not miss coexisting abdominal complications, and also provides information on the diseased bowel segments. In addition, it can be easily repeated over time in order to monitor the course of fistulas undergoing conservative treatment. (+info)Persistent frontal fistula. (5/133)
The frontal sinus is prone to various complications--usually secondary to blockage of the fronto-nasal duct and stagnation of frontal sinus secretions. These pent-up secretions may result in pressure necrosis of the inferior or posterior sinus wall. Involvement of anterior wall is uncommon. We present a case of an anterior wall frontal sinus fistula and discuss its management. (+info)Possibilities of preventing osteoradionecrosis during complex therapy of tumors of the oral cavity. (6/133)
In recent years, there has been a dramatic increase in the number of tumors of the head and neck. Their successful treatment is one of the greatest challenges for physicians dealing with oncotherapy. An organic part of the complex therapy is preoperative or postoperative irradiation. Application of this is accompanied by a lower risk of recurrences, and by a higher proportion of cured patients. Unfortunately, irradiation also has a disadvantage: the development of osteoradionecrosis, a special form of osteomyelitis, in some patients (mainly in those cases where irradiation occurs after bone resection or after partial removal of the periosteum). Once the clinical picture of this irradiation complication has developed, its treatment is very difficult. A significant result or complete freedom from complaints can be attained only rarely. Attention must therefore be focussed primarily on prevention, and the oral surgeon, the oncoradiologist and the patient too can all do much to help prevent the occurrence of osteoradionecrosis. Through coupling of an up-to-date, functional surgical attitude with knowledge relating to modern radiology and radiation physics, the way may be opened to forestall this complication that is so difficult to cure. (+info)Neck infection associated with pyriform sinus fistula: imaging findings. (7/133)
BACKGROUND AND PURPOSE: Acute suppurative neck infections associated with branchial fistulas are frequently recurrent. In this study, we describe the imaging findings of acute suppurative infection of the neck caused by a third or fourth branchial fistula (pyriform sinus fistula). METHODS: Imaging findings were reviewed in 17 patients (11 female and six male patients, 2 to 49 years old) with neck infection associated with pyriform sinus fistula. Surgery or laryngoscopic examination confirmed the diagnoses. Fourteen patients had a history of recurrent neck infection and seven had cutaneous openings on the anterior portion of the neck (all lesions were on the left side). Imaging studies included barium esophagography (n = 16), CT (n = 14), MR imaging (n = 2), and sonography (n = 3). RESULTS: A sinus or fistulous tract was identified in eight of 16 patients on barium esophagograms. In 14 patients, CT studies showed the inflammatory infiltration and/or abscess formation along the course of the sinus or fistulous tract from the pyriform fossa to the thyroid gland. In nine patients, CT scans showed the entire course or a part of the sinus or fistulous tract as a tiny spot containing air. MR images showed a sinus or fistulous tract in two patients, whereas sonograms could not depict a sinus or fistulous tract in three patients. All 17 patients were treated with antibiotics. In one patient, the sinus tract was surgically excised, while 15 patients underwent chemocauterization of the sinus or fistulous tract with good outcome. Follow-up was possible for 16 of the 17 patients. CONCLUSION: When an inflammatory infiltration or abscess is present between the pyriform fossa and the thyroid bed in the lower left part of the neck, an infected third or fourth branchial fistula should be strongly suspected. (+info)Lymphocutaneous fistula as a long-term complication of multiple central venous catheter placement. (8/133)
We report a case of a lymphocutaneous fistula in a 19-month-old boy who had been a premature neonate, born in the 23rd week of gestation. The fistula, an apparent complication of central venous line placement during the patient's first 5 months of life, was composed of a distinct lymphatic vessel bundle in the right supraclavicular region, with its exit point at the posterior aspect of the right shoulder. The drainage ceased immediately after resection and repair of a 1-cm obstruction in the superior vena cava. (+info)A cutaneous fistula is a type of fistula that occurs when a tract or tunnel forms between the skin (cutaneous) and another organ or structure, such as the gastrointestinal tract, vagina, or urinary system. Cutaneous fistulas can result from various medical conditions, including infections, inflammatory diseases, surgical complications, trauma, or malignancies.
Cutaneous fistulas may present with symptoms such as drainage of fluid or pus from the skin, pain, redness, swelling, or irritation around the affected area. The treatment for cutaneous fistulas depends on their underlying cause and can range from conservative management with antibiotics and wound care to surgical intervention.
It is essential to seek medical attention if you suspect a cutaneous fistula, as untreated fistulas can lead to complications such as infection, sepsis, or tissue damage. A healthcare professional can provide an accurate diagnosis and develop an appropriate treatment plan based on the individual's needs.
A fistula is an abnormal connection or passage between two organs, vessels, or body parts that usually do not connect. It can form as a result of injury, infection, surgery, or disease. A fistula can occur anywhere in the body but commonly forms in the digestive system, genital area, or urinary system. The symptoms and treatment options for a fistula depend on its location and underlying cause.
A gastric fistula is an abnormal connection or passage between the stomach and another organ or the skin surface. This condition can occur as a result of complications from surgery, injury, infection, or certain diseases such as cancer. Symptoms may include persistent drainage from the site of the fistula, pain, malnutrition, and infection. Treatment typically involves surgical repair of the fistula and management of any underlying conditions.
An arteriovenous fistula is an abnormal connection or passageway between an artery and a vein. This connection causes blood to flow directly from the artery into the vein, bypassing the capillary network that would normally distribute the oxygen-rich blood to the surrounding tissues.
Arteriovenous fistulas can occur as a result of trauma, disease, or as a planned surgical procedure for patients who require hemodialysis, a treatment for advanced kidney failure. In hemodialysis, the arteriovenous fistula serves as a site for repeated access to the bloodstream, allowing for efficient removal of waste products and excess fluids.
The medical definition of an arteriovenous fistula is:
"An abnormal communication between an artery and a vein, usually created by surgical means for hemodialysis access or occurring as a result of trauma, congenital defects, or disease processes such as vasculitis or neoplasm."
An intestinal fistula is an abnormal communication or connection between the intestines (or a portion of the intestine) and another organ or the skin surface. This connection forms a tract or passage, allowing the contents of the intestines, such as digestive enzymes, bacteria, and waste materials, to leak into other body areas or outside the body. Intestinal fistulas can develop due to various reasons, including inflammatory bowel diseases (like Crohn's disease), infections, complications from surgery, radiation therapy, or trauma. They can cause symptoms such as abdominal pain, diarrhea, skin irritation, and infection. Treatment of intestinal fistulas often involves a combination of medical management, nutritional support, and surgical intervention.
A bronchial fistula is an abnormal connection or passage between the bronchial tree (the airways in the lungs) and the surrounding tissues, such as the pleural space (the space between the lungs and the chest wall), blood vessels, or other organs. This condition can result from various causes, including lung injury, infection, surgery, or certain diseases such as cancer or tuberculosis.
Bronchial fistulas can lead to symptoms like coughing, wheezing, shortness of breath, and chest pain. They may also cause air leaks, pneumothorax (collapsed lung), or chronic infections. Treatment for bronchial fistulas depends on the underlying cause and severity of the condition but often involves surgical repair or closure of the abnormal connection.
A vascular fistula is an abnormal connection or passage between the artery and vein, which usually results from a surgical procedure to create access for hemodialysis in patients with chronic kidney disease. This communication allows blood to flow directly from the artery into the vein, bypassing the capillary network and causing high-flow conditions in the affected area. Over time, the increased pressure and flow can lead to various complications such as venous hypertension, stenosis, aneurysm formation, or even heart failure if left untreated. Vascular fistulas may also occur spontaneously due to certain medical conditions like vasculitis, trauma, or infection, although this is less common.
A rectal fistula is an abnormal connection or tunnel that develops between the rectum, which is the lower end of the colon, and another organ or the skin surface surrounding the anus. This condition often results from inflammation, infection, trauma, or surgery in the anal area. The fistula can cause symptoms such as pain, discharge, irritation, and swelling around the anus. In some cases, it may also lead to complications like abscesses or recurrent infections if not treated promptly and effectively. Treatment options typically include surgical intervention to close the fistula and promote healing of the affected tissues.
A urinary fistula is an abnormal connection or passage between the urinary tract and another organ or tissue, such as the bladder, ureter, or kidney, and the skin, vagina, or intestine. This condition can lead to urine leakage through the abnormal opening, causing discomfort, infection, and other complications if not treated promptly and effectively. Urinary fistulas can be caused by various factors, including surgery, injury, radiation therapy, inflammation, or cancer. The type and location of the fistula will determine the specific symptoms and treatment options.
An esophageal fistula is an abnormal connection or passage between the esophagus (the tube that carries food and liquids from the throat to the stomach) and another organ, such as the trachea (windpipe) or the skin. This condition can result from complications of certain medical conditions, including cancer, prolonged infection, or injury to the esophagus.
Esophageal fistulas can cause a variety of symptoms, including difficulty swallowing, coughing, chest pain, and fever. They can also lead to serious complications, such as pneumonia or sepsis, if left untreated. Treatment for an esophageal fistula typically involves surgical repair of the abnormal connection, along with management of any underlying conditions that may have contributed to its development.
A biliary fistula is an abnormal connection or passage between the biliary system (which includes the gallbladder, bile ducts, and liver) and another organ or structure, usually in the abdominal cavity. This connection allows bile, which is a digestive fluid produced by the liver, to leak out of its normal pathway and into other areas of the body.
Biliary fistulas can occur as a result of trauma, surgery, infection, or inflammation in the biliary system. Symptoms may include abdominal pain, fever, jaundice (yellowing of the skin and eyes), nausea, vomiting, and clay-colored stools. Treatment typically involves addressing the underlying cause of the fistula, such as draining an infection or repairing damaged tissue, and diverting bile flow away from the site of the leak. In some cases, surgery may be necessary to repair the fistula.
A pancreatic fistula is an abnormal connection or passage between the pancreas and another organ, often the digestive system. It usually occurs as a complication following trauma, surgery, or inflammation of the pancreas (such as pancreatitis). The pancreas secretes digestive enzymes, and when these enzymes escape the pancreas through a damaged or disrupted duct, they can cause irritation and inflammation in nearby tissues, leading to the formation of a fistula.
Pancreatic fistulas are typically characterized by the drainage of pancreatic fluid, which contains high levels of digestive enzymes, into other parts of the body. This can lead to various symptoms, including abdominal pain, swelling, fever, and malnutrition. Treatment may involve surgical repair of the fistula, as well as supportive care such as antibiotics, nutritional support, and drainage of any fluid collections.
A rectovaginal fistula is an abnormal connection or passage between the rectum (the lower end of the colon, leading to the anus) and the vagina. This type of fistula can result from various causes, such as childbirth injuries, surgery complications, Crohn's disease, radiation therapy, or infections. The condition may lead to symptoms like fecal matter passing through the vagina, recurrent vaginal infections, discomfort during sexual intercourse, and skin irritation around the vaginal area. Treatment options typically involve surgical repair of the fistula, depending on its size, location, and underlying cause.