1/37. Medication-induced oesophageal injury leading to broncho-oesophageal fistula.Medication-induced oesophageal injury is one of the least recognised side-effects of oral medication and, in contrast to other oesophageal pathologies, is rarely considered in the differential diagnosis of chest pain. We describe a case of medication-induced oesophageal injury with a rare complication in which the diagnosis was not considered until the characteristic features were demonstrated at endoscopy.- - - - - - - - - - ranking = 1keywords = chest pain, chest (Clic here for more details about this article) |
2/37. Treatment of severe esophageal Crohn's disease with infliximab.Esophageal ulceration with fistula is an uncommon manifestation of Crohn's disease. Typical presentation of symptomatic esophageal Crohn's disease may include dysphagia, odynophagia, weight loss, and chest discomfort. We present a patient with severe esophageal and skin involvement of Crohn's disease that was progressive despite conventional therapy including prednisone and 6-mercaptopurine. The diagnosis of Crohn's was based on the presence of typical clinical, endoscopic, and pathologic findings, including granulomas in the skin ulcer and the absence of infectious etiologies. The patient had a nearly complete resolution of her esophageal disease with a single infusion of infliximab.- - - - - - - - - - ranking = 0.19294903268987keywords = chest (Clic here for more details about this article) |
3/37. Primary aortoesophageal fistula: presenting as massive upper gastrointestinal hemorrhage.Primary aortoesophageal fistula is a rare cause of upper gastrointestinal bleeding. A six-year-old boy presented with massive upper gastrointestinal hemorrhage. endoscopy revealed a submucosal bulge in the esophagus with an ulcer and clot at the top. Lateral skiagram of the chest showed a posterior mediastinal mass. CT scan of the chest revealed a ruptured aortic aneurysm into the oesophagus, confirmed the diagnosis. The patient succumbed to the illness before he could be subjected to definitive treatment.- - - - - - - - - - ranking = 0.38589806537974keywords = chest (Clic here for more details about this article) |
4/37. Congenital broncho-esophageal fistula in the adult.The case of a 62-year-old woman with a type II congenital broncho-esophageal fistula is presented. She had had recurrent pulmonary infections that were more prominent in the last 15 years. A barium swallow examination showed a communication between the esophagus and the right lower lobe. High resolution computed tomographic scan of the chest revealed right middle and lower lobe bronchiectasis. bronchoscopy was unremarkable. At thoracotomy bronchoesophageal fistula was divided and the esophageal end was repaired in two layered fashion and reinforced by pediculed parietal pleural flap. Right middle and lower lobectomies were performed. Demonstration of the broncho-esophageal fistula and assessment of the status of the pulmonary parenchyma are important steps prior to surgery.- - - - - - - - - - ranking = 0.19294903268987keywords = chest (Clic here for more details about this article) |
5/37. An unusual case of double tuberculous broncho-oesophageal fistulas in an adult.Broncho-oesophageal fistula associated with tuberculosis is rarely reported in the literature and has not been reported in hong kong. We describe a 30-year-old Chinese human immunodeficiency virus (hiv)-negative man with double tuberculous broncho-oesophageal fistulas proven by histology. Constitutional symptoms of active tuberculosis were absent and chest radiograph did not show an obvious lung lesion. Our case shows that broncho-oesophageal fistula can be the sole manifestation of active tuberculosis and that the diagnosis should be suspected in patients who are seen with chronic respiratory symptoms in areas where the prevalence of tuberculosis is high.- - - - - - - - - - ranking = 0.19294903268987keywords = chest (Clic here for more details about this article) |
6/37. aortic aneurysm involving a right-sided arch complicating aortobronchopulmonary and aortoesophageal fistula.A 66-year-old man with hemoptysis, chest pain, fever, and hoarseness was admitted to our department. A right-sided aortic arch and three aneurysms in the proximal arch, distal arch, and descending aorta were confirmed by aortography and surgery. Fistula formations were discovered between the proximal arch aneurysm and the right upper lobe (aortobronchopulmonary fistula: ABF), and between the descending aorta and the esophagus (aortoesophageal fistula: AEF). Concomitant ABF and AEF are very rare. Aortopulmonary and/or aortoesophageal fistula complicated by a right-sided aortic arch have not been previously reported.- - - - - - - - - - ranking = 1keywords = chest pain, chest (Clic here for more details about this article) |
7/37. delayed diagnosis of purulent pericarditis caused by esophagopericardial fistula by computed tomography scan and echocardiography.We report a case of esophagopericardial fistula with subsequent purulent pericarditis that was diagnosed with computed tomography and echocardiography. In a patient with non-specific chest pain and vague past history, serial echocardiography demonstrated rapid aggravation of pyopneumopericardium and chest CT scan showed a foreign body that caused the fistula in the esophageal wall. Removal of a piece of fish bone, closure of the fistula, and creation of a pericardial window for continuous drainage were performed through a low lateral thoracotomy.- - - - - - - - - - ranking = 1.1929490326899keywords = chest pain, chest (Clic here for more details about this article) |
8/37. Thoracoscopic approach for congenital bronchoesophageal fistula in an adult.We present a case of a congenital bronchoesophageal fistula in an adult male who underwent video-assisted thoracic surgery for a resection of the fistula. The patient had not suffered from any serious respiratory infection since the adolescence. However, at 49 years old, the patient experienced persistent cough and back pain. An abnormal shadow in the right lower lobe was observed on a chest X-ray. Chest computed tomography scanning indicated bronchiectasia in the lower superior segment and an abnormal air duct in the posterior mediastinum. Esophagography revealed a 4-cm-long and 1-cm-diameter fistula between the midesophagus and the right lower lobe. esophagoscopy and bronchoscopy revealed the orifice of the fistula. Three-dimensional computed tomography scanning demonstrated that there was no abnormal artery supplying blood to the affected lung. He underwent video-assisted thoracic surgery, and was uneventfully discharged. thoracoscopy offered excellent anatomical visualization of the fistula and safe surgical resection.- - - - - - - - - - ranking = 0.19294903268987keywords = chest (Clic here for more details about this article) |
9/37. Endoluminal stenting of the aorta as treatment of aortoesophageal fistula due to primary aortic disease.A 78-year-old woman with severe chronic obstructive pulmonary disease was admitted to the emergency room with hematemesis. With use of esophagoscopy, chest computed tomographic scanning, and aortography, we found a large descending aortic aneurysm and a penetrating ulcer of the proximal descending aorta. We determined that the patient had an aortoesophageal fistula and pseudoaneurysm that had originated from a ruptured penetrating ulcer of the mid-descending aorta. We deployed two 100-mm stent grafts to seal the ruptured thoracic aorta. Six months later, the pseudoaneurysm was almost completely resolved, with no infection or endoleak. We advocate the use of endoluminal aortic stenting for aortoesophageal fistulas of aortic origin, particularly in patients with severe concomitant disease.- - - - - - - - - - ranking = 0.19294903268987keywords = chest (Clic here for more details about this article) |
10/37. Tuberculous involvement of the oesophagus with oesophagobroncheal fistula.Tuberculous involvement of the oesophagus is a rare disease. Even if it is suspected, diagnosis is often difficult though dysphagia and chest pain are the most common symptoms without any other specific signs of tuberculosis. The diagnosis is based on oesophagography, oesophagoscopy, bronchoscopy, and computed tomographic scan. Suspected tuberculosis can be confirmed with histology, smear, and culture. The two most common differential diagnoses are Crohn's disease and carcinoma. The case is reported of a female patient with tuberculous involvement of the oesophagus, who developed an oesophagobroncheal fistula during steroid treatment started for suspicion of Crohn's disease. The patient was immunocompromised due to treatment with azathioprine that she was receiving for multiple sclerosis. The fistula was successfully treated by antituberculous chemotherapy alone.- - - - - - - - - - ranking = 1keywords = chest pain, chest (Clic here for more details about this article) |
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