1/117. Treatment of a malignant enterocutaneous fistula with octreotide acetate.An enterocutaneous malignant fistula developed in a patient who had a retroperitoneal angiosarcoma. He was treated with octreotide acetate subcutaneously. drainage decreased and ceased after 2 weeks of therapy. The closure of this malignant fistula suggests that palliative therapy with octreotide acetate merits further study in view of the grave prognosis of this complication.- - - - - - - - - - ranking = 1keywords = closure (Clic here for more details about this article) |
2/117. Iliopsoas haemophiliac pseudotumours with bowel fistulation.Two cases of iliopsoas haemophilic pseudotumours are presented. In one patient a fistula developed between a pseudotumour and the large bowel. This resulted in an abscess involving the pseudotumour and adjacent tissues. It resolved after 5 years of therapy involving percutaneous drainage and closure of the fistula. The second patient had a massive pseudotumour that had obstructed both ureters. Later he suffered a fatal mixed Gram negative septicaemia probably related to erosion into the colon.- - - - - - - - - - ranking = 1keywords = closure (Clic here for more details about this article) |
3/117. Double pylorus: a complication of chronic gastric ulcer?A case of double pylorus with a chronic ulcer in one of the two channels is described. The patient, a middle-aged man with active rheumatoid arthritis, required partial gastrectomy to allow continued treatment of the arthritis with anti-inflammatory drugs. Detailed histological examination of the surgical specimen revealed features consistent with intramural penetration of an ulcer across the pyloric ring, resulting in a gastro-duodenal fistula. The findings provide further support for the hypothesis that the double pylorus is an acquired lesion, which occurs as an uncommon complication of chronic peptic ulcer.- - - - - - - - - - ranking = 0.0050512225046953keywords = drug (Clic here for more details about this article) |
4/117. The split notochord syndrome with dorsal enteric fistula, meningomyelocele and imperforate anus.A male infant was referred to our department because of lumbosacral meningomyelocele, dorsal enteric fistula and imperforate anus. The mother had received a parenteral drug containing estradiol benzoate and progesterone for inducing abortion in the first trimester. She also used an anal pomade containing triamcinolone and lidocaine-HCl during the pregnancy for hemorrhoids. Sigmoid end colostomy was performed after meningomyelocele repair. On abdominal exploration a wandering spleen was detected but no other anomalies. Two months later, an abdominoperineal pullthrough was performed, and the patient was discharged well after three weeks. Our case is the sixth that had split notochord syndrome associated with dorsal enteric fistula and imperforate anus. Additionally, penoscrotal transposition and wandering spleen were present in this case. To our knowledge, these associated anomalies have been extremely rare.- - - - - - - - - - ranking = 0.0050512225046953keywords = drug (Clic here for more details about this article) |
5/117. Complex enterocutaneous fistula: closure with rectus abdominis muscle flap.Most enterocutaneous fistulas are caused by complications of abdominal surgery that may result from anastomotic failure, poor blood supply, or iatrogenic bowel injuries. mortality rates are high when associated sepsis and malnutrition are uncontrolled. Fistulas that occur late and those that recur spontaneously present more difficulty and may close spontaneously in less than 30% of cases. mortality rates in patients with complex enterocutaneous fistulas may reach 60% to 80%. When traditional conservative surgeries of fistulous tract excision, bowel mobilization, and resection with primary end-to-end anastomosis fail, a more aggressive approach is required. The rectus abdominis muscle flap has been extensively studied and used in a wide variety of abdominal, vaginal, and perineal repairs. We report successful closure of complex enterocutaneous fistulas with a rectus abdominis muscle flap in a complicated case.- - - - - - - - - - ranking = 5keywords = closure (Clic here for more details about this article) |
6/117. Ileovesical fistula. Failure of T.P.N. role of oral 14C PEG (polyethylene glycol) and charcoal in diagnosis.A patient with regional enteritis presenting with symptoms of fecaluria and pneumaturia is presented. Most of the established technics such as upper gastrointestinal series, cystography, cystoscopy and colonoscopy failed to demonstrate the fistula in this patient. 14C PEG as a nonabsorbable marker was given by mouth and a seven-fold increase in the counts at the fourth hour of urine collection confirmed the presence of an ileovesical fistula. This increase in counts was not seen when 14C PEG test was repeated after closure of this fistula surgically and was also not seen in a similar disease control patient and a healthy normal volunteer. Total parenteral nutrition with intralipids, Freamine II and glucose given in a peripheral vein for 45 days failed to close this fistula.- - - - - - - - - - ranking = 1keywords = closure (Clic here for more details about this article) |
7/117. vacuum-assisted closure for cutaneous gastrointestinal fistula management.BACKGROUND: Cutaneous gastrointestinal (GI) fistulas are a challenging complication in the oncologic patient population. The fistulous effluent is difficult to manage and adversely alters quality of life. Nonsurgical management of enteric fistulas is successful in 30% of cases, requiring at least 4 to 6 weeks. Recently a new technology has been developed to expedite wound healing. The vacuum-Assisted Closure (VAC) method is a subatmospheric pressure technique that has been demonstrated in laboratory and clinical studies to significantly improve wound healing. Here we report its use in the successful medical management of a cutaneous GI fistula. CASE: A 63-year-old woman with advanced ovarian cancer developed an extensive complex cutaneous GI fistula in an open healing wound. She was treated with total parental nutrition and the VAC device, which resulted in complete closure of the fistula. CONCLUSION: We propose that the VAC device may be a useful adjunct for the medical management of cutaneous GI fistulas.- - - - - - - - - - ranking = 5keywords = closure (Clic here for more details about this article) |
8/117. Electrical nerve stimulation in the management of enterocutaneous low-output fistulas: a report of two cases.Two patients with low-output enterocutaneous fistulas after surgery were treated with electrical nerve stimulation (ENS). ultrasonography was useful for the application of this treatment method and for the charting of its progress. fistula output diminished rapidly in both cases, and the closure of the track was achieved after several sessions of ENS. The procedure is simple and safe and is suggested as an option for the treatment of low-output enterocutaneous fistulas.- - - - - - - - - - ranking = 1keywords = closure (Clic here for more details about this article) |
9/117. Bouveret's syndrome complicated by distal gallstone ileus after laser lithotropsy using holmium: YAG laser.BACKGROUND: Bouveret's syndrome is an unusual presentation of duodenal obstruction caused by the passage of a large gallstone through a cholecystoduodenal fistula. Endoscopic therapy has been used as first-line treatment, especially in patients with high surgical risk. CASE PRESENTATION: We report a 67-year-old woman who underwent an endoscopic attempt to fragment and retrieve a duodenal stone using a holmium: yttrium-aluminum-Garnet Laser (Ho:YAG) which resulted in small bowel obstruction. The patient successfully underwent enterolithotomy without cholecystectomy or closure of the fistula. CONCLUSION: We conclude that, distal gallstone obstruction, due to migration of partially fragmented stones, can occur as a possible complication of laser lithotripsy treatment of Bouveret's syndrome and might require urgent enterolithotomy.- - - - - - - - - - ranking = 1keywords = closure (Clic here for more details about this article) |
10/117. vacuum assisted closure system in the management of enterocutaneous fistulae.BACKGROUND: A very important yet often troublesome element in the conservative management of enterocutaneous fistulae is the protection of the surrounding skin from contact with the effluent. This report describes the successful use of a vacuum assisted closure (VAC) system in dealing with this problem. methods: The results of using the VAC system were studied in three patients with moderate or high volume output enterocutaneous fistulae where conventional treatment had failed to prevent skin excoriation. RESULTS: The VAC system was found to be highly effective in controlling fistula effluent and in promoting healing of excoriated skin in all three patients. Complete healing of the fistula was also achieved in two of the three patients. CONCLUSION: The VAC system can be an effective and economically viable method of containing fistula effluent and protecting the skin of patients with enterocutaneous fistulae. Contrary to conventional thought, the VAC system may also actually promote healing of the fistula.- - - - - - - - - - ranking = 5keywords = closure (Clic here for more details about this article) |
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