1/6. Aortobronchial fistula after aortic dissection type B.Although rare, aortobronchial fistula complicates thoracic aortic surgery. Correct diagnosis and the infectious nature of the lesion are the most important conditions to define, for the following best therapy. We presented a case of non-infectious postsurgical aortobronchial fistula, revealed by computed-tomographic scan and angiography procedure, treated with prosthetic graft replacement and broad spectrum antibiotic therapy. In the case of infection our policy is homograft replacement. Computed tomography, being able to make diagnosis, should be performed as the initial technique.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/6. Recurrent aortoenteric fistula: case report and review.Aortoenteric fistulas (AEFs) are abnormal communications between the aorta and the bowel most frequently resulting from prosthetic graft erosion. Despite advances in surgery and medical technology, these entities are still associated with significant morbidity and mortality for the patient. Multiple case reports and reviews have attempted to elucidate the nature of AEFs in an effort to better characterize and manage these entities. However, reports of recurrence of this process are extremely rare. In this article, we describe a unique case of recurrence of an AEF that was successfully managed with primary aortic oversew and bowel resection. We will also review the literature on AEFs with a comprehensive overview on background, presentation, diagnosis, and current management options.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/6. Successful surgical treatment of a mycotic right coronary artery aneurysm complicated by a fistula to the right atrium.We reported successful surgical treatment of a mycotic right coronary artery aneurysm complicated by a fistula to the right atrium in a 60-year-old man admitted to hospital because of acute worsening of renal function and erythroderma. After admission, he suffered from methicillin-resistant staphylococcus aureus septicemia. Despite administration of vancomycin hydrochloride, a low-grade fever persisted. Subacute cardiac tamponade occurred three months after admission, and acute inferior wall myocardial infarction occurred two weeks after pericardial drainage. An emergent coronary angiography demonstrated a large saccular aneurysm of the right coronary artery forming a fistula to the right atrium and obstruction of the distal right coronary artery. We emergently resected the aneurysm including the right atrial wall and repaired the defect in the right atrium. Pathological examination of the aneurysmal wall revealed its mycotic nature; the postoperative course was uneventful.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/6. Endovascular repair of a recurrent aortocaval fistula and anastamotic false aneurysm.Aortocaval fistula (ACF) and false aneurysm are a recognized complication of open abdominal aortic aneurysm (AAA) repair. Untreated they are often fatal. However, open surgical repair of this complication is associated with a high operative mortality and a significant complication rate. Endovascular management using a stent-graft to exclude the false aneurysm and fistula is a technically feasible alternative and confers many advantages over open repair by virtue of its minimally invasive nature. We report the endovascular management of this rare but serious complication of open AAA repair.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/6. Subclavian-oesophageal fistula as a complication of foreign body ingestion: a case report.foreign bodies in the upper aerodigestive tract are very common. In the local community, the commonest foreign body encountered in the oesophagus is the fish bone. Impaction in the thoracic oesophagus can lead to perforation and the subsequent formation of an arterial-oesophageal fistula. Such fistulae are inevitably aorto-oesophageal in nature. A subclavian-oesophageal fistula is described in this patient.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/6. Aortoesophageal fistula: recognition and diagnosis in the emergency department.An aortoesophageal fistula is a life-threatening cause of gastrointestinal bleeding where an abnormal communication between the esophagus and the aorta may result from a thoracic aortic aneurysm, foreign body ingestion, esophageal malignancy, or postoperative complications. The diagnosis can be made on the basis of clinical findings alone. Classic patients present with the triad of midthoracic pain, sentinel arterial hemorrhage, and exsanguination after a symptom-free interval (Chiari's triad). The identification of massive upper gastrointestinal hemorrhage that is bright red and arterial in nature is characteristic. Most diagnostic tests have significant individual limitations. endoscopy of the upper gastrointestinal tract should exclude alternative bleeding sources and may show a submucosal hematoma. aortography may be useful during active hemorrhage to demonstrate the fistula, but results of aortography may be negative during the symptom-free interval. Dynamic computed tomography may be a more rapid alternative. For patients who are in stable condition after the sentinel hemorrhage, a confirmatory test is reasonable. patients in unstable condition should undergo immediate surgery. survival is now possible with rapid surgical intervention.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |