• Title/Summary/Keyword: Fistula

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Neobladder-vaginal Fistula Repair with Modified Martius Bulbocavernosus Fat Pad Flap (변형 Martius 구해면체 지방피판술을 이용한 신생방광-질루의 치험례)

  • Myung, Yu-Jin;Park, Ji-Ung;Jeong, Eui-Cheol;Kim, Suk-Wha
    • Archives of Plastic Surgery
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    • v.38 no.3
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    • pp.329-332
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    • 2011
  • Purpose: In developed countries, vesicovaginal fistula occur from various pelvic operations including total hysterectomy, leading to urinary leakage and incontinence. Although various methods have been proposed for adequate tissue coverage in fistula repair, the surgical treatment of is not simple and still controversial. We report a case of neobladder-vaginal fistula repair using modified Martius fat pad flap. Methods: A 62-year-old female patient underwent radical cystectomy with total abdominal hysterectomy and neobladder formation due to invasive bladder tumor 5 years ago. For 3 years following the operation, urine leakage was observed. Exploration demonstrated neobladder-vaginal fistula and primary repair including fistulectomy and direct closure was performed. Urinary incontinence relapsed 2 years after primary repair, and after demonstrating the recurrence of fistula on urography, repair of recurrent fistula was performed. After dissection of vagina and neobladder and closure of fistula by urologic surgeon, fibroadipose flap was elevated, rotated and advanced through the tunnel at vaginal sidewall, and interpositioned to the fistula site between neobladder and vagina. Results: There was no acute complication after the surgery and urethral catheter was extracted on the 8th day after the operation. During six month follow-up period after the operation, there is no clinical evidence of fistula recurrence. Conclusion: From our clinical experience and literature review, we think Martius fat pad flap is a useful technique in management of neobladder-vaginal fistula, for it provides enough vascularity, major epithelization surface and better lymphatic drainage, and also prevents overlapping of vesical, vaginal suture lines at the same time.

Endoscopic Chemocauterization for Pyriform Sinus Fistula (이상와루(Pyriform Sinus Fistula)에 대한 내시경적 경화요법의 3예)

  • Park Yoon-Ah;Seo Jin-Hak;Cho Sang-Hyun;Chung Woong-Yoon;Choi Eun-Chang;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.2
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    • pp.234-237
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    • 2001
  • Pyriform sinus fistula is a rare anomaly arising from 3rd or 4th branchial apparatus and has been recognized as one cause of acute suppurative thyroiditis or acute deep neck infection. Pyriform sinus fistula must be considered when a clinician is encountered recurrent left lower neck abscess and a history of repeated incision and drainage. The confirmation of the diagnosis is made when the fistula tract is identified on a barium swallow study and when the internal orifice of the fistula is found at the apex of pyriform sinus on laryngoscopic examination. A complete excision of the fistula tract has been proposed as a treatment of choice. However, in some cases it is very difficult to resect the tract completely because of severe inflammation and repeated drainage procedure. We present three cases of pyriform sinus fistula which are successfully treated by laryngomicroscopic chemocauterization using synthetic fibrin and $AgNO_3$.

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Acquired Palatal Fistula in Patients with Submucous and Incomplete Cleft Palate before Surgery

  • Park, Ie Hyon;Chung, Jee Hyeok;Choi, Tae Hyun;Han, Jihyeon;Kim, Suk Wha
    • Archives of Plastic Surgery
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    • v.43 no.6
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    • pp.582-585
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    • 2016
  • It is uncommon for a palatal fistula to be detected in individuals who have not undergone surgery, and only sporadic cases have been reported. It is even more difficult to find cases of acquired palatal fistula in patients with submucous or incomplete cleft palate. Herein, we present 2 rare cases of this phenomenon. Case 1 was a patient with submucous cleft palate who acquired a palatal fistula after suffering from oral candidiasis at the age of 5 months. Case 2 was a patient with incomplete cleft palate who spontaneously, without trauma or infection, presented with a palatal fistula at the age of 9 months.

Congenital Fistula of the Right Coronary Artery to the Left Ventricle; A Case Report (우관동맥과 좌심실사이의 선천성 동맥루;1례 보고)

  • 홍은표
    • Journal of Chest Surgery
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    • v.26 no.9
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    • pp.710-713
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    • 1993
  • Congenital coronary fistula is a rare condition, and with widespread use of cardiac catheterization, angiography and selective coronary arteriography are being recognized with increasing frequency. Fistula originating from the right coronary artery are more common than those from the left coronary artery. The fistula empties into the right side of the heart in 90% of the cases with the right ventricle being the most common recipient chamber, followed by the right atrium and the pulmonary artery. We report a case of congenital coronary artery fistula of the right coronary artery to the left ventricle with significant shunt in a 20 - year old female. It was detected by transthoracic and transesophageal echocardiography and confirmed by cardiac catheterization and coronary angiography. The fistula opening was closed with 6-0 Prolene continuously under cardiopulmonary bypass and moderate hypothermia [ 28 oC ]. Postoperative course was uneventful and the patient was discharged without specific problem.

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Acquired Pulmonary Arteriovenous Fistula -A Case Report- (후천성 폐 동정맥루 -1례 보고-)

  • 김남혁
    • Journal of Chest Surgery
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    • v.28 no.5
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    • pp.495-498
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    • 1995
  • Pulmonary arteriovenous fistula can be either congenital or acquired. The vast majority are congenital, and about 60% have been associated with hereditary hemorrhagic telangiectasia [Rendu-Osler-Weber disease . Secondary or acquired pulmonary arteriovenous fistula occurs with trauma, schistosomiasis, long-standing hepatic cirrhosis, metastatic carcinoma, and actinomycosis. Pulmonary hemorrhage secondary to acquired pulmonary arteriovenous fistula is a rare event associated with mortality. We have experienced 64 year-old female patient with the hemoptysis secondary to acquired pulmonary arteriovenous fistula due to the infection of pulmonary parasite. The chest PA and CT scan was showed calcified nodule to the distal portion of lateral segmental bronchus of RML. The bronchial angiogram was demonstrated slightly hypertrophied bronchial artery supplying RML bronchus and the presence of hypervascularization around the calcified nodule, rapid A-V shunting is noted by fluoroscopy. The patient was successfully treated by the right middle lobectomy.

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Congenital Bronchoesophageal Fistula in Adult -Report of Three Cases- (성인의 선천성 식도기관지루 3례 보고)

  • Lee, Yong-Hun;Choe, Pil-Jo;U, Jong-Su
    • Journal of Chest Surgery
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    • v.28 no.5
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    • pp.525-529
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    • 1995
  • We have experienced three cases of congenital bronchoesophageal fistula which is rare and usually has an insidious clinical course. The patients included a thirty year old man and thirty six, thirty eight year old women respectively. Bronchiectatsis was found in all three cases, and bronchoesophageal fistula was found in one case preoperatively by esophagography and esophagoscopy, and other two cases operative field. The fistula was found between right lower esophagus and right lower lobe in all cases and esophageal diverticulum in one case. So they belonged to type I[1 case , II[2 cases of Braimbridge and Keith`s classification of congenital bronchoesophageal fistula . The fistulectomy was performed in all cases and concomitant lobectomy [2 cases and bilobectomy [1 case were done. There were toxic hepatitis in two cases and prolonged air leakage in one case postoperatively. They were discharged on recovered state and have continued to do well.

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Interventional Management of Malignant Esophagorespiratory Fistula and Bronchopleural Fistula (악성 기관지호흡기루와 기관지흉강루에 대한 인터벤션 치료)

  • Shin, Ji-Hoon;Kim, Kyung-Rae;Kim, Jin-Hyoung;Song, Ho-Young
    • Korean Journal of Bronchoesophagology
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    • v.14 no.1
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    • pp.8-13
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    • 2008
  • Malignant esophagorespiratory fistula is a devastating and life-threatening complication of esophageal and bronchogenic carcinomas. As a non-surgical treatment, peroral stent placement into the esophagus or airway can close-off the fistula and prevent progression of the pneumonia. Although reopening of the fistula is not uncommon despite stent placement, interventional treatment is effective for sealing off reopened ERFs. Bronchopleural fistula is a well-recognized complication of pneumonectomy. There have been several reports to occlude the fistula with use of stents and much more experience is required.

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Congenital Esophgo-bronchial Fistula without Esophageal Atresia in the Adult -A Case Report- (성인의 선천성 식도 기관지루 -수술치험 1례 보고-)

  • Kim, Byeong-Rin;O, Tae-Yun;Jang, Un-Ha
    • Journal of Chest Surgery
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    • v.28 no.4
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    • pp.431-436
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    • 1995
  • Congenital esophago-bronchial fistula without atresia is very rare and usually demonstrate more insidious clinical effects, and patients may reach adult life before the diagnosis. We had been experienced a typical case of esophago-bronchial fistula without atresia and document the case. A 42-year-old women was admitted to our hospital due to frequent choking symptom and attacks of pneumonia, and patient status was in chronic pulmonary infection status such as most probably bronchiectatic state of right middle & lower lobe including significant destructive changes. We had confirmed esophago-bronchial fistula without atresia with esophagoscopy, esophagogram, and chest CT, and performed esophago-bronchial fistulectomy and right middle & lower lobectomy. Its belongs to type II of Braimbridge`s classification for congenital esophago-bronchial fistula. Postoperation course was smooth and uneventful.

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Surgical Treatment of Bronchobiliary Fistula with Pulmonary Resection and Omentopexy

  • Joh, Hyon Keun;Park, Seong Yong
    • Journal of Chest Surgery
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    • v.53 no.1
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    • pp.38-40
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    • 2020
  • Bronchobiliary fistula is a rare disease defined as an abnormal connection between the biliary tract and the bronchial tree. We report the successful surgical repair of bronchobiliary fistula. A 78-year-old man underwent surgery and several rounds of transcatheter arterial chemoembolization and radiofrequency ablation as treatment for hepatocellular carcinoma. He presented with greenish sputum and chronic cough for several months, and his symptoms did not resolve after endoscopic treatment. We performed lobectomy of the right lower lobe and omentopexy for bronchobiliary fistula under laparotomy and thoracotomy. The bronchobiliary fistula was successfully closed, and the bilious sputum disappeared after surgery.

Esophageal Stent in Postpneumonectomy Esophagopleural Fistula (폐전절제술후 발생한 식도흉막루 -식도스텐트를 이용한 치험 1례-)

  • 신용철;임용택;정승혁;김병렬
    • Journal of Chest Surgery
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    • v.32 no.10
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    • pp.958-961
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    • 1999
  • A case of esophagopleural fistula after pleuropneumonectomy is reported. A 59 years old male underwent right pleuropneumonectomy due to tuberculous empyema. The postoperative small esophagopleural fistula was confirmed by esophagogram and was initially managed by a conservative treatment. There was a persistent fistula on follow up esophagogram, therefore we planned the next treatment modality for obstruction of the fistula. For poor general conditions and arrhythmia, an esophageal stent was applied as a non-surgical method. At first, a covered-form stent was inserted, but it migrated to the stomach after 3 months. By using an uncovered-form stent, a complete obstruction of the esophagopleural fistula was achieved.

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