Bile Duct Diseases
Cholangiopancreatography, Endoscopic Retrograde
Respiratory Tract Fistula
Digestive System Fistula
Chronic cough due to bronchobiliary fistula. (1/165)Bronchobiliary fistula is a rare cause of chronic cough. Here we describe a 70-year-old woman complaining of chronic cough and copious dark-yellow watery sputum. The presence of air in the biliary tract in the lower cuts of a computerized tomography scan of the chest and positive bile in the sputum led to the suspicion of bronchobiliary fistula. The diagnosis was confirmed by percutaneous transhepatic cholangiography. Drainage of the intrahepatic biliary tract resulted in complete resolution of her symptoms. (+info)
Roux-en-Y hepaticojejunostomy: a reappraisal of its indications and results. (2/165)A critical evaluation is made of 131 patients submitted to choledocho or hepaticojejunostomy. The main indications for hepaticojejunostomy were iatrogenic strictures of CBD (60 patients), and choledocholithiasis with markedly dilated duct (41 patients). The overall mortality rate was 4% representing principally renal hepatic failure, bile peritonitis and bleeding. The complications following hepaticojejunostomy included only in one case biliary fistula which required reoperation. The long-term results of 80 patients available for a followup study were as follows: 63 patients (78.7%) were symptom-free at 2-13 years followup; 8 patients had brief episodes of cholangitis which responded to antibiotic and corticosteroid treatment; 9 patients required reoperation for stricture of anastomosis. These overall results are a strong argument for hepaticojejunostomy which, compared with choledochoduodenostomy, avoids the hazards of the so-called sump syndrome and of the reflux of enteric contents in the CBD. An increased incidence of peptic ulcer disease in the patients submitted to hepaticojejunostomy was not observed. In very high strictures and in reinterventions anastomosis between left hepatic duct and Roux-en-Y jejunal limb was carried out. The results achieved with this technique, which was performed in 26 patients, were about the same following hepaticojejunostomy. (+info)
Genetic factors at the enterocyte level account for variations in intestinal cholesterol absorption efficiency among inbred strains of mice. (3/165)Interindividual and interstrain variations in cholesterol absorption efficiency occur in humans and animals. We investigated physiological biliary and small intestinal factors that might determine variations in cholesterol absorption efficiency among inbred mouse strains. We found that there were significant differences in cholesterol absorption efficiency measured by plasma, fecal, and lymphatic methods: <25% in AKR/J, C3H/J, and A/J strains; 25-30% in SJL/J, DBA/2J, BALB/cJ, SWR/J, and SM/J strains; and 31-40% in C57L/J, C57BL/6J, FVB/J, and 129/SvJ strains. In (AKRxC57L)F1 mice, the cholesterol absorption efficiency (31 +/- 6%) mimicked that of the C57L parent (37 +/- 5%) and was significantly higher than in AKR mice (24 +/- 4%). Although biliary bile salt compositions and small intestinal transit times were similar, C57L mice displayed significantly greater bile salt secretion rates and pool sizes than AKR mice. In examining lymphatic cholesterol transport in the setting of a chronic biliary fistula, C57L mice displayed significantly higher cholesterol absorption rates compared with AKR mice. Because biliary and intestinal transit factors were accounted for, we conclude that genetic variations at the enterocyte level determine differences in murine cholesterol absorption efficiency, with high cholesterol absorption likely to be a dominant trait. This study provides baseline information for identifying candidate genes that regulate intestinal cholesterol absorption at the cellular level. (+info)
Biliary-bronchial fistula demonstrated by endoscopic retrograde cholangiography. (4/165)Endoscopic retrograde cholangiography is valuable in the evaluation of biliary tract disorders. A 50-year-old Italian woman developed biloptysis 1 year after cholecystectomy because of intrabiliary rupture of a hydatid cyst with secondary infection, which resulted in intrathoracic rupture and communication with the bronchial tree. Endoscopic retrograde cholangiography showed the cause and pathway of the fistulous tract by outlining the biliary tree, abscess cavity and communication with the right upper lobe bronchus. This technique appears to be well suited to the investigation of patients with biliary-bronchial fistula. (+info)
External biliary fistula. (5/165)External biliary fistulas, once common, are now rare: before the present report of 4 cases only 27 cases have been reported in the English literature since 1900. Review of the records of four patients with external biliary fistula confirmed its occurrence in patients over 50 years of age and the variable site for operning of the fistulous tract. Cholecystectomy provided successful treatment in three of the four patients but the fourth was too ill to undergo an operation; in general, definitive treatment is cholecystectomy, together with excision of the fistulous tract if this takes a direct path through the abdominal wall from the gallbladder, or curettage if the course is devious. (+info)
Percutaneous evacuation (PEVAC) of multivesicular echinococcal cysts with or without cystobiliary fistulas which contain non-drainable material: first results of a modified PAIR method. (6/165)BACKGROUND: Surgery is the treatment of choice in echinococcal cysts with cystobiliary fistulas. PAIR (puncture, aspiration, injection, and reaspiration of scolecidals) is contraindicated in these cases. AIM: To evaluate a modified PAIR method for percutaneous treatment of multivesicular echinococcal cysts with or without cystobiliary fistulas which contain non-drainable material. PATIENTS: Twelve patients were treated: 10 patients with multivesicular cysts which contained non-drainable material and were complicated by spontaneous intrabiliary rupture, secondary cystobiliary fistulas, cyst infection, or obstructed portal or hepatic veins; and two patients with large univesicular cysts and a ruptured laminated membrane, one obstructing the portal and hepatic veins and one a suspected cystobiliary fistula. METHODS: The methods used, termed PEVAC (percutaneous evacuation of cyst content), involved the following steps: ultrasound guided cyst puncture and aspiration of cyst fluid to release intracystic pressure and thereby to avoid leakage; insertion of a large bore catheter; aspiration and evacuation of daughter cysts and endocyst by injection and reaspiration of isotonic saline; cystography; injection of scolecidals only if no cystobiliary fistula was present; external drainage of cystobiliary fistulas combined with endoprosthesis or sphincterotomy; catheter removal after complete cyst collapse and closure of the cystobiliary fistula. RESULTS: In all 12 patients initial cyst size was 13.1 (6-20) cm (mean (range)). At follow up 17.9 (4-30) months after PEVAC, seven cysts had disappeared and five cysts had decreased to 2.4 (1-4) cm (p=0.002). In eight patients with multivesicular cysts, a cystobiliary fistula, and infection, cyst size was 12.5 (6-20) cm, catheter time 72.3 (28-128) days, and hospital stay 38.1 (20-55) days. At 17.3 (4-28) months of follow up, six cysts had disappeared and in two cysts residual size was 1 and 2.9 cm, respectively (p=0.012). In four patients without a cystobiliary fistula, cyst size was 14.4 (12.7-16) cm, catheter time 8.8 (3-13) days, and hospital stay 11.5 (8-14) days. At 19.3 (9-30) months of follow up, one cyst had disappeared and three cysts were 85 (69-94)% smaller (2.2 (1-4) cm) (p=0.068). CONCLUSION: PEVAC is a safe and effective method for percutaneous treatment of multivesicular echinococcal cysts with or without cystobiliary fistulas which contain non-drainable material. (+info)
Regulation of hepatic connexins in cholestasis: possible involvement of Kupffer cells and inflammatory mediators. (7/165)Hepatocyte gap junction proteins, connexins (Cxs) 26 and 32, are downregulated during obstructive cholestasis (OC) and lipopolysaccharide hepatocellular cholestasis (LPS-HC). We investigated rat hepatic Cxs during ethynylestradiol hepatocellular cholestasis (EE-HC) and choledochocaval fistula (CCF) and compared them with OC and LPS-HC. Levels (immunoblotting) and cellular distribution (immunofluorescence) of Cx26, -32, and -43, as well as macrophage infiltration, were studied in livers of rats under each condition. Cx26 and -32 were reduced in LPS-HC, OC, and CCF. However, in EE-HC, Cx26 did not change and Cx32 was increased. Prominent inflammation occurred in LPS-HC, OC, and CCF, which was associated with increased levels of Cx43 in LPS-HC and OC but not CCF. No inflammation nor changes in Cx43 levels occurred during EE-HC. In cultured hepatocytes, dye coupling was reduced by tumor necrosis factor-alpha and interleukins-1beta and -6, whereas reduction induced by LPS required coculture with Kupffer cells. Thus hepatocyte gap junctions are downregulated in forms of cholestasis associated with inflammation, and reduced intercellular communication might be induced in part by proinflammatory mediators. (+info)
Sirolimus/cyclosporine/tacrolimus interactions on bile flow and biliary excretion of immunosuppressants in a subchronic bile fistula rat model. (8/165)The new immunosuppressive agent sirolimus generally is combined in transplant patients with cyclosporine and tacrolimus which both exhibit cholestatic effects. Nothing is known about possible cholestatic effects of these combinations which might be important for biliary excretion of endogenous compounds as well as of immunosuppressants. Rats were daily treated with sirolimus (1 mg kg(-1) p.o.), cyclosporine (10 mg kg(-1) i.p.), tacrolimus (1 mg kg(-1) i.p.), or a combination of sirolimus with cyclosporine or tacrolimus. After 14 days a bile fistula was installed to investigate the effects of the immunosuppressants and their combinations on bile flow and on biliary excretion of bile salts, cholesterol, and immunosuppressants. Cyclosporine as well as tacrolimus reduced bile flow (-22%; -18%), biliary excretion of bile salts (-15%;-36%) and cholesterol (-15%; -47%). Sirolimus decreased bile flow by 10%, but had no effect on cholesterol or bile salt excretion. Combination of sirolimus/cyclosporine decreased bile flow and biliary bile salt excretion to the same extent as cyclosporine alone, but led to a 2 fold increase of biliary cholesterol excretion. Combination of sirolimus/tacrolimus reduced bile flow only by 7.5% and did not change biliary bile salt and cholesterol excretion. Sirolimus enhanced blood concentrations of cyclosporine (+40%) and tacrolimus (+57%). Sirolimus blood concentration was increased by cyclosporine (+400%), but was not affected by tacrolimus. We conclude that a combination of sirolimus/tacrolimus could be the better alternative to the cotreatment of sirolimus/cyclosporine in cholestatic patients and in those facing difficulties in reaching therapeutic ranges of sirolimus blood concentration. (+info)
The most common types of biliary fistulas are:
1. Bile duct-enteric fistula: This type of fistula connects the bile ducts to the small intestine.
2. Bile duct-skin fistula: This type of fistula connects the bile ducts to the skin, which can lead to a bile leak and infection.
3. Bile duct-liver fistula: This type of fistula connects the bile ducts to the liver, which can cause bleeding and infection.
Symptoms of biliary fistula may include:
* Jaundice (yellowing of the skin and whites of the eyes)
* Pale or clay-colored stools
* Dark urine
* Loss of appetite
* Weight loss
Diagnosis of biliary fistula is typically made through a combination of imaging tests such as endoscopy, CT scan, and MRI. Treatment options for biliary fistula include:
1. Endoscopic therapy: This may involve the use of an endoscope to repair or close off the fistula.
2. Surgery: In some cases, surgery may be necessary to repair or remove the damaged bile ducts.
3. Stent placement: A stent may be placed in the bile ducts to help keep them open and allow for proper drainage.
It is important to seek medical attention if you experience any symptoms of biliary fistula, as it can lead to serious complications such as infection or bleeding.
A parasitic infection caused by the larvae of the tapeworm Echinococcus granulosus, which primarily affects the liver. The adult worms live in the small intestine of dogs and other canines, and their eggs are shed in the feces. Humans become infected when they ingest the eggs, which then hatch and form cysts in various organs, including the liver.
Symptoms may include abdominal pain, nausea, vomiting, and weight loss. If untreated, the cysts can continue to grow and cause further damage to the liver and other organs. Treatment typically involves surgical removal of the cysts, followed by antiparasitic medication to kill any remaining adult worms.
Preventive measures include avoiding contact with dog feces and proper disposal of infected animal waste. In areas where the disease is common, control programs may involve mass treatment of dogs and other canines to reduce the risk of transmission to humans.
There are several types of fistulas, including:
1. Anal fistula: a connection between the anus and the skin around it, usually caused by an abscess or infection.
2. Rectovaginal fistula: a connection between the rectum and the vagina, often seen in women who have had radiation therapy for cancer.
3. Vesicovaginal fistula: a connection between the bladder and the vagina, often caused by obstetric injuries or surgery.
4. Enterocutaneous fistula: a connection between the intestine and the skin, often seen in patients with inflammatory bowel disease or cancer.
5. Fistula-in-ano: a connection between the rectum and the skin around the anus, often caused by chronic constipation or previous surgery.
Symptoms of fistulas can include pain, bleeding, discharge, and difficulty controlling bowel movements. Treatment depends on the type and location of the fistula, but may include antibiotics, surgery, or other interventional procedures.
Examples of bile duct diseases include:
1. Primary sclerosing cholangitis (PSC): An inflammatory condition that damages the bile ducts, leading to scarring and narrowing of the ducts.
2. Cholangiocarcinoma: A type of cancer that originates in the bile ducts.
3. Gallstones: Small, pebble-like deposits that form in the gallbladder or bile ducts and can cause blockages and inflammation.
4. Bile duct injuries: Damage to the bile ducts during surgery or other medical procedures.
5. Biliary atresia: A congenital condition where the bile ducts are blocked or absent, leading to jaundice and other symptoms in infants.
Treatment for bile duct diseases depends on the underlying cause and can include medications, endoscopic procedures, surgery, and in some cases, liver transplantation.
The AVF is created by joining a radial or brachial artery to a vein in the forearm or upper arm. The vein is typically a radiocephalic vein, which is a vein that drains blood from the hand and forearm. The fistula is formed by sewing the artery and vein together with a specialized suture material.
Once the AVF is created, it needs time to mature before it can be used for hemodialysis. This process can take several weeks or months, depending on the size of the fistula and the individual patient's healing response. During this time, the patient may need to undergo regular monitoring and testing to ensure that the fistula is functioning properly.
The advantages of an AVF over other types of hemodialysis access include:
1. Improved blood flow: The high-flow path created by the AVF allows for more efficient removal of waste products from the blood.
2. Reduced risk of infection: The connection between the artery and vein is less likely to become infected than other types of hemodialysis access.
3. Longer duration: AVFs can last for several years, providing a reliable and consistent source of hemodialysis access.
4. Improved patient comfort: The fistula is typically located in the arm or forearm, which is less invasive and more comfortable for the patient than other types of hemodialysis access.
However, there are also potential risks and complications associated with AVFs, including:
1. Access failure: The fistula may not mature properly or may become blocked, requiring alternative access methods.
2. Infection: As with any surgical procedure, there is a risk of infection with AVF creation.
3. Steal syndrome: This is a rare complication that occurs when the flow of blood through the fistula interferes with the normal flow of blood through the arm.
4. Thrombosis: The fistula may become occluded due to clotting, which can be treated with thrombolysis or surgical intervention.
In summary, an arteriovenous fistula (AVF) is a type of hemodialysis access that is created by connecting an artery and a vein, providing a high-flow path for hemodialysis. AVFs offer several advantages over other types of hemodialysis access, including improved blood flow, reduced risk of infection, longer duration, and improved patient comfort. However, there are also potential risks and complications associated with AVFs, including access failure, infection, steal syndrome, and thrombosis. Regular monitoring and testing are necessary to ensure that the fistula is functioning properly and to minimize the risk of these complications.
The term "intestinal fistula" encompasses several different types of fistulas that can occur in the gastrointestinal tract, including:
1. Enterocutaneous fistula: This type of fistula occurs between the intestine and the skin, typically on the abdominal wall.
2. Enteroenteric fistula: This type of fistula occurs between two segments of the intestine.
3. Enterofistulous intestinal tract: This type of fistula occurs when a segment of the intestine is replaced by a fistula.
4. Fecal fistula: This type of fistula occurs between the rectum and the skin, typically on the perineum.
The causes of intestinal fistulas are varied and can include:
1. Inflammatory bowel disease (IBD): Both Crohn's disease and ulcerative colitis can lead to the development of intestinal fistulas.
2. Diverticulitis: This condition can cause a fistula to form between the diverticula and the surrounding tissues.
3. Infection: Bacterial or parasitic infections can cause the formation of fistulas in the intestine.
4. Radiation therapy: This can damage the intestinal tissue and lead to the formation of a fistula.
5. Trauma: Blunt or penetrating trauma to the abdomen can cause a fistula to form between the intestine and surrounding tissues.
6. Cancer: Malignancies in the intestine or surrounding tissues can erode through the bowel wall and form a fistula.
7. Rare genetic conditions: Certain inherited conditions, such as familial polyposis syndrome, can increase the risk of developing intestinal fistulas.
8. Other medical conditions: Certain medical conditions, such as tuberculosis or syphilis, can also cause intestinal fistulas.
The symptoms of intestinal fistulas can vary depending on the location and severity of the fistula. Common symptoms include:
1. Abdominal pain
3. Rectal bleeding
4. Infection (fever, chills, etc.)
5. Weakness and fatigue
6. Abdominal distension
7. Loss of appetite
8. Nausea and vomiting
The diagnosis of an intestinal fistula is typically made through a combination of physical examination, medical history, and diagnostic tests such as:
1. Imaging studies (X-rays, CT scans, MRI scans) to visualize the fistula and surrounding tissues.
2. Endoscopy to examine the inside of the intestine and identify any damage or abnormalities.
3. Biopsy to obtain a tissue sample for further examination.
4. Blood tests to check for signs of infection or inflammation.
Treatment of an intestinal fistula depends on the underlying cause and the severity of the condition. Treatment options may include:
1. Antibiotics to treat any underlying infections.
2. Surgery to repair the fistula and remove any damaged tissue.
3. Nutritional support to help the body heal and recover.
4. Management of any underlying medical conditions, such as diabetes or Crohn's disease.
5. Supportive care to manage symptoms such as pain, nausea, and vomiting.
The prognosis for intestinal fistulas varies depending on the underlying cause and the severity of the condition. In general, with prompt and appropriate treatment, many people with intestinal fistulas can experience a good outcome and recover fully. However, in some cases, complications such as infection or bleeding may occur, and the condition may be challenging to treat.
Terms commonly used when discussing cutaneous fistula include:
* Cutaneous: refers to the skin
* Fistula: a tunnel-like structure that connects two organs or tissues
* Drainage: the removal of fluid or pus from the body
Example sentences using the word "cutaneous fistula":
1. The patient developed a cutaneous fistula on their abdomen after undergoing surgery for an abscess.
2. The cutaneous fistula was causing discomfort and infection, so the doctor recommended draining it to prevent further complications.
3. The cause of the cutaneous fistula was determined to be a cyst that had ruptured and formed a tunnel-like structure to the skin.
In medical terminology, a bronchial fistula is an unusual connection between two organs or between an organ and the skin that allows air to escape from the respiratory tract and enter the skin. This can result in a persistent cough and other symptoms, such as chest pain, fever, and difficulty breathing.
Bronchial fistulas are relatively rare and can be caused by a variety of factors, including:
1. Trauma to the chest, such as from a car accident or fall.
2. Infections, such as tuberculosis or pneumonia, that can damage the lungs and cause an abnormal connection to form.
3. Cancer, such as lung cancer, that has spread to the skin and formed a fistula.
4. Congenital conditions, such as bronchial malformations that are present at birth.
Treatment for a bronchial fistula depends on the underlying cause and may include antibiotics for infections, surgery to repair or remove damaged tissue, or other interventions to manage symptoms. In some cases, a bronchial fistula may be treated with endobronchial therapy, in which a small tube is inserted through the mouth or nose and guided to the site of the fistula to close it off.
In summary, a bronchial fistula is an abnormal connection between two organs or between an organ and the skin that can cause air to leak into the skin and lead to chronic cough and other symptoms. Treatment depends on the underlying cause of the fistula and may involve antibiotics, surgery, or endobronchial therapy.
Example sentence: "The patient underwent surgery to create a vascular fistula in her arm to improve the flow of blood to her kidneys."
Please note that this definition is a summary and may not be comprehensive or up-to-date. For accurate and current information, I recommend consulting a medical professional or a reputable online source.
Also known as: Gastric-enteric fistula, gastrointestinal fistula, stomach fistula.
1. The patient was diagnosed with a gastric fistula and underwent surgery to repair the abnormal connection.
2. The symptoms of gastric fistula can be severe and debilitating, making it important to seek medical attention if they persist or worsen over time.
3. Gastric fistula is a rare complication of gastric surgery, but it can be managed with prompt and appropriate treatment.
The symptoms of urinary fistula can vary depending on the location and severity of the condition, but may include:
* Incontinence or leakage of urine
* Pain or discomfort in the abdomen or pelvis
* Frequent urination or difficulty starting a stream of urine
* Blood in the urine
* Cloudy or strong-smelling urine
* Recurring urinary tract infections
Treatment for urinary fistula typically involves surgery to repair the abnormal connection and restore normal urinary function. In some cases, this may involve creating a new opening for urine to pass through or repairing damaged tissue.
Preventive measures for urinary fistula are not well established, but good hygiene practices and proper care after surgery can help reduce the risk of developing the condition. Early detection and treatment are important to prevent complications and improve outcomes.
Symptoms of an esophageal fistula may include difficulty swallowing, regurgitation of food, coughing, and chest pain. Diagnosis is typically made through endoscopy, imaging studies such as CT scans or MRIs, and other tests such as barium swallows or pH monitoring.
Treatment options for esophageal fistula depend on the location and severity of the fistula, as well as the underlying cause. Conservative management with antibiotics and acid suppression may be sufficient for some cases, while more complex interventions such as surgery or endoscopic therapy may be required for others. In severe cases, esophageal fistula may require emergency surgical repair to prevent life-threatening complications such as aspiration pneumonia or sepsis.
The severity and impact of pancreatic fistula can vary depending on factors such as the size and location of the fistula, the extent of the pancreatectomy, and the overall health status of the individual. Treatment options for pancreatic fistula may include conservative management with supportive care, surgical repair or revision of the pancreatectomy, or other interventional procedures to manage symptoms and prevent complications.
Symptoms of a rectovaginal fistula may include:
* Incontinence of stool or gas into the vagina
* Pain in the rectal or vaginal area
* Discharge of stool or gas from the vagina
* Perineal pain during sexual activity
* Difficulty with bowel movements
Diagnosis is typically made through a physical examination, and may also include imaging tests such as an MRI or CT scan.
Treatment for a rectovaginal fistula usually involves surgery to repair the defect. The type of surgery used will depend on the location and size of the fistula, as well as the patient's overall health. In some cases, multiple procedures may be necessary to achieve complete resolution of symptoms.
In addition to surgical treatment, other therapies such as bowel training, stool softeners, and antibiotics may be used to manage symptoms and prevent complications. Patients with rectovaginal fistulas should work closely with their healthcare provider to develop a personalized treatment plan that addresses their individual needs and goals.
In the medical field, VVF is typically diagnosed through a combination of physical examination, imaging tests such as ultrasound or MRI, and cystography, which involves injecting dye into the bladder to visualize its shape and function.
Treatment for VVF usually involves surgery to repair the connection between the bladder and vagina. The specific surgical approach will depend on the location and severity of the fistula, as well as the patient's overall health. In some cases, a seton or a catheter may be used to help drain urine from the bladder until the fistula can be repaired.
In addition to surgical treatment, patients with VVF may also require ongoing management of related complications such as urinary tract infections, and may need to make lifestyle changes such as avoiding certain foods or activities that can exacerbate the condition.
Overall, vesicovaginal fistula is a serious medical condition that requires prompt diagnosis and treatment to prevent complications and improve quality of life for patients.
The symptoms of a respiratory tract fistula can vary depending on the location and size of the connection. Some common symptoms include:
* Difficulty breathing
* Nasal regurgitation of food or liquids
* Coughing up blood or mucus
* Chest pain or pressure
* Wheezing or stridor (a high-pitched sound when breathing in)
* Pneumonia or other respiratory infections
If you suspect that you or someone else may have a respiratory tract fistula, it is important to seek medical attention as soon as possible. A healthcare professional will perform a physical examination and order imaging tests, such as a CT scan or MRI, to confirm the diagnosis and determine the location and size of the fistula.
Treatment for a respiratory tract fistula depends on the severity of the condition and may include:
* Observation and monitoring: Small fistulas may not require treatment and can be monitored with regular check-ups to ensure that they do not cause any complications.
* Endoscopy: A thin, flexible tube with a camera and light on the end can be inserted through the nose or mouth to visualize the fistula and remove any obstructions.
* Surgery: Larger fistulas may require surgical repair, which can involve closing the connection between the two organs or structures with sutures or staples.
* Laser therapy: A laser can be used to burn away the abnormal tissue creating the fistula.
It is important to note that respiratory tract fistulas are rare and most people with this condition will not experience any complications or symptoms. However, if you suspect that you or someone you know may have a respiratory tract fistula, it is important to seek medical attention as soon as possible to receive an accurate diagnosis and appropriate treatment.
In the medical field, "vaginal fistula" is a term that is used to describe an abnormal connection between two organs or between an organ and the skin that occurs in the vagina. This condition can have a significant impact on a woman's quality of life, causing a range of symptoms such as urinary incontinence, vaginal discharge, pain during intercourse, and pelvic pressure.
The causes of vaginal fistula can be varied and may include:
* Childbirth: Vaginal tears or episiotomy during delivery can sometimes lead to a fistula.
* Sexual trauma: Traumatic sexual experiences, such as rape or sexual assault, can cause a fistula to develop.
* Radiation therapy: Radiation therapy to the pelvic area can damage the vaginal tissue and lead to a fistula.
* Surgery: Certain surgeries, such as hysterectomy or bladder neck suspension, can sometimes result in a fistula.
Treatment options for vaginal fistula depend on the underlying cause and the severity of the condition. Surgery is often the primary treatment approach, and may involve repairing or closing the fistula, or removing any damaged tissue. Hormonal therapy may also be prescribed to help manage symptoms such as vaginal dryness or pain during intercourse. Other supportive measures, such as catheterization or urethral dilatation, may also be necessary to help manage urinary incontinence or other complications.
In summary, vaginal fistula is a condition that can cause significant distress and disrupt daily life. It is important to seek medical attention if symptoms persist or worsen over time, as early diagnosis and treatment can improve outcomes and reduce the risk of long-term complications.
1. Infection: Bacterial or viral infections can develop after surgery, potentially leading to sepsis or organ failure.
2. Adhesions: Scar tissue can form during the healing process, which can cause bowel obstruction, chronic pain, or other complications.
3. Wound complications: Incisional hernias, wound dehiscence (separation of the wound edges), and wound infections can occur.
4. Respiratory problems: Pneumonia, respiratory failure, and atelectasis (collapsed lung) can develop after surgery, particularly in older adults or those with pre-existing respiratory conditions.
5. Cardiovascular complications: Myocardial infarction (heart attack), cardiac arrhythmias, and cardiac failure can occur after surgery, especially in high-risk patients.
6. Renal (kidney) problems: Acute kidney injury or chronic kidney disease can develop postoperatively, particularly in patients with pre-existing renal impairment.
7. Neurological complications: Stroke, seizures, and neuropraxia (nerve damage) can occur after surgery, especially in patients with pre-existing neurological conditions.
8. Pulmonary embolism: Blood clots can form in the legs or lungs after surgery, potentially causing pulmonary embolism.
9. Anesthesia-related complications: Respiratory and cardiac complications can occur during anesthesia, including respiratory and cardiac arrest.
10. delayed healing: Wound healing may be delayed or impaired after surgery, particularly in patients with pre-existing medical conditions.
It is important for patients to be aware of these potential complications and to discuss any concerns with their surgeon and healthcare team before undergoing surgery.
There are different types of TEF, classified based on the location of the connection:
1. Intrathoracic TEF: This type of fistula connects the trachea and esophagus within the chest cavity.
2. Extraluminal TEF: This type of fistula connects the trachea and esophagus outside the chest cavity, usually near the thyroid gland or cricothyroid membrane.
The symptoms of TEF can vary depending on the location and size of the fistula. Some common symptoms include:
* Difficulty breathing
* Coughing or wheezing
* Swallowing difficulties
* Pneumonia or other respiratory infections
* Aspiration pneumonia (when food, liquids, or stomach contents enter the lungs)
* Chest pain or discomfort
* Weight loss or failure to gain weight
TEF can be diagnosed using a variety of tests, including:
1. Endoscopy: A flexible tube with a camera and light on the end is inserted through the nose or mouth to visualize the esophagus and trachea.
2. Imaging studies: X-rays, CT scans, or MRI scans can help identify the location and size of the fistula.
3. Bronchoscopy: A thin, flexible tube with a camera and light on the end is inserted through the nose or mouth to visualize the inside of the airways and trachea.
4. Biopsy: A small sample of tissue may be taken from the fistula for further examination.
Treatment for TEF depends on the location, size, and severity of the fistula, as well as the patient's overall health and medical history. Treatment options may include:
1. Endoscopic therapy: The fistula may be closed using endoscopy, either by injecting a special medication or by using a device to close the opening.
2. Surgery: In some cases, surgery may be necessary to repair the fistula. This may involve removing the diseased tissue and reconstructing the airway.
3. Antibiotics: If an infection is present, antibiotics may be prescribed to help clear it up.
4. Supportive care: Patients with TEF may require supportive care, such as oxygen therapy or mechanical ventilation, to help them breathe and manage their symptoms.
Overall, early diagnosis and treatment of TEF are important to prevent complications and improve outcomes.
Types: There are several types of digestive system fistulae, including:
* Esophago-gastric fistula: A connection between the esophagus and stomach
* Gastric-duodenal fistula: A connection between the stomach and small intestine
* Jejuno-ileal fistula: A connection between the small intestine and large intestine
* Ileo-caecal fistula: A connection between the large intestine and the caecum, a pouch-like structure in the appendix
Causes: Digestive system fistulae can be caused by a variety of factors, including:
* Inflammatory bowel disease (IBD) such as Crohn's disease or ulcerative colitis
* Diverticulitis, a condition in which pouches form in the wall of the GI tract and become infected
* Cancer, such as rectal cancer or colon cancer
* Radiation therapy to the pelvic area
* Infections, such as abscesses or gangrene
Symptoms: Symptoms of digestive system fistulae can include:
* Pain in the abdomen or pelvis
* Swelling in the abdomen or pelvis
* Diarrhea or constipation
* Abdominal distension
* Weight loss
Treatment: Treatment for digestive system fistulae depends on the underlying cause and may include antibiotics, surgery, or other interventions. In some cases, the condition may be managed with draining of the abscess or fistula, or with the use of a nasogastric tube to drain the contents of the stomach. Surgical repair of the fistula may also be necessary.
Prognosis: The prognosis for digestive system fistulae depends on the underlying cause and the severity of the condition. In general, early diagnosis and treatment can improve outcomes. However, if left untreated, the condition can lead to serious complications such as sepsis, organ damage, or death.
Prevention: Preventing digestive system fistulae involves managing any underlying conditions that may contribute to their development. For example, people with inflammatory bowel disease should adhere to their treatment regimens and make lifestyle changes as recommended by their healthcare providers. In addition, good hand hygiene and proper sterilization techniques can help prevent the spread of infections that can lead to fistulae.
* Inguinal hernia: Occurs when part of the intestine bulges through a weakened area in the inguinal canal, which is located in the groin area.
* Umbilical hernia: Occurs when an organ or tissue protrudes through a weakened area near the belly button.
* Hiatal hernia: Occurs when the stomach bulges up into the chest through a weakened area in the diaphragm.
* Ventral hernia: Occurs when an organ or tissue protrudes through a weakened area in the abdominal wall, usually in the upper abdomen.
Symptoms of Abdominal Hernia may include pain or discomfort in the affected area, bulging or swelling, and difficulty passing stool or gas. Treatment options range from lifestyle changes to surgery, depending on the severity of the condition.
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- Enterocutaneous fistulas, defined as an abnormal communication between the small bowel and skin, are among the most daunting problems for an intestinal surgeon. (abdominalkey.com)
- The impact of an enterocutaneous fistula on a patient varies from a minor inconvenience to fatal malnutrition and dehydration. (abdominalkey.com)
- Eight patients with BBF that without biliary obstruction admitted to the Department of Respiratory and Critical Care Medicine , the First Affiliated Hospital of Naval Medical University from January 1, 2015 to December 31, 2021 were included in this study. (bvsalud.org)
- Patients who develop a gastrointestinal vaginal fistula may also have a bowel obstruction and require surgical intervention, as well as a diverting ostomy. (pfizermedicalinformation.com)
- Iatrogenic fistulas that occur where the bowel is healthy may well heal with time as long as no distal obstruction and no associated abscess cavity or foreign body are present and the bowel has not matured itself to the skin, as in a stoma. (abdominalkey.com)
- Hone and expand your surgical skills by watching videos of minimally invasive procedures for recto urethral fistula, biliary atresia, laparoscopic splenectomy, uterine horn, and more. (pickpdfs.com)
- Necrotizing fasciitis including fatal cases, has been reported in patients receiving bevacizumab usually secondary to wound healing complications, gastrointestinal perforation or fistula formation. (pfizermedicalinformation.com)
- Perforation can be complicated by intra-abdominal abscess, fistula formation, and the need for diverting ostomies. (pfizermedicalinformation.com)
- Surgical management of biliary injuries achieve controlled drainage of biliary fistula during the conditions, gender, type of biliary injury (E4E1), and early period and to timely treat the biliary stricture and associated vascular injury. (who.int)
- The standard surgical management done for major biliary injuries is Roux-en-Y Hepaticojejunostomy (R-en-Y HJ). (bvsalud.org)
- Separately, studies are given on the diagnosis of diseases of the bile ducts with altered biliary anatomy, biliary fistulas after surgical interventions. (spr-journal.ru)
- Liver function tests and ultrasound of major postcholecystectomy biliary injuries managed of the abdomen were done at each visit. (who.int)
- After 2-6 times of bronchial silicone plug (5 cases), fistula were successfully blocked in 3 cases, and the frequency and volume of bile -like sputum decreased by 50% or more in 2 cases. (bvsalud.org)
- Headed by a dedicated team of expert doctors and backed by sophisticated equipments and well trained staff, the department provides quality treatment for complicated and uncomplicated gastrointestinal and biliary disorders. (pvshospital.com)
- Discontinue in patients who develop gastrointestinal perforation, tracheoesophageal fistula or any Grade 4 fistula. (pfizermedicalinformation.com)
- However, this chapter deals primarily with fistulas relating to the small bowel. (abdominalkey.com)
- High-output fistulas: An output of more than 500 mL per 24 hours normally indicates a fistula in the proximal small bowel. (abdominalkey.com)
- Moderate-output fistulas: An output of 200 to 500 mL per 24 hours indicates that the fistula is likely to be more distal in the small bowel. (abdominalkey.com)
- Low-output fistulas: An output of less than 200 mL per 24 hours suggests that most of the stool is passing through the small bowel normally and the fistula is diverting a small fraction of it. (abdominalkey.com)
- Abstract for major biliary injuries is RouxenY Hepaticojejunostomy (RenY HJ). (who.int)
- Among the 6 patients who used bronchial silicone plug as plugging material in the first SBO treatment , 1 case was successfully plugged, 2 cases did not achieve symptoms relief after plugging, 2 cases coughed up the plugging device immediately after surgery , and 1 case developed a new fistula . (bvsalud.org)
- Patients managed surgically for definitive management of biliary injuries in the form of RenY HJ were included. (who.int)
- A total of 24 patients presented with ongoing biliary fistula. (who.int)
- Materials and Methods: Patients managed surgically for definitive management of biliary injuries in the form of R-en-Y HJ were included. (bvsalud.org)
- Serious fistulae (including, tracheoesophageal, bronchopleural, biliary, vaginal, renal and bladder sites) occurred at a higher incidence in patients receiving bevacizumab products compared to patients receiving chemotherapy. (pfizermedicalinformation.com)
- In the 15% to 20% of fistulas that are not iatrogenic, disease results from a perforation of the bowel with surrounding inflammation that quarantines the leak and prevents peritoneal contamination with fecal peritonitis. (abdominalkey.com)
- Because of the nature of enterocutaneous fistulas (especially those occurring after surgery), it is proper to allow 4 to 5 months (if possible) between surgeries that are designed to fix the fistula. (abdominalkey.com)
- Management of these injuries the timing of repair of biliary fistula also need to be requires expertise and involves a patient who is addressed with some recent studies showing equivalent troubled as well as drained of personal resources. (who.int)
- The care and repair of enterocutaneous fistulas require meticulous attention to detail. (abdominalkey.com)
- Colocutaneous fistulas are a different proposition with different, usually less major challenges. (abdominalkey.com)
- Instead, an abscess is usually present that, when drained, results in a fistula or erodes through tissues as it works its way to the surface and drains spontaneously. (abdominalkey.com)
- It is tempting to perform a second operation immediately to fix a postoperative fistula and make the patient normal, but this temptation should be resisted. (abdominalkey.com)
- Creation of an artificial external opening or fistula in the intestines. (bvsalud.org)
External Biliary Fistula3
- Hepatobiliary and Pancreatic: Spontaneous cholecystocutaneous fistula. (medscape.com)
- Waheed A, Mathew G, Tuma F. Cholecystocutaneous Fistula . (medscape.com)
- Spontaneous cholecystocutaneous fistula as a primary manifestation of gallbladder adenocarcinoma associated with gallbladder lithiasis - case report. (medscape.com)
- Spontaneous cholecystocutaneous fistula presenting with a cellulitis and portal vein thrombosis. (medscape.com)
- Vasanth A, Siddiqui A, O'Donnell K. Spontaneous cholecystocutaneous fistula. (medscape.com)
- Spontaneous external biliary fistulas. (medscape.com)
- Sodhi K, Athar M, Kumar V, Sharma ID, Husain N. Spontaneous cholecysto-cutaneous fistula complicating carcinoma of the gall bladder: a case report. (medscape.com)
- 1. [Spontaneous biliodigestive fistulae. (nih.gov)
- 16. [Spontaneous cholecysto-gastric fistula with massive gastrointestinal bleeding. (nih.gov)
- The patient developed a biliary fistula that was managed conservatively with long-term drainage (the abdominal drain was left in place for 4 weeks) and octreotide. (medscape.com)
- Association Between Biliary Pathogens, Surgical Site Infection, and Pancreatic Fistula: Results of a Randomized Trial of Perioperative Antibiotic Prophylaxis in Patients Undergoing Pancreatoduodenectomy. (bvsalud.org)
- Patients undergoing pancreatoduodenectomy experience high rates of surgical site infection (SSI) and clinically relevant postoperative pancreatic fistula (CR-POPF). (bvsalud.org)
- Weiler H, Grandel A. Postoperative fistula of the abdominal wall after laparascopic cholecystectomy due to lost gallstones. (medscape.com)
- Gallstone ileus, a rather rare complication of a rather common pathology, biliary lithiasis, is found in 0.000015% of hospitalized patients but in 0.0003% of surgical patients. (nih.gov)
- Iatrogenic fistulas, due to surgery or instrumental exploration, are not included in this definition. (nih.gov)
- Endoscopic retrograde cholangiography can also be useful in localizing biliary leaks, and it has the additional advantage of providing the opportunity to place an endoluminal stent across the papilla of Vater. (medscape.com)
- 3. [Biliary ileus: review of the literature and presentation of 7 cases]. (nih.gov)
- 5. [Biliary ileus: a review of the literature and report of a clinical case treated by minilaparotomy]. (nih.gov)
- 13. [Choledocho-duodenal fistula due to perforating duodenal ulcer disease. (nih.gov)
- Shrestha BM, Wyman A. Cholecystocolocutaneous fistula: a case report. (medscape.com)
- The most common type of SBEF is cholecystoduodenal fistula and the least common is choledochoduodenal fistula. (nih.gov)