Cutaneous Fistula
Fistula
Arteriovenous Fistula
Intestinal Fistula
Bronchial Fistula
Vascular Fistula
Rectal Fistula
Urinary Fistula
Esophageal Fistula
Biliary Fistula
Digestive System Fistula
Hernia, Abdominal
Cardiocutaneous fistula. (1/133)
Infection of the Teflon pledgets on the heart suture line after left ventricular aneurysm repair, presenting late with a fistulous tract connecting the heart with the skin (cardiocutaneous fistula) is an uncommon but potentially serious condition. The case is reported of a 73 year old man who developed a cardiocutaneous fistula extending through the left hemidiaphragm and draining at the abdominal wall, which developed six years after left ventricular aneurysmectomy. Following radiographic evaluation, which established the diagnosis, the Teflon pledgets and fistulous tract were successfully surgically removed. Prompt diagnosis depends on a high index of suspicion. Eradication of infection requires excision of infected material, which must be planned on an individual basis. (+info)Infliximab for the treatment of fistulas in patients with Crohn's disease. (2/133)
BACKGROUND: Enterocutaneous fistulas are a serious complication of Crohn's disease and are difficult to treat. Infliximab, a chimeric monoclonal antibody to tumor necrosis factor alpha, has recently been developed as a treatment for Crohn's disease. We conducted a randomized, multicenter, double-blind, placebo-controlled trial of infliximab for the treatment of fistulas in patients with Crohn's disease. METHODS: The study included 94 adult patients who had draining abdominal or perianal fistulas of at least three months' duration as a complication of Crohn's disease. Patients were randomly assigned to receive one of three treatments: placebo (31 patients), 5 mg of infliximab per kilogram of body weight (31 patients), or 10 mg of infliximab per kilogram (32 patients); all three were to be administered intravenously at weeks 0, 2, and 6. The primary end point was a reduction of 50 percent or more from base line in the number of draining fistulas observed at two or more consecutive study visits. A secondary end point was the closure of all fistulas. RESULTS: Sixty-eight percent of the patients who received 5 mg of infliximab per kilogram and 56 percent of those who received 10 mg per kilogram achieved the primary end point, as compared with 26 percent of the patients in the placebo group (P=0.002 and P=0.02, respectively). In addition, 55 percent of the patients assigned to receive 5 mg of infliximab per kilogram and 38 percent of those assigned to 10 mg per kilogram had closure of all fistulas, as compared with 13 percent of the patients assigned to placebo (P=0.001 and P=0.04, respectively). The median length of time during which the fistulas remained closed was three months. More than 60 percent of patients in all the groups had adverse events. For patients treated with infliximab, the most common were headache, abscess, upper respiratory tract infection, and fatigue. CONCLUSIONS: Infliximab is an efficacious treatment for fistulas in patients with Crohn's disease. (+info)Thyroglossal duct cysts: sonographic appearances in adults. (3/133)
BACKGROUND AND PURPOSE: Previous reports have suggested that thyroglossal duct cysts (TDCs) appear on sonograms as well-defined cystic masses with thin walls and posterior enhancement. In our experience, however, TDCs have a variable sonographic appearance. We report our findings in 40 patients with TDCs and document the variability of sonographic patterns. METHODS: All patients in whom the diagnosis of TDC was made clinically (by at least two head and neck surgeons) and sonography detected a cystic mass related to the hyoid bone were included in this study. Sonograms of 40 patients with TDCs were reviewed. The features evaluated were the location, internal echogenicity, posterior enhancement, presence of septa, solid component, and fistulous tract. The echo pattern was not compared with the biopsy results. RESULTS: Four patterns of TDCs were identified: anechoic (28%), homogeneously hypoechoic with internal debris (18%), pseudosolid (28%), and heterogeneous (28%). The majority showed posterior enhancement (88%), were midline (63%), and infrahyoid in location (83%). Only half of all TDCs showed a typical thin wall. CONCLUSION: On sonograms, TDCs in adults are not simple cysts, as previously suggested, but have a complex pattern ranging from a typical anechoic to a pseudosolid appearance. (+info)Hydrogen peroxide enhanced ultrasound- fistulography in the assessment of enterocutaneous fistulas complicating Crohn's disease. (4/133)
BACKGROUND/AIMS: Proper management of enterocutaneous fistulas complicating Crohn's disease largely depends on the anatomical characteristics of the sinus tracks as well as the coexistence of complications such as abscesses and distal bowel stenosis. The aim of this prospective study was to evaluate the accuracy of a new technique (hydrogen peroxide enhanced ultrasound (US)-fistulography) compared with conventional x ray fistulogram and/or surgical findings in the detection of Crohn's disease associated enterocutaneous fistulas. METHODS: Patients with known Crohn's disease and a suspicion of enterocutaneous fistulas were prospectively studied with this novel technique, conventional x ray fistulogram, and barium radiography as well as with computed tomography whenever an abdominal abscess was suspected at US. In those undergoing surgery, intraoperative findings were also compared. RESULTS: Seventeen of 502 (3.4%) consecutive patients with Crohn's disease seen over a ten month period had associated enterocutaneous fistulas and were enrolled. Hydrogen peroxide enhanced US-fistulography visualised the extent and configuration of fistula in all cases: 13 patients had a fistula arising from the ileum and two from the sigmoid colon, whereas in two there was no evidence of communication with intestinal loops; in contrast, conventional x ray fistulography missed a correct definition of the fistulous branches or communication with intestinal loops in 50% (4/8) and 36% (4/11) of patients respectively; barium radiography showed fistulas in two cases only. The presence of abscesses along or close to the sinus track, as well as the coexistence of intestinal stenosis, was correctly detected at US in all patients. CONCLUSIONS: Hydrogen peroxide enhanced US-fistulography could be considered the diagnostic procedure of choice in Crohn's disease associated enterocutaneous fistulas, as it is at least as accurate, simple, and safe as conventional x ray fistulogram, does not miss coexisting abdominal complications, and also provides information on the diseased bowel segments. In addition, it can be easily repeated over time in order to monitor the course of fistulas undergoing conservative treatment. (+info)Persistent frontal fistula. (5/133)
The frontal sinus is prone to various complications--usually secondary to blockage of the fronto-nasal duct and stagnation of frontal sinus secretions. These pent-up secretions may result in pressure necrosis of the inferior or posterior sinus wall. Involvement of anterior wall is uncommon. We present a case of an anterior wall frontal sinus fistula and discuss its management. (+info)Possibilities of preventing osteoradionecrosis during complex therapy of tumors of the oral cavity. (6/133)
In recent years, there has been a dramatic increase in the number of tumors of the head and neck. Their successful treatment is one of the greatest challenges for physicians dealing with oncotherapy. An organic part of the complex therapy is preoperative or postoperative irradiation. Application of this is accompanied by a lower risk of recurrences, and by a higher proportion of cured patients. Unfortunately, irradiation also has a disadvantage: the development of osteoradionecrosis, a special form of osteomyelitis, in some patients (mainly in those cases where irradiation occurs after bone resection or after partial removal of the periosteum). Once the clinical picture of this irradiation complication has developed, its treatment is very difficult. A significant result or complete freedom from complaints can be attained only rarely. Attention must therefore be focussed primarily on prevention, and the oral surgeon, the oncoradiologist and the patient too can all do much to help prevent the occurrence of osteoradionecrosis. Through coupling of an up-to-date, functional surgical attitude with knowledge relating to modern radiology and radiation physics, the way may be opened to forestall this complication that is so difficult to cure. (+info)Neck infection associated with pyriform sinus fistula: imaging findings. (7/133)
BACKGROUND AND PURPOSE: Acute suppurative neck infections associated with branchial fistulas are frequently recurrent. In this study, we describe the imaging findings of acute suppurative infection of the neck caused by a third or fourth branchial fistula (pyriform sinus fistula). METHODS: Imaging findings were reviewed in 17 patients (11 female and six male patients, 2 to 49 years old) with neck infection associated with pyriform sinus fistula. Surgery or laryngoscopic examination confirmed the diagnoses. Fourteen patients had a history of recurrent neck infection and seven had cutaneous openings on the anterior portion of the neck (all lesions were on the left side). Imaging studies included barium esophagography (n = 16), CT (n = 14), MR imaging (n = 2), and sonography (n = 3). RESULTS: A sinus or fistulous tract was identified in eight of 16 patients on barium esophagograms. In 14 patients, CT studies showed the inflammatory infiltration and/or abscess formation along the course of the sinus or fistulous tract from the pyriform fossa to the thyroid gland. In nine patients, CT scans showed the entire course or a part of the sinus or fistulous tract as a tiny spot containing air. MR images showed a sinus or fistulous tract in two patients, whereas sonograms could not depict a sinus or fistulous tract in three patients. All 17 patients were treated with antibiotics. In one patient, the sinus tract was surgically excised, while 15 patients underwent chemocauterization of the sinus or fistulous tract with good outcome. Follow-up was possible for 16 of the 17 patients. CONCLUSION: When an inflammatory infiltration or abscess is present between the pyriform fossa and the thyroid bed in the lower left part of the neck, an infected third or fourth branchial fistula should be strongly suspected. (+info)Lymphocutaneous fistula as a long-term complication of multiple central venous catheter placement. (8/133)
We report a case of a lymphocutaneous fistula in a 19-month-old boy who had been a premature neonate, born in the 23rd week of gestation. The fistula, an apparent complication of central venous line placement during the patient's first 5 months of life, was composed of a distinct lymphatic vessel bundle in the right supraclavicular region, with its exit point at the posterior aspect of the right shoulder. The drainage ceased immediately after resection and repair of a 1-cm obstruction in the superior vena cava. (+info)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.
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.
Also known as: Gastric-enteric fistula, gastrointestinal fistula, stomach fistula.
Example sentences:
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 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
2. Diarrhea
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.
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.
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 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
* Fatigue
* 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.
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.
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
* Fever
* 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.