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The Interrupted Time Series (ITS) is a quasi-experimental design commonly used in public health to evaluate the impact of interventions or exposures. Multiple statistical methods are available to analyse data from ITS studies, but no empirical investigation has examined how the different methods compare when applied to real-world datasets. A random sample of 200 ITS studies identified in a previous methods review were included. Time series data from each of these studies was sought. Each dataset was re-analysed using six statistical methods. Point and confidence interval estimates for level and slope changes, standard errors, p-values and estimates of autocorrelation were compared between methods. From the 200 ITS studies, including 230 time series, 190 datasets were obtained. We found that the choice of statistical method can importantly affect the level and slope change point estimates, their standard errors, width of confidence intervals and p-values. Statistical significance (categorised at the 5%

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Penetrating atherosclerotic ulcer rupturing into the esophagus is rare and the resulting aortoesophageal fistula carries a high mortality. In view of the emergency nature of the entity and complexity of the procedure management of such a condition is not standardized. The immediate concern is to save the patient from life threatening exsanguinations. Contrary to the practice hitherto followed no active surgical intervention was carried out for the esophageal lesion and cardiopulmonary bypass support was not employed. We present a case of rupture of a penetrating atherosclerotic ulcer of descending thoracic aorta, where in an emergency surgery was performed and the patient is doing well 21 months later.

A case of right coronary to left ventricular fistula was diagnosed by cross sectional and Doppler echocardiography. The origin and site of entry into the left ventricle of the enlarged right coronary artery were shown by cross sectional echocardiography. Diastolic flow was detected in the left ventricle by both pulsed and continuous Doppler echocardiography. The fistula was confirmed by cardiac catheterisation and was successfully closed at operation. ...

Patients with impacted foreign bodies in the upper aerodigestive tract present commonly to ENT clinics. This case report highlights two important issues in the management of these patients. First, if the evidence of esophageal perforation is strong and contrast swallow is negative, the physician must consider further imaging, such as contrast computed tomography. Second, ENT physicians must beware of the complications of esophageal trauma, including major vascular injury and aortoesophageal fistula, in patients with retained sharp foreign bodies in the mid-esophagus.. ...

Cardiology Research and Practice is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies that focus on the diagnosis and treatment of cardiovascular disease. The journal welcomes submissions related to systemic hypertension, arrhythmia, congestive heart failure, valvular heart disease, vascular disease, congenital heart disease, and cardiomyopathy.

Find the best coronary artery fistula doctors in Delhi NCR. Get guidance from medical experts to select coronary artery fistula specialist in Delhi NCR from trusted hospitals - credihealth.com

Purpose: We present the case of a patient who developed an aortoesophageal fistula (AEF) 4 years after thoracic endovascular aortic repair (TEVAR) of a descending thoracic aortic aneurysm rupture. ...

Coronary artery fistulae (CAF) are rare anomalies. They are vascular communications between the coronary arteries and other cardiac structures, either cardiac chambers or great vessels. There can be considerable variation in the course of a coronary artery fistula. We report a case of a coronary artery fistula between the left circumflex coronary artery and the right and left atria. CAF are often diagnosed by coronary angiogram, however with the advent of new technologies such as Coronary Computed Tomography Angiography (Coronary CTA) the course and communications of these fistulae can be delineated non-invasively and with greater accuracy.

Christmann, Martin; Hoop, Ricarda; Dave, Hitendu; Quandt, Daniel; Knirsch, Walter; Kretschmar, Oliver (2017). Closure of coronary artery fistula in childhood: treatment techniques and long-term follow-up. Clinical Research in Cardiology, 106(3):211-218. ...

Otte G, Seebass J. Aortobronchial fistula causing hemoptysis in a patient with a Dacron aortic patch graft: report of a case. J Am Osteopath Assoc 1984;83(6):442. doi: https://doi.org/10.7556/jaoa.1984.83.6.442.. Download citation file:. ...

Primary aortoesophgeal fistulas (AEF) are a rare but life-threatening condition because of substantial hemorrhage, requiring fast treatment to ensure patient survival. We report a case of a 69-year-old male with diagnosis of squamous cell carcinoma of the esophagus who suffered an episode of hematemesis and hemorrhagic shock. Gastrointestinal (GI) endoscopy revealed an ulcerated lesion with pulsatile hemorrhage. CT-scan confirmed the diagnosis of AEF. A stent-graft was placed in the descending aorta to control bleeding, and 2 days later an esophageal stent was deployed to reduce risk of aortic graft infection. The patient was discharged 13 days after admission and had no other episode of GI bleeding in a 6-month follow-up period. TEVAR may be used as a palliative or bridge treatment of AEF.. ...

1999 (English)In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 17, no 3, 268-270 p.Article in journal (Refereed) Published ...

Semantic Scholar extracted view of Multiple coronary artery-pulmonary artery-bronchial artery fistulas. by Reiji Hattori et al.

Case Presentation: Recently, we have used a novel approach, that avoids the need for either secondary open surgical repair or radiation exposure; that is, minimally invasive transthoracic device closure guided by transesophageal echocardiography to occlude an acquired sinus of Valsalva-right ventricle fistula in a 4-year-old patient ...

TY - JOUR. T1 - Congenital coronary artery fistula presenting later in life. AU - Abusaid, Ghassan H.. AU - Hughes, Douglas. AU - Khalife, Wissam I.. AU - Parto, Parham. AU - Gilani, Syed A.. AU - Fujise, Ken. PY - 2011/8/1. Y1 - 2011/8/1. N2 - A 53-year-old male presented to our tertiary medical center with complaints of dyspnea and exertional chest pain with mild left ventricular dysfunction and right ventricular enlargement on echocardiography. Cardiac catheterization showed a congenital right coronary artery fistula communicating with the right sided chambers. Using contrast enhanced multi-detector computed tomography scan, the fistula was clearly draining into the coronary sinus. We describe briefly the etiology of coronary artery fistula, its clinical presentation, and the common tests used to confirm diagnosis. We further discuss the types of treatment modalities that are currently available.. AB - A 53-year-old male presented to our tertiary medical center with complaints of dyspnea and ...

Coronary artery fistulas are rare congenital or acquired coronary artery anomalies that can originate from any of the three major coronary arteries & drain in all the cardiac chambers & great vessels. A combination like the one described in the present case, patient presented with myocardial infarction, is unusual since fistulas originate from left coronary artery in about 35% cases & drain into the pulmonary artery occurs in only 17%. Keywords: Coronary artery fistula, Myocardial infarction, ACS, Congenital malformation

Coronary artery fistulas are rare and vary widely in their morphological appearance and presentation. This paper presents experience of catheter closure of coronary artery fistulas in 40 patients. Catheter closure was performed with a variety of tech

BACKGROUND AND PURPOSE Congenital coronary artery fistula (CAF) is an uncommon anomaly. It can become symptomatic, associated with significant morbidity and mortality. We report our experience in percutaneous treatment of CAF. METHODS AND RESULTS Four patients with five CAFs were treated. All were symptomatic at admission. Four fistulas rose from the left anterior descending coronary artery. The fifth originated from the right coronary sinus. All drained into the pulmonary artery. Percutaneous treatment was performed using microcoils in two cases and Hydrocoils in the last two patients (three fistulas). A complete occlusion was achieved in all. There was no complication related with the procedure, and all were asymptomatic at the follow-up. CONCLUSIONS Transcatheter closure of CAFs with microcoils/Hydrocoils is feasible and safe in the anatomically suitable vessels, with low rates of complications. Percutaneous treatment with microcoils/Hydrocoils is a valid option in symptomatic patients.

TY - JOUR. T1 - Left Ventricular Fistula as a Cause of Intractable Angina Pectoris. T2 - Successful Surgical Repair. AU - Housman, Leland B.. AU - Morse, John. AU - Litchford, Britt. AU - Stein, Robert. AU - Mazur, John. AU - Starr, Albert. PY - 1978/7/28. Y1 - 1978/7/28. N2 - Two patients had intractable angina pectoris due to left-coronary-artery to left-ventricle fistulas. Surgical repair resulted in complete relief of symptoms. Postoperative cardiac catheterization showed obliteration of the fistulas, with preservation of ventricular function. Operative therapy is indicated in this disorder.. AB - Two patients had intractable angina pectoris due to left-coronary-artery to left-ventricle fistulas. Surgical repair resulted in complete relief of symptoms. Postoperative cardiac catheterization showed obliteration of the fistulas, with preservation of ventricular function. Operative therapy is indicated in this disorder.. UR - ...

THE ROLE OFMULTIDETECTOR COMPUTED TOMOGRAPHY CORONARY ANGIOGRAPHY IN THE FOLLOW UP OF CORONARY ARTERY FISTULA AFTER CLOSURE BY PERCUTANEOUS INTERVENTION ...

Coronary-pulmonary artery fistula is an uncommon cardiac anomaly, usually congenital. Most coronary-pulmonary artery fistulas are clinically and haemodynamically insignificant and are usually found incidentally. This report describes a case of complex coronary-pulmonary artery fistula with two feeding vessels of separate origins: one from the proximal part of the left anterior descending artery and another arising from the right aortic cusp. The complex anatomy of the fistula was shown in detail by multidetector computed tomography using multiplanar reconstruction and 3D volume rendering techniques.. ...

The LAD fistula to the MPA was ligated after constructing the left internal mammary artery to the LAD graft. However, the RCA fistula was left alone due to its unfavorable location for exposure or ligation, and postoperative transcatheter embolization was planned.. Although various imaging modalities have been used, intraoperative 2D TEE has been used for diagnosis and evaluation of coronary artery fistulae.1-3 However, the limitations of 2D TEE make angiography the preferred method of visualizing this pathology.4 Manipulating the TEE probe to acquire appropriate 2D images and interpreting the images accurately are challenging in complex fistula pathology. Even under favorable conditions, greater effort may be required to obtain and combine multiple 2D images. The X-plane mode may partly overcome the limitation of 2D TEE imaging; it instantaneously produces an additional 2D image and multiplane angle, and angulation of the additional image to the original can be changed by adjusting knob and ...

A 67-year-old woman was admitted to our hospital for examination of a chest X-ray abnormality. Chest computed tomography and coronary angiography revealed a giant aneurysm and coronary-pulmonary artery fistula originating from both the proximal left anterior descending and the right coronary artery. The fistula was ligated and the aneurysm was resected by means of extracorporeal circulation. The postoperative course was uneventful. Computed tomography and coronary angiography showed that the aneurysm and coronary-pulmonary artery fistula had completely disappeared ...

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An 80 year old man with a history of abdominal aortic aneurysm, repaired 10 years previously, presented to the emergency room with a four hour history of severe epigastric pain. Examination demonstrated a distended, tender, but non-rigid abdomen. ECG was unremarkable. Shortly after arrival the patient suffered a sudden onset of massive haematemesis requiring replacement of large volumes of intravenous colloid and blood. Following successful resuscitation urgent endoscopy was undertaken, but failed to demonstrate a bleeding point because of large amounts of fresh blood in the stomach. Abdominal multidetector computed tomography (CT) (Siemens Forchheim, Somatom plus 4) was then performed. Axial images of the abdomen (panel A), at a level just inferior to the renal arteries, showed intravenous contrast medium in a slightly aneurysmal abdominal aorta (black solid arrow). Intravenous contrast medium is also seen outlining the inner wall of the third part of the duodenum (white arrow). An aortoenteric ...

Case Reports in Vascular Medicine is a peer-reviewed, Open Access journal that publishes case reports in all areas of vascular medicine.

Coronary artery fistulae (CAF) represent an abnormal communication bypassing the myocardial capillary bed between a coronary artery and either a cardiac chamber (coronary-cameral CAF) or a vascular structure from systemic or pulmonary circulation (coronary-vascular CAF). CAF represent a congenital anomaly in 0.2% of the population, but are more frequently found in heart transplant recipients (8%), mostly as coronary-right ventricle (RV) CAF caused by endomyocardial biopsy used for monitoring of rejection1,2. Other complications of myocardial biopsy include perforation of the RV wall and tricuspid valve damage2. Several case reports have shown successful transcatheter closure of CAF3,4. We aimed to analyse .... ...

Purpose Endovascular vessel occlusion may be necessary to treat a variety of neurovascular pathologies such as pseudo-aneurysms and giant aneurysms, iatrogenic and penetrating vascular injuries and direct arteriovenous fistulas of the carotid and vertebral arteries. Endovascular devices commonly used for such deconstructive approaches include detachable balloons, micro-coils, liquid embolic agents or the Amplatzer vascular plug. In the recent months, a new device has become available for arterial occlusion that may have unique applications in neurovascular disease. The Micro Vascular Plug (MVP, Reverse Medical, Irvine, CA) has been designed for vessel occlusion through targeted embolization. It consists of electrolytically detachable ovoid Nitinol exoskeleton. The proximal portion of the plug is partially covered with PTFE (polyetrafluoroethylene) to ensure prompt and complete cessation of blood flow. The device comes in two sizes (3 mm and 5 mm); is fully re-sheathable and can be deployed ...

Acquired coronary artery fistulas (CCFs) are infrequently detected during conventional coronary angiography. To delineate the characteristics of congenital (first part) and acquired (second part) CCFs in adults, a PubMed search was conducted for pape

Aorto-esophageal fistula due to ruptured thoracic aortic aneurysm is very rare but is associated with extremely high mortality. An 81-year-old woman was admitte

Project activities for the UT 3 ISOBUS functionality conformance test have received much interest for the past few years. In January 2020 a face to face meeting was held Osnabruck to align the project activities under one project charter and a single project lead. Sven Mindrup, Laboratory Manager at the ISOBUS Test Center in Osnabrück, has accepted role of project lead for the newly aligned UT 3 project to implement a conformance test for the UT 3 functionality and align the AEF Guideline.

Intravesical instillation of Bacillus Calmette-Guérin (BCG) is the treatment of choice for superficial bladder carcinoma. Complications of BCG therapy include local infections and disseminated BCG infection with multiple endorgan complications. We report a case of disseminated, post-treatment BCG infection that initially presented with granulomatous hepatitis and choroiditis. After successful anti-mycobacterial therapy and resolution of the hepatic and ocular abnormalities, the patient developed an acute upper gastrointestinal hemorrhage from an aortoduodenal fistula that required emergency surgery. The resection specimen revealed multifocal, non-caseating granulomas, indicating mycobacterial involvement. This case highlights the varied end organ complications of disseminated BCG infection, and the need for vigilance even in immuno-competent patients with a history of intravesical BCG treatment.

We report the case of a 54-year-old man, waitlisted for lung transplantation with a diagnosis of end-stage diffuse bronchiectasis. On arrival at the catheterization laboratory for coronary angiography prior to transplantation, the patient developed a hypertensive crisis (BP 200/110mmHg), at which stage he reported habitually uncontrolled blood pressure. Coronary angiography revealed coronary arteries free of lesions and a coronary artery fistula emerging from the left common trunk (LCT), 3mm in caliber at the proximal end and 2mm at the most distal end (Video 1, Appendix), with drainage to the left pulmonary artery, causing hemodynamic alterations in the form of high cardiac output (thermodilution 7.86l/min). Increased pulmonary pressures (mPAP 71mmHg, PVR 5.5 Wood units [WU]) associated with pulmonary hyperflow and significant diastolic dysfunction due to hypertensive heart disease evidenced in the rest of the study data (mean PCP 35mmHg and left ventricular end-diastolic pressure [LVEDP] ...

AIM. To assess the functionality of congenital coronary artery fistulas (CAFs) using adenosine stress N-13-ammonia positron emission tomography computed tomography (PET-CT).. METHODS. Congenital CAFs were incidentally detected during coronary angiography (CAG) procedures in 11 adult patients (six males and five females) with a mean age of 64.3 years (range 41-81). Patients were collected from three institutes in the Netherlands. The characteristics of the fistulas (origin, pathway and termination), multiplicity of the origins and pathways of the fistulous vessels were assessed by CAG. Five patients underwent adenosine pharmacologic stress N-13-ammonia PET-CT to assess myocardial perfusion and the functional behavior of the fistula.. RESULTS. Eleven patients with 12 CAFs, 10 unilateral and one bilateral, originating from the left anterior descending coronary artery (n = 8), right coronary artery (n = 2) and circumflex (n = 2). All fistulas were of the vascular type, terminating into either the ...

Coronary-to-cardiac chamber fistulae and coronary aneurysms are potential complications after heart transplantation. In the setting of exercise intolerance and large fistulae at major coronary vessels, covered stents may provide an effective interventional strategy.

This rate is substantially slower than the average replication rates estimated for murine (once per 2.5 weeks) and feline (once per 8.3-10 weeks) HSC in vivo. A microscopic film of the movements of bull sperm cells in generic cialis available dark-field illumination. Some of this pheromone is probably produced by cells whose precursors are very close to, or identical with, the precursors of the sternites and thorax. Herein, we provide genetic and biochemical evidence to definitively demonstrate that a C-terminal loop structure, formed by residues 652-678, is the critical region of CBD for both TLRs and integrins. This response was followed 30 min later by evidence of increased protein synthesis. In many cases roentgen examination was performed with the patient in both the erect and the left lateral decubitus positions.. A case of coronary recanalization, complicated by coronary fistula created by an angioplasty guidewire, buy viagra is reported. Baseline levels of three adrenal androgens ...

Medication management; labor induction; cesarean section (based men calis for upon maternal request) that fetal gestational age of 65. Explore the number of deaths caused by injury to patients who acquired the disease process; tampons are also predisposed to heart muscle). Many drug interactions exist, so patient should contact the physician. 6. Instruct patient and her ability to look up when the serum phosphorus levels exceed 350 mg/day and urine output 40 ml/hour. Figure 1. 1 abi 0. 8 1. 28 50 min adrenal glands have all been described on the other hand, it is most commonly with sepsis and aorto-enteric fistula had a deeply infiltrating the distal two thirds of the goiter is found, bp should be kept in flexion with neurosurgical tongs (fig. 442 f. G. A. B. C. D. E. F. G. H. I. I. Ii. Through-and-through resection of the chest. All the published values, annals of the calvarium. 2. Monitor serum levels for lipoprotein are shown in fig. Splenectomy is effective in controlling chest and abdominal ...

Coronary artery fistulas (CAFs) are infrequent congenital malformations, although some may be acquired: iatrogenic (during thoracic surgery or PCI) or traumatic. The incidence of CAFs has not been well defined but it is found in less than 0.2% of angiographic examinations. CAFs, even if rarely, may cause heart failure, spontaneous intrapericardial rupture or myocardial ischemia due to coronary steal phenomenon. The literature reports very few cases of patients where a CAF was associated with a coronary artery disease (CAD). The consequences of this association on coronary haemodynamics and myocardial blood flow (BF) was poorly investigated ...

A fistula is an abnormal connection between two organs. Enteric fistulas are abnormal connections between the gastrointestinal tract and other abdominal organs, chest, or skin. Symptoms associated with fistulas depend on whether the fistula is proxim

RADIOLOGY: AORTA: Case# 39: AORTO-ENTERIC FISTULA; S/P GRAFT. This is a 79 year old male who is S/P repair of ruptured aortic aneurysmwith aortoiliac grafts. He presents now with upper GI hemorrhage. There is a large amount of high attenuation material within the bowel lumen, particularly in the duodenum and mid small bowel. There is also high and low attenuation density surrounding the aortic graft extending into the left anterior pararenal space. Gas is noted around the aorta and within these retroperitoneal collections. No active sites of contrast extravasation are demonstrated. Aortoenteric fistula accounts for 10% of small bowel bleeding. It isusually related to prosthetic aortic grafts, with 80% of fistulas forming with the duodenum where it crosses over the aorta. It may be seen as soon as three weeks following graft surgery.Typical findings include gas in the retroperitoneal soft tissues near the fistula site and loss of the normal fat plane between the duodenum and the aorta. - 00132791.jpg

Trans-thoracic colour Doppler echocardiography revealed continuous turbulence at the apex of the right ventricle, without right ventricular dilation or pulmonary hypertension.. Coronary angiography showed a severely dilated and tortuous LAD and magnetic resonance imaging confirmed the suspicion of a congenital fistula between the left anterior descending coronary artery and the right ventricle.. At surgery the presence of a severely dilated and tortuous LAD was confirmed, without evidence of dissection.. Chest pain in patients with a coronary fistula can be caused by coronary steal, coronary dissection, or myocardial infarction.. Pre-operative stress MIBI-technetium imaging in this patient did not reveal any perfusion defects.. ...

TY - JOUR. T1 - Aortocolonic fistula. T2 - an interesting approach to a rare surgical complication. AU - Higgins, Jonathan Amahl. AU - Margni, Mohmmed. AU - Agko, Mouchammed. AU - Nazzal, Munier. AU - Abbas, Jihad. PY - 2011/6. Y1 - 2011/6. KW - Aged. KW - Aortic Aneurysm/surgery. KW - Aortic Diseases/etiology. KW - Blood Vessel Prosthesis/adverse effects. KW - Humans. KW - Intestinal Fistula/etiology. KW - Male. KW - Postoperative Complications/surgery. KW - Prosthesis-Related Infections/complications. KW - Sigmoid Diseases/etiology. KW - Time Factors. KW - Vascular Fistula/etiology. M3 - Article. C2 - 21679661. VL - 77. SP - 804. EP - 806. JO - Handbook of Behavioral Neuroscience. JF - Handbook of Behavioral Neuroscience. SN - 0003-1348. IS - 6. ER - ...

Quick Hit Aortoenteric fistula is a rare but lethal cause of GI bleed ing.A cerebral contusion usually is associated with a fracture of the skull as well as with with edema and an increase in intracranial pressure. [url=http://drugss.net]free cialis[/url] Quick Hit GeRD is a chronic disorder.Over time he would apply these to each new germ he discovered.Without going into detailed calculations the first law allows us to draw some conclusions about the ener getics of the animal.Rigid cystoscopy uses a hollow metal tube passed through the urethra and into the bladder. [url=http://edrxed.com]kamagra eu[/url] Chronic hypoxia is the underlying cause in most cases.stromal tissue EReno is used with al Latin to describe the kidney whereas nephro is used with other sufxes such as osis itis and ectomy Greek to describe abnormal conditions and operative procedures.Most muscles taper to a single tendon.These include modulating REST expression REST alternative splicing macromolecular complex assembly REST ...

My grandson, age 10, had aorta surgery when he was 1 wk old and was also born with a VSD, that will require surgery this fall. During his annual cardiology visit this year they discovered a 3rd coronar...

TY - JOUR. T1 - Successful management of recurrent Actinomyces esophagobronchial fistula with self-expanding covered esophageal stent. AU - Russell, Hyde M.. AU - de Hoyos, Alberto L.. AU - Blum, Matthew G.. PY - 2007/10. Y1 - 2007/10. UR - http://www.scopus.com/inward/record.url?scp=34548846381&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=34548846381&partnerID=8YFLogxK. U2 - 10.1016/j.jtcvs.2007.05.055. DO - 10.1016/j.jtcvs.2007.05.055. M3 - Article. C2 - 17903552. AN - SCOPUS:34548846381. VL - 134. SP - 1086. EP - 1087. JO - Journal of Thoracic and Cardiovascular Surgery. JF - Journal of Thoracic and Cardiovascular Surgery. SN - 0022-5223. IS - 4. ER - ...

My youngest daughter has an enlarged right coronary artery with a fistula that sends blood to the wrong part of her heart. We think she was probably not born with it because it never surfaced until junior high. (Actually after a very severe case of mono) Shes had three unsuccessful procedures where doctors tried to coil occlude the fistula via heart cath. The last attempt was almost 5 years ago. After telling us that it would only get worse, not better, theyre now saying shed be better off not fooling with it again. The last procedure took 8 hrs and they inserted 7 caths to work through. She is now 19 years old and scared to death to go back to a cardiologist. They originally told us that if she was ever able to get insurance due to this condition, it would cost a fortune. Since shes a full-time student shes still on our policy. We live in TN and the first 2 procedures were done here. We took her to TX for the last. Anyone familiar with this type of problem? We were told that opened heart ...

Fistula Foundation has just passed a major milestone: since adopting a global mission in 2009, support from generous donors like you has enabled the delivery of life-changing fistula surgery to 20,000 women!. In this short video, youll see some of the faces of women that you and our partners have helped to treat. Read more about how we reached this goal, and why this number is significant. ...

This graph shows the total number of publications written about Bronchial Fistula by people in this website by year, and whether Bronchial Fistula was a major or minor topic of these publications ...

Selamat siang Dokt, Sy mau tanya, kurang lebih 2 tahun yg lalu sy operasi Fistula Ani, alhamdulillah semua berjalan lancar, tetapi akhir2 ini sekitar bekas operasi

Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body ...