ABSTRACT
Broncho-esophageal fistula (BEF) are quite rare in adults, more so the congenital variety. The common causes of BEF in adults include infections, trauma, and malignancies. We report a rare case of congenital BEF manifesting in adulthood with repeated pulmonary infections. We emphasize mainly on the preoperative preparation and perioperative management of this patient. It is essential to have a high index of suspicion to diagnose congenital BEF in adults. Anesthesiologists play an important role in successful management of these cases.
Subject(s)
Adult , Anesthesia/methods , Bronchial Fistula/complications , Bronchial Fistula/congenital , Bronchial Fistula/diagnosis , Bronchial Fistula/therapy , Cough/etiology , Esophageal Fistula/complications , Esophageal Fistula/congenital , Esophageal Fistula/diagnosis , Esophageal Fistula/therapy , Humans , Lung Diseases/etiology , MaleABSTRACT
A correção endovascular da dissecção de aorta tipo B tem se mostrado como uma nova alternativa para reduzir o trauma cirúrgico. No entanto, as complicações de médio e longo prazo, tais como a fístula aortoesofágica, são ainda pouco conhecidas e pouco relatadas. O objetivo deste trabalho é descrever três casos de fístula aortoesofágica após o tratamento endovascular de 23 casos de dissecção de aorta descendente conduzidos pela equipe de Cirurgia Vascular da Santa Casa de São Paulo em um estudo retrospectivo. Esses pacientes apresentavam características em comum, como dissecção crônica, pós-operatório imediato sem intercorrências, necessidade de reintervenções, oclusão de troncos arteriais como a artéria subclávia, mesentérica, tronco celíaco, e, ainda, uma rápida evolução para o óbito após os primeiros sinais de fístula. Portanto, embora raramente descrita na literatura, a ocorrência de fístula aortoesofágica é uma complicação de causa até o momento indefinida do tratamento endovascular da dissecção de aorta descendente que merece atenção, dada sua recorrência e evolução fatal.
Endoluminal stent-graft for type B aortic dissection is a new alternative to reduce surgical trauma. However, medium- and long-term complications are still little known and poorly reported, such as the aortic-esophageal fistula. The objective of this study is to describe three cases of aortic-esophageal fistula after the endovascular treatment of 23 cases of descending aortic dissection conducted by the vascular surgery team of Santa Casa de São Paulo in a retrospective study. These patients presented some common characteristics: chronic dissection, successful early outcome, need of reinterventions, occlusion of arterial trunks such as subclavian artery, mesenteric artery, celiac trunk, and finally, a fast fatal course after the first fistula-related symptoms. Therefore, despite rarely described in the literature, aortic-esophageal fistula is a complication of the endovascular treatment of descending aortic dissection which demands attention due to its unpredictability, recurrence, and fatal outcome.
Subject(s)
Humans , Male , Middle Aged , Aorta, Thoracic/pathology , Esophagus/pathology , Esophageal Fistula/diagnosis , Postoperative Care/nursing , Dissection/methods , Time Factors , Tomography, Emission-Computed/methodsABSTRACT
Broncho-oesophageal fistula is rare and occurs mostly in acquired condition. Report of a new case. We report a case of a 58-years-old woman which has, since 38 years ago, a chronic cough, recurrent bronchopulmonary suppurations and hemoptysis. Clinical examination let to the diagnosis of a broncho-oesophageal fistula. Surgical treatment resulted in complete recovery. There was no evidence of any aetiology. Congenital origin of the fistula was deduced
Subject(s)
Humans , Female , Esophageal Fistula/congenital , Respiratory Tract Fistula/surgery , Esophageal Fistula/surgery , Respiratory Tract Fistula/diagnosis , Esophageal Fistula/diagnosisABSTRACT
Presentamos el caso de un varón de 70 años que sufrió una hemorragia digestiva alta exanguinante, con resultado final de muerte. Fue diagnosticada una fístula aorto-esofágica mediante escáner como causante de la misma, debida con alta probabilidad a una espina de pescado.
We report a case of a 70 old man, who suffered a severe upper gastrointestinal haemorrhage, with final result of death. A scanner diagnosed an aortoesophageal fistula, due with high probability to a fish thorn.
Subject(s)
Humans , Male , Aged , Foreign Bodies/complications , Esophageal Fistula/complications , Esophageal Fistula/diagnosis , Esophageal Fistula/etiology , Gastrointestinal Hemorrhage/complications , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/etiology , Aortic Diseases/diagnosis , Aortic Diseases/etiology , Fatal Outcome , ShockABSTRACT
En este artículo se presentan los casos de dos pacientes con fístula del segundo arco branquial y, a partir de ahí, se hace una breve revisión de esta entidad. Se hace hincapié en la utilidad de la fistulografía para la planeación quirúrgica de esta entidad
Subject(s)
Esophageal Fistula/diagnosis , Esophageal FistulaABSTRACT
La Fístula Aorto-esofágica es una condición poco frecuente pero altamente letal. Su diagnóstico precoz puede mejorar el pronóstico. El presente es un reporte de 3 casos de fístula aorto-esofágica por cuerpo extraño. Todos presentaron un caso clínico caracterizado por: historia de ingestión de cuerpo extraño, disfagia, dolor retroesternal y hematemesis. La endoscopia superior demostró lesión de la pared esofágica localizada entre 23-25 cm de la arcada dentaria en la zona comprendida por la pared esofágica lateral izquierda y la pared posterior. La ubicación de una lesión en esta localización debe sugerirnos el diagnóstico de fístula aorto-esofágica por cuerpo extraño en aquellos pacientes que presenten clínica similar a la antes descrita
Subject(s)
Humans , Male , Female , Adolescent , Adult , Esophageal Fistula/diagnosis , Foreign Bodies , HematemesisABSTRACT
Primary aortoesophageal fistula is a rare cause of upper gastrointestinal bleeding. A six-year-old boy presented with massive upper gastrointestinal hemorrhage. Endoscopy revealed a submucosal bulge in the esophagus with an ulcer and clot at the top. Lateral skiagram of the chest showed a posterior mediastinal mass. CT scan of the chest revealed a ruptured aortic aneurysm into the oesophagus, confirmed the diagnosis. The patient succumbed to the illness before he could be subjected to definitive treatment.
Subject(s)
Aortic Dissection/complications , Aortic Aneurysm, Abdominal/complications , Aortic Diseases/complications , Aortic Rupture/complications , Child , Esophageal Fistula/diagnosis , Fatal Outcome , Gastrointestinal Hemorrhage/etiology , Humans , Male , Tomography, X-Ray Computed , Vascular Fistula/complicationsABSTRACT
Primary aorto-oesophageal fistula is a rare cause of massive and usually fatal gastrointestinal haemorrhage. We herein present a case of a 62-year-old chronic alcohol abuser who had a small haematemesis after a week of persistent vomiting. He succumbed to an exsanguinating bleed 36 hours after admission. An aorto-oesophageal fistula was found at autopsy. We emphasize the need for a high index of suspicion and recognition of premonitory signs for accurate diagnosis and management of this condition.
Subject(s)
Aortic Diseases/complications , Esophageal Fistula/complications , Gastrointestinal Hemorrhage/etiology , Aorta, Thoracic , Aortic Diseases/diagnosis , Barium , Hematemesis/complications , Esophageal Fistula/diagnosis , Diagnosis, DifferentialABSTRACT
Reportamos el primer caso en nuestro medio de reconstrucción exitosa de un segmento esofágico, usando injerto libre de intestino. Se describe la técnica de dicho procedimiento. Esta operación es considerada como la de elección para ciertos defectos esofágicos considerando las ventajas funcionales sobre los colgajos cutáneos o miocutáneos tradicionales. Se resalta la importancia de la participación de un equipo conformado por cirujanos generales y cirujanos especialistas en microcirugía. Estas consideraciones limitan la aplicación de éste método de reconstrucción a centros que tengan la infraestructura para desarrollar procedimientos microquirúrgicos