ABSTRACT
Arch Argent Pediatr 2020;118(1):e81-e84 / e81Presentación de casos clínicosRESUMENLas fístulas del seno piriforme son anomalías poco frecuentes de los arcos branquiales. La forma de presentación más común en los niños y los adolescentes es la tiroiditis aguda supurada y/o los abscesos cervicales laterales recurrentes. Sin embargo, las fístulas se pueden manifestar de forma atípica. La rareza de esta patología y la presentación clínica atípica pueden demorar el diagnóstico, lo que aumenta el riesgo de infecciones recurrentes y complicaciones.Se presenta el caso inusual de una adolescente de 13 años con absceso retrofaríngeo debido a una fístula congénita del seno piriforme, tratada de forma exitosa mediante electrocauterización endoscópica.
Pyriform sinus fistulas are rare anomalies of the branchial arches. The most common form of presentation in children and adolescents is acute suppurative thyroiditis and/or recurrent lateral cervical abscesses. However, fistulas can manifest atypically. The rarity of this pathology and the atypical clinical presentation can delay the diagnosis increasing the risk of recurrent infections and complications.We present the unusual case of a 13-year-old teenager with retropharyngeal abscess due to a congenital pyriform sinus fistula successfully treated by endoscopic electrocautery
Subject(s)
Humans , Female , Adolescent , Retropharyngeal Abscess/diagnostic imaging , Fistula/congenital , Retropharyngeal Abscess/drug therapy , Electrocoagulation , Endoscopy , Pyriform Sinus/abnormalitiesABSTRACT
Resumen: Las anomalías de las arterias coronarias son poco frecuentes, con una prevalencia de 0,21- 5,79%. Su presentación clínica es amplia, pudiendo ser asintomáticas o presentarse como isquemia miocárdica y muerte súbita, la que puede estar ligada o no al ejercicio. Existen varias clasificaciones, siendo las más usadas las que las agrupan desde un punto de vista anatómico en relación con el segmento afectado (origen, curso o terminación) y desde el punto de vista funcional (hemodinámicamente significativa y no significativa). Actualmente la Tomografía Computada Cardiaca se considera el estándar de referencia, siendo de suma importancia su adecuada caracterización ya que, de requerir tratamiento, este generalmente es quirúrgico. El objetivo de este trabajo es identificar, caracterizar y clasificar las anomalías congénitas de las arterias coronarias por su importancia hemodinámica mediante la presentación de casos clínicos y revisión de la literatura.
Abstract: Coronary artery anomalies are rare, with a prevalence ranging from 0.21 to 5.79%. Their clinical presentation is variable; being either asymptomatic or presenting as myocardial ischemia and sudden death, which may or may not be linked to exercise. There are several classifications, the most commonly used being those that sort them from an anatomical point of view in relation to the affected segment (origin, course or termination) and from a functional point of view (hemodynamically significant and not significant). Currently, Cardiac Computed Tomography is considered the reference standard allowing an adequate characterization of the anomaly, which is highly relevant since, if treatment is needed, it usually involves surgery. The purpose of this review is to identify, characterize and classify congenital anomalies of the coronary arteries according to their hemodynamic significance through the presentation of clinical cases and review of the literature.
Subject(s)
Humans , Male , Middle Aged , Coronary Vessel Anomalies/diagnostic imaging , Pulmonary Artery/abnormalities , Pulmonary Artery/embryology , Tomography, X-Ray Computed , Coronary Vessel Anomalies/classification , Coronary Vessel Anomalies/embryology , Coronary Vessel Anomalies/therapy , Fistula/congenital , HemodynamicsABSTRACT
Resumen Introducción: Las fístulas del seno piriforme, originadas desde el tercer o cuarto arco branquial, son entidades poco frecuentes. Se pueden presentar como aumento de volumen cervical, fístula cervical, absceso cervical, tiroiditis abscedada y/o disfonía. Objetivo: Reportar 4 casos tratados en nuestro hospital y revisión de la literatura. Discusión: Frente a un cuadro clínico compatible, se debe realizar estudio endos- cópico y de imágenes. El manejo quirúrgico sigue siendo el de mejores resultados, pero se han desarrollado terapias endoscópicas y combinaciones de estas con buenos resultados. Conclusión: El diagnóstico requiere un alto índice de sospecha clínica. La cirugía abierta se mantiene como el gold standard, sin embargo, en población pediátrica estaría indicada la resolución endoscópica debido a la alta morbilidad de la cirugía tradicional.
Introduction: Pyriform sinus fistula is a rare cervical branchial anomaly derived from the third and fourth branchial arch. Pyriform sinus fistula should be considered in children presenting enlarged neck mass, fistula, abscess, thyroid infection and/or dysphonia. Objective: We here report 4 cases treated in Hospital Clínico Universidad de Chile and review of the current literature on pyriform sinus fistula. Discussion: When clinical presentation is compatible with pyriform sinus fistula, endoscopic and imaging techniques are required. Surgical outcomes are better, although endoscopic therapies and combination of both surgery and endoscopy have also reported good outcomes. Conclusion: Diagnosis is made based on signs and symptoms and a high index of clinical suspicion. Open surgery is gold standard, however in pediatric population endoscopic resolution should be considered to reduce the high morbidity of traditional surgery.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Pharyngeal Diseases/surgery , Pyriform Sinus , Fistula/surgery , Pharyngeal Diseases/congenital , Pharyngeal Diseases/diagnosis , Endoscopy , Fistula/congenital , Fistula/diagnosisABSTRACT
Coronary artery fistula is an uncommon finding during angiographic exams. We report a case series of five patients with congenital coronary fistulas. The first patient was 56 years old and had a coronary fistula associated with a partial atrio ventricular defect, the second patient was 54 years old and had two fistulas originating from the right coronary artery with a severe atherosclerotic coronary disease, the third patient was 57 years old with a fistula originating from the circumflex artery associated with a rheumatic mitral stenosis, the fourth patient was 50 years old and had a fistulous communication between the right coronary artery and the right bronchial artery, and the last patient was 12 years old who had bilateral coronary fistulas draining into the right ventricle with an aneurismal dilatation of the coronary arteries. Angiographic aspects of coronary fistulas are various; management is controversial and depends on the presence of symptoms
Subject(s)
Humans , Female , Male , Coronary Artery Disease/congenital , Fistula/congenital , Coronary AngiographyABSTRACT
Congenital lacrimal fistulae are rare in Down syndrome and bilateral presentation is very unusual. It can be associated with nasolacrimal duct obstruction. We report a 3-year-old female with Down syndrome who presented with watering and discharge from both eyes and bilateral fistulous openings present inferonasal to the medial canthus. Upon examination, the lacrimal sac regurgitation test was positive on both sides. Our case report documents a distinctive case of bilateral congenital lacrimal fistulae in association with Down syndrome. It was managed successfully by primary fistulectomy and nasolacrimal duct probing
Subject(s)
Humans , Female , Fistula/surgery , Lacrimal Apparatus Diseases , Nasolacrimal Duct , Fistula/congenitalABSTRACT
We report a case of congenital lacrimal sac fistula located on the temporal side of the lateral canthus. A systemically healthy 1-year-old girl came to the outpatient clinic with a complaint of tearing on the temporal side of the right lateral canthus since birth. On examination, a small orifice was found in the skin on the temporal side of the lateral canthus. There was no evidence of inflammation or swelling within the opening. Surgeons carried out an operation under general anesthesia. They passed a probe through the lacrimal orifice and advanced it toward the lacrimal sac. Next, they introduced saline to the inferior punctum and found that it drained to the lateral fistula. The lower lid stretched as the dissected fistula was pulled. After the operation, the patient was free of the symptom. This paper is to report a case of congenital lacrimal sac fistula located on the temporal side of the lateral canthus.
Subject(s)
Female , Humans , Infant , Diagnosis, Differential , Eye Abnormalities , Fistula/congenital , Lacrimal Apparatus/abnormalities , Lacrimal Apparatus Diseases/congenitalSubject(s)
Humans , Female , Male , Rectovaginal Fistula/diagnosis , Urogenital System , Ureteral Diseases , Prospective Studies , Fistula/congenitalABSTRACT
Coronary artery fistula between a coronary artery and a cardiac chamber is a rare condition, especially when multiple fistulas communicate with the left ventricle. Herein we report a case of an elderly woman with multiple diffuse coronary artery-left ventricular fistulas diagnosed by angiography. Since the coronary artery-cardiac chamber communications were multiple and diffuse neither surgery nor transcatheter coil occlusion was considered in this case.
Las fístulas de las arterias coronarias que drenan a las cavidades cardíacas son una anomalía infrecuente, especialmente cuando son múltiples y drenan hacia el ventrículo izquierdo. Presentamos el caso de una mujer octogenaria con múltiples fístulas difusas que se originan de la coronaria izquierda y que drenan al ventrículo izquierdo. El hecho de que fuesen múltiples y difusas imposibilitó una intervención quirúrgica o percutánea como se recomienda en estos casos. (Arch Cardiol Mex 2004; 74:45-48).
Subject(s)
Aged , Female , Humans , Coronary Vessel Anomalies , Fistula/congenital , Heart Ventricles/abnormalities , Adrenergic beta-Antagonists/therapeutic use , Coronary Angiography , Coronary Vessel Anomalies/drug therapy , Fistula , Fistula/therapy , Heart Ventricles , Treatment OutcomeABSTRACT
La fístula coronaria (FC) es una patología de baja incidencia en el universo de las cardiopatías congénitas, por lo cual la experiencia de cada centro es limitada. Respecto del diagnóstico prenatal, la experiencia es aún menor.El espectro clínico abarca desde el paciente asintomático hasta la presencia de insuficiencia cardíaca y shock cardiogénico pedendiendo del tamaño de la fístula. La letalidad es muy alta en casos de fístulas gigantes. Se presenta un caso de diagnóstico prenatal de FC gigante, proveniente del sur del país. Se describe su manejo pre y post natal.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Heart Defects, Congenital , Fetal Diseases/diagnosis , Fistula/congenital , Fistula , Ultrasonography, Prenatal , Heart Ventricles/abnormalities , EchocardiographyABSTRACT
Various systemic arteriovenous fistulas have been described. The arteriovenous fistula arising from the ascending aorta and draining separately into the superior vena cava is very uncommon. The authors report a case of congenital aortocaval fistula to the superior vena cava in a 22 year-old woman in whom the fistula was closed successfully.
Subject(s)
Adult , Aortic Diseases/congenital , Female , Fistula/congenital , Humans , Vena Cava, Superior/abnormalitiesSubject(s)
Humans , Male , Female , Head and Neck Neoplasms/diagnosis , Branchial Region/surgery , Cysts/congenital , Fistula/congenital , Facial Nerve , Branchioma/surgerySubject(s)
Cerebrospinal Fluid Otorrhea/etiology , Child, Preschool , Cochlea/abnormalities , Deafness/congenital , Ear, Inner/abnormalities , Fistula/congenital , Humans , Magnetic Resonance Imaging , Male , Meningitis, Meningococcal/etiology , Organ of Corti/abnormalities , Recurrence , Tomography, X-Ray ComputedABSTRACT
Presentamos una paciente que consulta por una fístula lagrimal congénita, entidad que es infrecuente y raramente diagnosticada en la consulta dermatológica. Los pacientes pueden ser asintomáticos o presentar lagrimeo desde el orificio de la fístula. Con respecto al tratamiento se recomienda la dacriocistorrinostomía con disección de los canalículos comunes; excisión de la fístula e intubación canicular en todos los pacientes sintomáticos, para facilitar el drenaje desde la misma y para prevenir así la obstrucción de los canalículos comunes
Subject(s)
Humans , Female , Adult , Fistula/surgery , Lacrimal Apparatus Diseases/congenital , Fistula/congenitalABSTRACT
This is a case report of an auro-cervical fistula. It is a rare congenital anomaly, its understanding is important in dealing with sinus or chronic ulcer in the neck
Subject(s)
Humans , Neck/pathology , Fistula/congenital , Culture Media , Anti-Bacterial AgentsSubject(s)
Adolescent , Coronary Vessels/surgery , Female , Fistula/congenital , Heart Atria/surgery , HumansABSTRACT
Presentamos un paciente con Hoyuelos y Fístulas Labiales congénitas, al que consideramos el primer caso publicado en la literatura argentina de la especialidad. Por la extremada rareza de esta afección, se realiza una puesta al día sobre la clínica, incidencia, etiología y terapéutica de la misma
Subject(s)
Humans , Male , Fistula/genetics , Lip Diseases/genetics , Lip/abnormalities , Fistula/congenital , Lip Diseases/congenitalABSTRACT
Os autores apresentam dois casos de fístula congênita do lábio inferior. Estudam a hereditariedade, associaçäo com a fissura labiopalatina, aspectos histológicos e tratamento