ABSTRACT
Las anomalías de cuarto arco branquial corresponden a una entidad patológica infrecuente. Para su manejo existen distintas alternativas terapéuticas siendo una de ellas la cauterización endoscópica. Reportamos 3 casos de senos de cuarto arco branquial tratados mediante cauterización endoscópica en el Hospital Regional de Concepción luego de una revisión de fichas clínicas de todos los pacientes con diagnóstico de anomalías de cuarto arco branquial. Se identificaron tres casos de senos de cuarto arco branquial. Todos corresponden a pacientes de sexo masculino que presentaron cuadro de absceso cervical, diagnosticándose 2 de ellos al presentar recurrencia. Todos fueron tratados mediante cauterización endoscópica de la apertura fistulosa en seno piriforme. Estas anomalías representan vestigios de un trayecto que se origina desde el vértice del seno piriforme. La cauterización endoscópica presenta una serie de ventajas con tasas de recurrencia similares a la cirugía abierta de cuello, menores tasas de complicaciones y costo económico. Las anomalias de cuarto arco branquial constituyen una patología infrecuente y el diagnóstico requiere alta sospecha clínica. El manejo endoscópico ha demostrado ser una alternativa segura y efectiva con menor tasa de complicaciones.
Anomalies of the fourth branchial arch correspond to an uncommon pathological entity. There are different therapeutic alternatives being one of them the endoscopic cauterization. We report 3 cases of fourth branchial arch anomalies treated by endoscopic cauterization in the Regional Hospital of Concepción. Review of clinical records of all patients with diagnosis of fourth branchial anomalies operated by endoscopic cauterization at the Regional Hospital of Concepción. Cases: Three cases of fourth branchial arch sinus were identified. All of them were male patients who presented with a cervical abscess, diagnosing 2 of them when they recurred. All 3 cases were treated by endoscopic cauterization of the fistulous opening in the piriform sinus. These anomalies represent vestiges of a path that originates from the apex of the piriform sinus. Endoscopic cauterization presents a number of advantages with recurrence rates similar to open neck surgery, with lower complication rates and economic cost. Fourth branchial anomalies constitute an uncommon pathology and the diagnosis requires high clinical suspicion. Endoscopic management has proven to be a safe and effective alternative with a lower rate of complications.
Subject(s)
Humans , Male , Child, Preschool , Child , Adolescent , Branchial Region/abnormalities , Branchial Region/surgery , Respiratory Tract Fistula/surgery , Endoscopy/methods , Cautery , Abscess/surgeryABSTRACT
ABSTRACT Introduction: Pancreaticopleural fistula is a rare complication of chronic pancreatitis. Objective: To describe pancreaticopleural fistula due to chronic pancreatitis and perform an extensive review of literature on this topic. Methods: Comprehensive narrative review through online research on the databases Medline and Lilacs for articles published over the last 20 years. There were 22 case reports and four case series selected. Results: The main indication for surgical treatment is the failure of clinical and/or endoscopic treatments. Surgery is based on internal pancreatic drainage, especially by means of pancreaticojejunostomy, and/or pancreatic resections. Conclusion: Pancreaticopleural fistula is a rare complication of chronic pancreatitis and the Frey procedure may be an appropriate therapeutic option in selected cases when clinical and endoscopic treatments are unsuccessful.
RESUMO Introdução: A fístula pancreaticopleural é complicação rara da pancreatite crônica. Objetivo: Descrever a fístula pancreaticopleural consequente à pancreatite crônica e fazer revisão extensa da literatura sobre o tópico. Métodos: Revisão narrativa abrangente através de pesquisa online nas bases de dados Medline e Lilacs para artigos publicados nos últimos 20 anos. Resultados: Houve 22 relatos de casos e quatro séries de casos selecionadas. A principal indicação para o tratamento cirúrgico é a falha de tratamentos clínicos e/ou endoscópicos. A cirurgia é baseada na drenagem pancreática interna, especialmente por meio de pancreaticojejunostomias e/ou ressecções pancreáticas. Conclusão: A fístula pancreaticopleural é complicação rara da pancreatite crônica e o procedimento de Frey pode ser opção terapêutica apropriada em casos selecionados quando os tratamentos clínico e endoscópico não obtiverem êxito.
Subject(s)
Humans , Pleural Diseases/surgery , Pleural Diseases/etiology , Respiratory Tract Fistula/etiology , Pancreatic Fistula/surgery , Pancreatic Fistula/etiology , Pancreatitis, Chronic/complications , Respiratory Tract Fistula/surgeryABSTRACT
We report a 28-year-old woman, pregnant, at 24 weeks, with 3-day history of right-sided chest pain and shortness of breath. Few hours after admission, she delivered a dead baby. She had a history of right partial hepatic lobotomy and cholecystectomy at UK on May 2004 because of multiple pyogenic liver abscesses. Chest examination revealed signs of hydrothorax on the right side. Chest X-ray showed pleural effusion on the right side. Pleural fluid was exudative with high neutrophils. Gram stain and culture showed multiple organisms. CT scan chest and abdomen with contrast, combined with barium enema, revealed right colothorax communication. Colothorax fistula was closed surgically. On the following days, the patient's symptoms resolved, and she was consequently discharged
Subject(s)
Humans , Female , Respiratory Tract Fistula/surgery , Respiratory Tract Fistula/diagnostic imaging , /diagnosis , /surgery , Colon/pathology , Pleura/pathology , Hydrothorax/etiology , Pregnancy , Treatment Outcome , Review Literature as TopicABSTRACT
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
Antecedentes: La casuística mundial publicada al respecto es escasa por lo que se infiere que su incidencia de presentación no es significativa o que existe un desconocimiento de la existencia de esta complicación. Objetivo: Destacar los aspectos clínicos y jerarquizar el valor de los estudios complementarios. Lugar de aplicación: Hospital público e institución privada. Diseño: Estudio retrospectivo. Método: Se presentan 3 casos detectados en los dos últimos años. Resultados: Se realizó la oclusión quirúrgica de las fístulas en los 3 casos, con buenos resultados. Conclusión: Es una patología insuficientemente detectada en la mayoría de las series de resección del esófago, por lo que enfatizamos su reconocimiento
Subject(s)
Humans , Male , Female , Child, Preschool , Adult , Aged , Bronchial Fistula/surgery , Digestive System Fistula/surgery , Respiratory Tract Fistula/surgery , Esophagectomy/adverse effects , Bronchial Fistula/etiology , Digestive System Fistula/etiology , Respiratory Tract Fistula/etiology , Gastroplasty/adverse effectsABSTRACT
Se presenta la experiencia, evaluada prospectivamente, del tratamiento por videotoracoscopia (VTC) del neumotórax espontáneo entre septiembre de 1994 y mayo de 1997. La indicación quirúrgica fue en el 36,5 por ciento por fístula aérea persistente, en 33,3 por ciento por recidiva, en 17,5 por ciento por bilateralidad, en 8 por ciento por tener certificado el diagnóstico de bulas y en 4,7 por ciento por petición del paciente para evitar recidiva. En 60 de los 63 pacientes se encontraron bulas, todas localizadas en los lóbulos superiores, en 7 de ellos habla además otras localizaciones. No hubo mortalidad, existieron 2 infecciones de herida operatoria, 2 recidivas precoces que se solucionaron por VTC y una fístula aérea prolongada que se resolvió con gel de fibrina. No hubo conversiones en la serie