ABSTRACT
High output external duodenal fistula is a difficult condition to treat and despite the advances in nutritional care, morbidity and mortality remain high. Although, non surgical methods (e.g. endoscopy, fistuloscopy and percutaneous injection of substances) have been reported sporadically in the treatment of enterocutaneous fistulae, gelfoam has not been tried. We present a case of duodenal fistula following blunt abdominal trauma which persisted for 14 weeks on conservative management. Percutaneous obliteration of the duodenal fistula was successfully performed using gelfoam injection through a catheter. This procedure is simple, safe and cheap and further experience may demonstrate that it is an easy and more practical tool in dealing with this problem.
Subject(s)
Duodenal Diseases/therapy , Intestinal Fistula/therapy , Abdominal Injuries/diagnostic imaging , Abdominal Injuries/etiology , Accidents, Traffic , Adult , Drainage , Duodenal Diseases/diagnostic imaging , Duodenal Diseases/etiology , Gelatin Sponge, Absorbable , Humans , Intestinal Fistula/diagnostic imaging , Intestinal Fistula/etiology , Male , Tomography, X-Ray ComputedABSTRACT
Congenital H-type anourethral fistula with severe urethral hypoplasia and normal anus is an extremely rare variant of anorectal malformations among boys. The authors report a case of a 5-year-old boy who underwent successful management of severe urethral hypoplasia with progressive augmentation by dilating urethra anterior gently and achieving a functionally normal urethra with minimal morbidity. H-type anourethral fistula was excised subsequently through anterior perianal approach.
Subject(s)
Rectal Fistula/congenital , Urethra/abnormalities , Child , Child, Preschool , Humans , Infant , Infant, Newborn , Male , Radiography , Rectal Fistula/diagnostic imaging , Urethra/diagnostic imagingABSTRACT
PURPOSE: Our aim was to describe the radiographic features of lobar agenesis of the liver. MATERIAL AND METHODS: Six patients with lobar agenesis of the liver, 5 right- and one left-sided, are presented. CT was used to confirm diagnosis. Chest radiography, barium meals, and urograms were also analyzed. RESULTS: In right-sided agenesis, the following were observed: a) hammock or U-shaped deformity of the stomach; b) colonic interposition of the diaphragm (Chilaiditi's syndrome); and c) reversal of the cranial orientation of the colonic hepatic flexure compared to the splenic flexure. The right kidney was higher in position than the left in both right- and left-sided lobar agenesis. CONCLUSION: Our radiographic findings can provide a multidisciplinary approach in the identification of this anatomic anomaly.
