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Tracheal fistula

Brooks V Udelsman, Jessica Eaton, Ashok Muniappan, Christopher R Morse, Cameron D Wright, Douglas J Mathisen
OBJECTIVE: Patients with complicated airway defects that exceed the limits of primary repair represent a challenging clinical problem and require alternative techniques for repair. The aim of this study was to evaluate bioprosthetic reconstruction of large tracheal and bronchial defects. METHODS: Retrospective chart review of patients treated at a single tertiary center from 2008 to 2015 who underwent repair of tracheal or bronchial defects with a bioprosthetic device, namely aortic homograft or acellular dermal matrix...
November 2016: Journal of Thoracic and Cardiovascular Surgery
Mitsuaki Sakai, Yuichiro Ozawa, Tomomi Nakajima, Akihiko Ikeda, Taisuke Konishi, Kanji Matsuzaki
Massive hemoptysis from an aortobronchial fistula due to thoracic aortic dissection is an extremely rare symptom, but is a potentially life-threatening condition. We report a case of acute massive hemoptysis due to aortobronchial fistula that was successfully controlled by a simple and rapid thick wedge resection of the lung with hematoma by using the black cartilage stapler. A 65-year-old man was admitted to our hospital with acute massive hemoptysis. After tracheal intubation, chest computed tomography revealed hematoma in the left lung and ruptured aortic dissection from the distal arch to the descending aorta...
September 2016: Journal of Thoracic Disease
Atilla Eroglu, Yener Aydin, Hayri Ogul, Bayram Altuntas
We describe a case of a 30-year-old woman who presented with a complaint of coughing while drinking water, which began 2 months earlier and was treated with surgical repair of esophageal and tracheal fistulization that resulted from a Pott's abscess. The patient had been diagnosed with pulmonary tuberculosis 4 years previously and had been treated for 6 months. Esophageal and tracheal fistulization of the abscess cavity was observed both radiologically and intraoperatively. The fistulas were closed through separate operations for the trachea and the esophagus...
October 2016: Annals of Thoracic Surgery
C Jason Smithers, Thomas E Hamilton, Michael A Manfredi, Lawrence Rhein, Peter Ngo, Dorothy Gallagher, John E Foker, Russell W Jennings
PURPOSE: Recurrent trachea-esophageal fistula (recTEF) is a frequent (5%-10%) complication of congenital TEF (conTEF) and esophageal atresia (EA) repair. In addition, postoperative acquired TEF (acqTEF) can occur in addition to or even in the absence of prior conTEF in the setting of esophageal anastomotic complications. Reliable repair often proves difficult by endoluminal or standard surgical techniques. We present the results of an approach that reliably identifies the TEF and facilitates airway closure as well as repair of associated tracheal and esophageal problems...
August 31, 2016: Journal of Pediatric Surgery
S Weiterer, K Schmidt, M Deininger, A Ulrich, U Tochtermann, R Eberhardt, S Hofer, M A Weigand, T Brenner
Here, we present a case of a tracheal fistula due to an anastomotic insufficiency following abdominothoracic esophageal resection. Despite immediate discontinuity resection, the tracheal fistula could not be surgically closed, resulting in incomplete control of the source of infection and an alternative treatment concept in the form of interventional fistula closure using a Y-tracheal stent. However, owing to existing severe acute respiratory distress syndrome (ARDS), which is associated with a considerable risk of peri-interventional hypoxia, a temporary bridging concept using venovenous extracorporeal membrane oxygenation (ECMO) was implemented successfully...
September 2016: Der Anaesthesist
Xinwei Han, Lei Li, Yanshi Zhao, Chao Liu, Dechao Jiao, Kewei Ren, Gang Wu
BACKGROUND: Thoracogastric airway fistula (TGAF) is a rare and dangerous complication of esophagectomy performed for esophageal and cardiac carcinomas. Herein, we aimed to explore the feasibility and efficacy of individualized airway stent implantation for the treatment of TGAF after esophagectomy. METHODS: Based on different TGAF types and relevant data on chest computed tomography, customized airway-covered stents were positioned so as to cover the entrance to the fistula by an interventional radiologist using fluoroscopic guidance...
August 12, 2016: Surgical Endoscopy
Rachid Tazi-Mezalek, Ali I Musani, Sophie Laroumagne, Philippe J Astoul, Xavier B D'Journo, Pascal A Thomas, Hervé Dutau
BACKGROUND AND OBJECTIVE: Iatrogenic tracheal injury (ITI) is a rare yet severe complication of endotracheal tube (ETT) placement or tracheostomy. ITI is suspected in patients with clinical and/or radiographic signs or inefficient mechanical ventilation (MV) following these procedures. Bronchoscopy is used to establish a definitive diagnosis. METHODS: We conducted a retrospective, single-centre chart review of 35 patients between 2004 and 2014. Depending on the nature and location of ITI and need for MV, patients were triaged to surgical repair, endoscopic management with airway stents or conservative treatment consisting of ETT or tracheotomy cannula (TC) placement distal to the wound and bronchoscopic surveillance...
November 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
Sandra Kampe, Miguel Rocha, Kaid Darwiche, Uwe Ebmeyer, Stamatis Georgios
We present a 54 year old female patient who had undergone a Ross procedure in 2009, and in 2013 again a replacement of the aortic root and arch with bioprothetic material and homograft replacement of the pulmonalis walve. Postoperatively the patient had experienced a functional compromising tracheal stenosis and a persistent esophago-tracheal fistula. Endoscopic attempts to close the fistula were not successful, and the fistula was "bridged" with an endoscopically positioned tracheal stent.We report the anaesthesiological management during the open surgical repair of the esophago-tracheal fistula and resection of 2 tracheal rings with high frequency jet ventilation over a period of 2...
June 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Benoit Jacques Bibas, Paulo Francisco Guerreiro Cardoso, Helio Minamoto, Leandro Picheth Eloy-Pereira, Mauro Federico L Tamagno, Ricardo Mingarini Terra, Paulo Manoel Pêgo-Fernandes
BACKGROUND: Benign tracheoesophageal fistulas (TEFs) are rare, and surgical correction is the ideal method of treatment. The objective of this study was to evaluate the results of operative treatment of benign TEFs in patients from a tertiary referral center. METHODS: Retrospective study of patients with benign TEFs who were treated between January 2005 and December 2014. Preoperative evaluation included computed tomography of the chest, bronchoscopy, and upper endoscopy...
October 2016: Annals of Thoracic Surgery
Jose Carlos Fraga, Russell W Jennings, Peter C W Kim
Tracheomalacia (TM) is defined as an increased collapsibility of the trachea due to structural anomalies of the tracheal cartilage and/or posterior membrane. Tracheomalacia has a wide range of etiologies but is most commonly present in children born with esophageal atresia and tracheal esophageal fistula. Clinical symptoms can range from minor expiratory stridor with typical barking cough to severe respiratory distress episodes to acute life-threatening events (ALTE). Although the majority of children have mild-to-moderate symptoms and will not need surgical intervention, some will need life-changing surgical treatment...
June 2016: Seminars in Pediatric Surgery
Aadel A Chaudhuri, Jie Jane Chen, Justin N Carter, Michael S Binkley, Kiran A Kumar, Sara A Dudley, Arthur W Sung, Billy W Loo
We present the case of a 63-year-old woman with limited metastatic colorectal cancer to the lungs and liver treated with FOLFIRI-bevacizumab, followed by consolidative hypofractionated radiotherapy to right paratracheal metastatic lymphadenopathy. We treated the right paratracheal site with 60 Gy in 15 fractions (70 Gy equivalent dose in 2 Gy fractions). The patient tolerated the treatment well, and six months later started a five-month course of FOLFIRI-bevacizumab for new metastatic disease. She presented to our clinic six months after completing this, complaining of productive cough with scant hemoptysis, and was found to have localized tracheal wall breakdown and diverticulum in the region of prior high-dose radiation therapy, threatening to progress to catastrophic tracheovascular fistula...
2016: Curēus
Canan Kucuk, Kemal Arda, Naim Ata, Mustafa Hamidullah Turkkani, Özgür Ömer Yildiz
Postintubation Tracheoesophageal fistula (TEF) is a rare complication. Acquired TEF most commonly occurred following prolonged mechanical ventilation with an endotracheal or tracheostomy tube, cuff-related tracheal injury, post-intubation injury. We present a case of both tracheomegaly and tracheosephagial fistula following mechanical ventilation for 15 days, in the light of the literature.
2016: Respiratory Medicine Case Reports
Luis Jorge Cerezal-Garrido, Javier Agudo-Bernal, Carlos Vaquero-Puerta
INTRODUCTION: The purpose of our study was to compare the effect, on the inflammatory response and fibrosis formation, of four commercially available sealant products applied on an injured trachea in a Wistar rat population. MATERIALS AND METHODS: We compared four different sealants: cyanoacrylate, fibrin/thrombin, albumin/glutaraldehyde, and polyethylene glycol-based hydrogel (PEG). Rats were organized into six groups of similar size. Four of them were experimental, one was a baseline control group (BCG), and the sixth one was a reference control group (RCG)...
April 2016: Surgical Technology International
Francesco Paolo Caronia, Alfonso Fiorelli, Ettore Arrigo, Mario Santini, Sergio Castorina
Herein, we reported a catastrophic condition as the almost complete rupture of trachea associated with esophageal lesion following an urgent surgical tracheostomy performed for unexpected difficult intubation. The extent of lesions required a surgical management. We decided against a resection and an end to end anastomosis but preferred to perform a direct suture of the lesion due to the presence of local and systemic infection. Then, the diagnosis of a tracheal fistula led us to perform a direct suture of the defect that was covered with muscle flaps...
May 2016: Journal of Thoracic Disease
Basil S Nasir, Mehdi Tahiri, Jordan Kazakov, Vicky Thiffault, Pasquale Ferraro, Moishe Liberman
BACKGROUND: Neoplastic involvement of the mediastinum can contribute to both airway and esophageal pathology. That can manifest as combined esophageal and airway stenosis, or tracheobronchoesophageal fistula. Conventional palliative treatment of these problems consists of endoluminal stent insertion. The double stenting approach consists of insertion of a tracheobronchial and an esophageal stent in parallel and allows concomitant symptomatic relief of both the airway and esophageal pathology...
August 2016: Annals of Thoracic Surgery
Elodie Mussat, Violaine Giraud, Catherine Julie, Thierry Chinet, Etienne Giroux Leprieur
The presence of an ALK (Anaplastic Lymphoma Kinase) rearrangement is a rare molecular feature in Non-Small Cell Lung Carcinoma (NSCLC), and concerns mainly non- or light smokers, young patients, with adenocarcinoma histological type. These tumours are particularly sensitive to Alk-targeted therapies, as crizotinib. Crizotinib is usually well-tolerated. We report a case of fatal haemoptysis associated with dramatic response to crizotinib in a patient with an ALK-rearranged lung adenocarcinoma. The patient presented a mediastinal invasion with tracheal involvement and compression of the right pulmonary artery...
March 2016: Journal of Clinical and Diagnostic Research: JCDR
Ping Li, Shisheng Li, Qinglai Tang, Xiangbo He, Danhui Yin, Shuang Wang, Xinming Yang
OBJECTIVE: This study aimed to explore the effectiveness of xenogenic acellular dermal matrix (xeno-ADM) in tracheal reconstruction. METHOD: Two patients were treated with this surgical method to reconstruct the trachea in 2013. The patients were diagnosed with tracheal adenoid cystic carcinoma by histopathological biopsy. The tumor was resected with half of the tracheal circumference and repaired by xeno-ADM. The patients were followed up for 31 and 33 months, respectively...
April 23, 2016: Auris, Nasus, Larynx
Elsa Oliveira, Margarida Anastácio, Anabela Marques
Aberrant right subclavian artery-esophageal fistula is a rare but potentially fatal complication. It may be associated with procedures, such as tracheostomy and tracheal or esophageal intubation, and yields massive upper gastrointestinal bleeding difficult to identify and to control. A high index of suspicion is essential for early diagnosis and better prognosis. We report a rare case of a patient who survived after emergent surgical procedure for massive upper gastrointestinal bleeding secondary to aberrant right subclavian artery-esophageal fistula after prolonged intubation...
May 2016: Brazilian Journal of Anesthesiology
Lucia Battistella, Giuseppe Marulli, Giovanni Maria Comacchio, Marco Mammana, Guido Di Gregorio, Federico Rea
Acquired nonmalignant tracheoesophageal fistula (TEF) is a rare condition that requires proper treatment. We present the case of a 55-year-old woman with a 4.5-cm recurrent TEF, which had developed after an attempted surgical repair. After closure of the esophageal defect in two layers, a tracheoplasty technique was used to repair the tracheal membranous wall with a synthetic bioabsorbable patch (Gore Bio-A tissue reinforcement) covered with an intercostal muscle flap. The use of Gore Bio-A tissue reinforcement is an innovative and effective method to close a wide tracheal defect while achieving a scaffold for epithelial colonization...
May 2016: Annals of Thoracic Surgery
Luv Javia, Matthew A Harris, Stephanie Fuller
Tracheal and bronchial pathologies in the neonate can be rapidly fatal if prenatal or quick postnatal diagnosis and intervention is not performed. Close multidisciplinary collaboration between multiple medical and surgical specialties is vital to the effective diagnosis and treatment of these pathologies. The fetal and neonatal airway may be affected or compromised by more prevalent pathologies such as tracheomalacia and tracheo-esophageal fistula with esophageal atresia. However, it is imperative that we also consider other potential sources that may perhaps be less familiar such as congenital cardiovascular abnormalities, tracheal stenosis, complete tracheal rings, tracheal sleeve, and foregut duplication cysts...
August 2016: Seminars in Fetal & Neonatal Medicine
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