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Fistula oesophageal

Ottorino Perrone, Valentina Tassi, Benedetta Mattioli, Niccolò Daddi, Mariella Uneddu, Ignazio Borghesi, Sandro Mattioli
OBJECTIVES: Pharyngo-oesophageal perforation is a rare, life-threatening complication of anterior cervical discectomy and fusion surgery; its management remains poorly defined. We reviewed our experience to understand the treatment of this dreadful complication. METHODS: Data regarding the demographics, clinical course, diagnosis, management and outcomes of 15 cases of pharyngo-oesophageal perforations in 14 patients were collected during the period from 2003 to 2016...
September 11, 2016: European Journal of Cardio-thoracic Surgery
Atsushi Omura, Masato Yoshida, Yojiro Koda, Nobuhiko Mukohara
A 79-year-old moderately frail man with a history of graft replacement for descending thoracic aortic aneurysm and chronic kidney disease presented with the onset of haemoptysis. Computed tomography demonstrated aorto-oesophageal fistula secondary to aortic arch aneurysm rupture. Emergency surgery was performed through a median sternotomy. Cardiopulmonary bypass was established via femoral artery inflow and bicaval venous drainage. After establishing circulatory arrest, the aortic arch was excised. Resection of the aortic aneurysm and debridement were performed during antegrade cerebral perfusion and lower body perfusion from femoral artery inflow using balloon occlusion of the previous graft...
August 19, 2016: Interactive Cardiovascular and Thoracic Surgery
Ross J Langley, Daniel Hufton, Julie Freeman, Michael Jackson, Don S Urquhart
No abstract text is available yet for this article.
August 18, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Tcc Boerlage, H S Hermanides, D E Moes, I L Tan, Gmp Houben, Yiz Acherman
A 43-year-old female patient suffered from persistent anastomotic leakage after Roux-en-Y gastric bypass for morbid obesity. Endoscopic stenting of the anastomotic leakage was performed. The patient presented with haematemesis 3 weeks later. An aorto-oesophageal fistula was diagnosed, most likely due to ulceration of the oesophageal stent. The fistula was closed with an endovascular covered aortic stent and a new gastrojejunostomy was created. One year after surgery, the patient is in good condition. Endoscopic stents are increasingly being used to treat anastomotic leakage in bariatric patients...
August 11, 2016: Annals of the Royal College of Surgeons of England
L J X Giesen, H M Kroon, R van Valen, N M S de Groot, C Kik, B P L Wijnhoven
BACKGROUND: An atrio-oesophageal fistula (AOF) is a rare but severe complication of radiofrequency ablation during video-assisted thoracoscopic pulmonary vein isolation (VATS-PVI). CASE DESCRIPTION: A 68-year-old man presented to the emergency department with reduced general well-being and a fever. Eight weeks prior he had undergone a VATS-PVI. Blood results revealed elevated inflammatory parameters, and blood cultures were positive for Streptococcus anginosus. A CT-scan demonstrated an air configuration in the left atrium...
2016: Nederlands Tijdschrift Voor Geneeskunde
Erwin Brosens, Florian Marsch, Elisabeth M de Jong, Hitisha P Zaveri, Alina C Hilger, Vera Gisela Choinitzki, Alice Hölscher, Per Hoffmann, Stefan Herms, Thomas M Boemers, Benno M Ure, Martin Lacher, Michael Ludwig, Bert H Eussen, Robert M van der Helm, Hannie Douben, Diane Van Opstal, Rene M H Wijnen, H Berna Beverloo, Yolande van Bever, Alice S Brooks, Hanneke IJsselstijn, Daryl A Scott, Johannes Schumacher, Dick Tibboel, Heiko Reutter, Annelies de Klein
Oesophageal atresia (OA) with or without tracheoesophageal fistula (TOF) are rare anatomical congenital malformations whose cause is unknown in over 90% of patients. A genetic background is suggested, and among the reported genetic defects are copy number variations (CNVs). We hypothesized that CNVs contribute to OA/TOF development. Quantifying their prevalence could aid in genetic diagnosis and clinical care strategies. Therefore, we profiled 375 patients in a combined Dutch, American and German cohort via genomic microarray and compared the CNV profiles with their unaffected parents and published control cohorts...
July 20, 2016: European Journal of Human Genetics: EJHG
Peter Donnelly, Steven McVea, Christopher Flannigan, Sanjeev Bali
A 6-day-old term neonate who was intubated on day 1 of life for apnoeic episodes, was transferred to the regional paediatric intensive care unit (PICU) for specialist opinion following 3 failed extubations in the neonatal unit. Escherichia coli congenital pneumonia was diagnosed and the child discharged to the local hospital. Chest radiographs and inflammatory markers were in keeping with infection. However, ongoing difficulties with secretions necessitated readmission to the PICU, following a significant cyanotic episode associated with coughing...
2016: BMJ Case Reports
Sven Knecht, Christian Sticherling, Tobias Reichlin, Aline Mühl, Nikola Pavlović, Beat Schaer, Stefan Osswald, Michael Kühne
AIMS: A current concept to prevent atrio-oesophageal fistula during radiofrequency (RF) catheter ablation of atrial fibrillation is to monitor luminal oesophageal temperature (LET). The objective of this study was to describe the temporal course of LET and to assess the reliability of monitoring the maximal LET during pulmonary vein isolation (PVI) using irrigated multi-electrode (IMEA, nMARQ(TM)) and focal ablation catheters. METHODS AND RESULTS: We studied 40 patients with LET monitoring during PVI (20 patients using the IMEA and 20 patients using the focal catheter)...
June 29, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Renu Sinha, S Shwetha
No abstract text is available yet for this article.
June 2016: Indian Journal of Anaesthesia
Palanivelu Praveenraj, Rachel M Gomes, Saravana Kumar, Palanisamy Senthilnathan, Ramakrishnan Parthasarathi, Subbiah Rajapandian, Chinnusamy Palanivelu
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is the most commonly performed 'standalone' bariatric procedure in India. Staple line gastric leaks occur infrequently but cause significant and prolonged morbidity. The aim of this retrospective study was to analyse the management of patients with a gastric leak after LSG for morbid obesity at our institution. PATIENTS AND METHODS: From February 2008 to 2014, 650 patients with different degrees of morbid obesity underwent LSG...
October 2016: Journal of Minimal Access Surgery
Milena Leo, Michala F Pedersen, Kim Rajappan, Matthew Ginks, Yaver Bashir, Timothy R Betts
AIMS: Oesophageal temperature monitoring is currently used during atrial fibrillation (AF) ablation to prevent atrio-oesophageal fistula. The aim of our study was to investigate if oesophageal temperature alerts, leading to early termination of radiofrequency (RF) energy and/or reduction in power during pulmonary vein isolation, can promote pulmonary vein reconnection (PVR). METHODS AND RESULTS: Patients undergone two consecutive AF ablation procedures with a three-dimensional electro-anatomical mapping system and oesophageal temperature monitoring were studied...
May 31, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Martin Vurma, Lam Dang, Hans-Peter Brunner-La Rocca, Gabor Sütsch, Christine H Attenhofer-Jost, Firat Duru, Christoph Scharf
AIMS: Circular irrigated radiofrequency ablation using the nMARQ catheter has recently been introduced for the treatment of atrial fibrillation (AF). The aim of this study is to report the safety and efficacy of catheter ablation using this technology in patients with paroxysmal and persistent AF. METHODS AND RESULTS: The data of a prospective registry describing the experience of a single operator using this technology on 327 consecutive patients were analysed...
August 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Piyush S Shah, Parshotam Gera, Ian J Gollow, Shripada C Rao
AIM: Immediate post-operative care of tracheoesophageal fistula (TEF) and oesophageal atresia (EA) requires mechanical ventilation. Early extubation is preferred, but subsequent respiratory distress may warrant re-intubation. Continuous positive airway pressure (CPAP) is a well-established modality to prevent extubation failures in preterm infants. However, it is not favoured in TEF/EA, because of the theoretical risk of oesophageal anastomotic leak (AL). The aim of this study was to find out if post-extubation CPAP is associated with increased risk of AL...
July 2016: Journal of Paediatrics and Child Health
Warwick J Teague, Jonathan Karpelowsky
There have been major advances in the surgery for oesophageal atresia (OA) and tracheo-oesophageal fistula(TOF) with survival now exceeding 90%. The standard open approach to OA and distal TOF has been well described and essentially unchanged for the last 60 years. Improved survival in recent decades is most attributable to advances in neonatal anaesthesia and perioperative care. Recent surgical advances include the use of thoracoscopic surgery for the repair of OA/TOF and in some centres isolated OA, thereby minimising the long term musculo-skeletal morbidity associated with open surgery...
June 2016: Paediatric Respiratory Reviews
Kiera Roberts, Jonathan Karpelowsky, Dominic A Fitzgerald, Soundappan Sv Soundappan
Oesophageal atresia and tracheo-oesophageal fistula are congenital anomalies of the oesophagus requiring surgical repair in infancy, either by open or thoracoscopic approach. Although mortality rates associated with this procedure are low, children may go on to have complications throughout childhood and into adulthood, most commonly related to ongoing gastrointestinal and respiratory symptoms. This review outlines the early, mid and long-term outcomes for these children in terms of quality of life and incidence of symptoms...
July 2016: Journal of Paediatrics and Child Health
Manish Kumar, Niranjan Thomas
Oesophageal atresia/trachea-Oesophageal fistula is commonly diagnosed in the newborn period by inability to pass a nasogastric tube (NGT). We present the instance of a newborn baby where the diagnosis of oesophageal atresia was delayed because of an apparent successful passage of nasogastric tube to the stomach. Failure to reinsert the NGT raised the suspicion of oesophageal atresia which was confirmed by contrast study showing blind upper oesophageal pouch.
April 2016: Journal of Clinical and Diagnostic Research: JCDR
Kazuo Oshima, Hiroo Uchida, Takahisa Tainaka, Akihide Tanano, Chiyoe Shirota, Kazuki Yokota, Naruhiko Murase, Ryo Shirotsuki, Kosuke Chiba, Akinari Hinoki
A right aortic arch (RAA) is found in 5% of neonates with tracheoesophageal fistulae (TEF) and may be associated with vascular rings. Oesophageal repairs for TEF with an RAA via the right chest often pose surgical difficulties. We report for the first time in the world a successful two-stage repair by left-sided thoracoscope for TEF with an RAA and a vascular ring. We switched from right to left thoracoscopy after finding an RAA. A proximal oesophageal pouch was hemmed into the vascular ring; therefore, we selected a two-stage repair...
May 4, 2016: Journal of Minimal Access Surgery
Apeksha Chaturvedi, Steven Lee, Nina Klionsky, Abhishek Chaturvedi
Evaluation for pneumothorax is an important indication for obtaining chest radiographs in patients who have had trauma, recent cardiothoracic surgery or are on ventilator support. By definition, a persistent pneumothorax constitutes ongoing bubbling of air from an in situ chest drain, 48 h after its insertion. Persistent pneumothorax remains a diagnostic dilemma and identification of potentially treatable aetiologies is important. These may be chest tube related (kinks or malposition), lung parenchymal disease, bronchopleural fistula, or rarely, oesophageal-pleural fistula...
June 2016: Insights Into Imaging
Edward J Hannon, Jennifer Billington, Edward M Kiely, Agostino Pierro, Lewis Spitz, Kate Cross, Joseph I Curry, Paolo De Coppi
INTRODUCTION: Management of oesophageal atresia (OA) and trachea-oesophageal fistula (TOF) in babies of low birth weight is challenging especially when associated with other anomalies. Birth weight of <1500 g has previously formed part of a classification system designed to predict outcome, alongside the cardiac status of the patient. Improvements in neonatal care have led to increasing numbers of premature low birth weight infants surviving. The aim of this study was to look at the experience of our institution in the extremely low birth weight (ELBW) patients...
June 2016: Pediatric Surgery International
Yixin Chen, Zhenlei Liu, Jia Chen, Yuzhi Zuo, Sen Liu, Weisheng Chen, Gang Liu, Guixing Qiu, Philip F Giampietro, Nan Wu, Zhihong Wu
VACTERL association is a condition comprising multisystem congenital malformations, causing severe physical disability in affected individuals. It is typically defined by the concurrence of at least three of the following component features: vertebral anomalies (V), anal atresia (A), cardiac malformations (C), tracheo-oesophageal fistula (TE), renal dysplasia (R) and limb abnormalities (L). Vertebral anomaly is one of the most important and common defects that has been reported in approximately 60-95% of all VACTERL patients...
July 2016: Journal of Medical Genetics
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