Fistula oesophageal

Acquired tracheo-oesophageal fistulas (TEFs) are rare and challenging complications in the course of oesophageal cancer. While surgery is the only curative treatment option for TEFs many patients are not eligible for surgery. Endoscopic treatment approaches such as tracheal- and/or oesophageal- stenting are available, but associated with complications like the development of new fistulas and mucus retention. Off- label-use of cardiac amplatzer occluder devices to close TEFs has been reported in few case-reports with inconsistent short-term outcomes...

In this case series, we investigated the feasibility of combining ultrasound and neurostimulation for inserting a stimulating epidural catheter in the thoracic epidural space through the caudal route in neonates. Twelve neonates undergoing tracheo-oesophageal fistula repair under general anaesthesia were studied. The catheter was visible on ultrasound as a hyperechoic dot in the epidural space. Inadvertent high placement was identified in two neonates with neurostimulation, in whom the catheter was withdrawn to the thoracic epidural space, and the position was confirmed on ultrasound...

BACKGROUND: Thoracoscopic repair of esophageal atresia (EA) and tracheoesophageal fistula (TEF) poses significant technical challenges. This study aimed to develop an inexpensive, reusable, high-fidelity synthetic tissue model for simulating EA/TEF repairs and to assess the validity of the simulator. METHODS: By using 3D printing and silicone casting, we designed an inexpensive and reusable inanimate model for training in thoracoscopic EA/TEF repair. The objective was to validate the model using a 5-point Likert scale and the Objective Structured Assessment of Technical Skills (OSATS) to evaluate participants' surgical proficiency...

AEF: aorto-oesophageal fistula;BB: button battery;CTA: computed tomography angiography;ER: emergency room;GI: gastro-intestinal;SBT: Sengstaken-Blakemore tube.

INTRODUCTION: Babies with oesophageal atresia (OA) who cannot achieve a primary anastomosis (complex OA) may be treated by attempted oesophageal lengthening. We contrast reported outcomes of lengthening with our experience of managing complex OA. PATIENTS AND METHODS: A consecutive series treated in an English regional centre was completed. Outcomes of interest were the rate of retention of the native oesophagus, complications requiring thoracotomy, rates of anastomotic leak, stricture, fundoplication, and mortality...

INTRODUCTION: Tracheoesophageal fistulas (TEF) are a rare complication that can occur in patients with radioactive iodine refractory metastatic follicular thyroid carcinoma (FTC) following treatment with radiotherapy (RT) and tyrosine kinase inhibitors (TKI). METHODS: We describe the case of a TEF development in a 69-year-old male who underwent targeted therapy TKIs and adjuvant RT for radioactive iodine refractory FTC. RESULTS: In the case, staging investigations revealed a metastatic, poorly differentiated FTC refractory to radioactive iodine...

Pharyngolaryngoesophageal (PLO) reconstruction is a complex and technically demanding procedure. The reconstructive surgeon's concerns include avoiding fistula and stricture formation, as well as restoring normal speech and swallowing. A retrospective observational study with circumferential pharyngo-laryngo-oesophagal defects with aims and objectives of evaluation and comparison of the long-term functional outcomes like speech and swallowing along with the complications of fistula and stricture in two groups of JFF and FC flaps from the data is collected from electronic medical records of Tata Memorial Hospital, Mumbai, from January 2011 to May 2020...

No abstract text is available yet for this article.

A 75-year-old male, without relevant medical history and negative HIV1/2 serology, presented at the emergency department with mixed shock (septic - from pleuroparenchymal origin - and hypovolemic due to upper gastrointestinal bleeding [UGIB]). Thoracoabdominal CT scan showed an esophagopleural fistula (EPF), with a large right pleural effusion (lately known to be compatible with exudate - Light's criteria) and right pneumothorax, without active bleeding. The upper gastrointestinal endoscopy (UGIE) showed a severe esophagitis and, in distal oesophagus, an ulcer with an orifice in the center...

PURPOSE: Recent series of newborn Oesophageal Atresia (OA) repair continue to report widespread use of chest drains, gastrostomy, routine contrast studies and parenteral nutrition (PN) despite evidence suggesting these are superfluous. We report outcomes using a minimally interventional approach to post-operative recovery. METHODS: Ethically approved (15/WA/0153), single-centre, retrospective case-note review of consecutive infants with OA 2000-2022. Infants with OA and distal trache-oesophageal fistula undergoing primary oesophageal anastomosis at initial surgery were included (including those with comorbidities such as duodenal atresia, anorectal malformation and cardiac lesions)...

Pulmonary vein isolation (PVI) of symptomatic atrial fibrillation is an effective method of maintaining sinus rhythm. Radiofrequency ablation and cryotechnology have been used for this purpose for many years. One disadvantage of these methods is the risk of serious complications such as pulmonary vein stenosis, phrenic nerve palsy and atrio-oesophageal fistula. Pulsed Field Ablation (PFA) is a promising ablation modality for treatment of atrial fibrillation. This technique employs a train of high amplitude electrical pulses with short duration that ablate myocardium with minimal effect on surrounding tissues...

A young woman with Rogers syndrome (thiamine-responsive megaloblastic anaemia, diabetes mellitus and sensorineural deafness) presented with headache, recurrent supraventricular tachycardia and features of an upper gastrointestinal bleed, 1 month after radiofrequency cardiac ablation for supraventricular tachycardia. She deteriorated rapidly after endoscopy and subsequently died. Brain imaging during the acute deterioration showed diffuse intracranial air embolism and hypoxic-ischaemic injury. Postmortem examination showed an atrio-oesophageal fistula, a rare complication of cardiac ablation...

BACKGROUND: Oesophageal atresia with or without a tracheoesophageal fistula (TEF) is a congenital abnormality that usually requires surgical repair within the first days of life. OBJECTIVE: Description of the perioperative anaesthetic management and outcomes of neonates undergoing surgery for oesophageal atresia with or without a tracheoesophageal fistula, included in the 'neonate and children audit of anaesthesia practice in Europe' (NECTARINE) database. DESIGN: Sub-analyses of prospective observational NECTARINE study...

No abstract text is available yet for this article.

AIMS: Cryoballoon (CB) ablation is the mainstay of single-shot pulmonary vein isolation (PVI). A radiofrequency balloon (RFB) catheter has recently emerged as an alternative. However, these two technologies have not been compared. This study aims to evaluate the freedom from atrial tachyarrhythmias (ATas) at 1 year: procedural characteristics, efficacy, and safety of the novel RFB compared with CB for PVI in patients with paroxysmal atrial fibrillation (AF). METHODS AND RESULTS: This prospective multi-centre study included consecutive patients with symptomatic drug-resistant paroxysmal AF who underwent PVI with RFB or CB between July 2021 and January 2022 from three European centres...

A 66-year-old man with a history of catheter ablation for atrial fibrillation presented with purulent cardiac tamponade, revealing an atrio-oesophageal fistula. He underwent successful endoscopic management. A few days later, the patient fell into a sudden coma due to multiple cerebral air embolisms, resulting from a fistula between the esophagus and the right superior pulmonary vein.

With increasing survival in patients with cystic fibrosis (CF), complications such as gastrointestinal (GI) malignancies are becoming more apparent, especially in transplanted patients. In patients with CF, these malignancies are most commonly found in the small bowel, colon, biliary tract and pancreas. We describe a patient with esophageal squamous cell cancer at the site of trachea-esophageal fistula repair in the setting of long-standing CF. Many factors such as low expression of CF transmembrane conductance regulator gene, inflammation and resulting metaplasia, bacterial dysbiosis, dysregulation of Wnt/β-catenin signalling, immune cell infiltration, disruption of intestinal stem cell homeostasis and intestinal barrier integrity have all been implicated in the causation of GI malignancy in patients with CF...

INTRODUCTION AND IMPORTANCE: Button battery ingestion and impaction in the oesophagus can result in severe morbidity and even fatality if not diagnosed and managed urgently. Delayed or missed diagnosis due to the sometimes-vague symptomatology and limited investigations in resource-limited settings further increases the complications rate. CASE PRESENTATION: Case 1: A 2 years old male child presented with a nine months history of recurrent respiratory tract infections not responding well to medical treatment...

No abstract text is available yet for this article.

BACKGROUND: Neonatal care is commonly regionalised, meaning specialist services are only available at certain units. Consequently, infants with surgical conditions needing specialist care who are born in non-surgical centres require postnatal transfer. Best practice models advocate for colocated maternity and surgical services as the place of birth for infants with antenatally diagnosed congenital conditions to avoid postnatal transfers. We conducted a systematic review to explore the association between location of birth and short-term outcomes of babies with gastroschisis, congenital diaphragmatic hernia (CDH) and oesophageal atresia with or without tracheo-oesophageal fistula (TOF/OA)...