[Radiological follow-up of anastomotic insufficiency following partial esophageal resections or gastrectomies. The effects of barium-containing contrast media]. / Radiologische Kontrolle von Anastomoseninsuffizienzen nach Osophagusteilresektionen oder Gastrektomien. Effekte bariumhaltiger Kontrastmittel.

ABSTRACT

Fistulae after abdomino-thoracic operations are usually treated conservatively because of the high complication rate of repeated surgery. If the anastomoses function adequately, healing usually occurs spontaneously after four to six weeks. Amongst 271 patients with intrathoracic oesophago-gastric or oesophago-jejunal anastomoses, entero-cutaneous fistulae occurred 29 times. Extension of the fistula into the pleura or peritoneum was first excluded by using an absorbable contrast medium and then a barium contrast examination was carried out. Thoracic fistulae closed, on average, after 21.8 days and fistulae in the upper abdomen after 20.3 days. Barium sulphate stimulates granulation tissue in the fistula and therefore leads to more rapid obliteration. This improves the quality of the patient's life and reduced the time the patient has to spend in hospital. There were no local or systematic complications.