RESUMO
Surgery-related salivary fistula is the result of intraoperative or postoperative parotid gland damage and extravasation of fluid secreted by acinar into the interstitial space. Most are treated conservatively. Local injection of botulinum toxin is an effective method, but it is relatively expensive and not available in some hospitals. In clinical practice, the authors observed that packing iodoform gauze from the fistula toward the parotid gland can quickly stop postoperative salivary fistula in several patients. This method is simple and easy to implement, and the effect is quick. The disappearance of the salivary fistula was observed on the next day after packing the iodoform gauze. Iodoform gauze packing is an alternative therapy for postoperative parotid fistula. It can be used in areas where botulinum toxin is not available.
Assuntos
Toxinas Botulínicas Tipo A , Fístula , Doenças Parotídeas , Humanos , Glândula Parótida/cirurgia , Fístula das Glândulas Salivares/tratamento farmacológico , Toxinas Botulínicas Tipo A/uso terapêutico , Doenças Parotídeas/tratamento farmacológico , Fístula/tratamento farmacológico , Complicações Pós-OperatóriasRESUMO
A 25-year-old male patient underwent restorative proctocolectomy and ileoanal anastomosis in 1991 for refractory ulcerative colitis. In February 2001, he presented with pneumaturia, faecaluria, pelvic 'pressure' and watery diarrhoea caused by passage of urine through the anal canal. A fistula between the pouch and the membranous urethra was demonstrated by a pouchogram contrast study. In October 2002, he was started on ciprofloxacin 250 mg once daily and metronidazole 400 mg twice daily. Apart from a short break in 2003 the patient has remained on this regimen until the time of writing (now over 10 years) and has had sustained remission, excellent quality of life and no adverse effects.
Assuntos
Canal Anal/cirurgia , Anti-Infecciosos/uso terapêutico , Ciprofloxacina/uso terapêutico , Colite Ulcerativa/cirurgia , Bolsas Cólicas/efeitos adversos , Fístula/tratamento farmacológico , Fístula/etiologia , Íleo/cirurgia , Metronidazol/uso terapêutico , Doenças Uretrais/tratamento farmacológico , Doenças Uretrais/etiologia , Fístula Urinária/tratamento farmacológico , Fístula Urinária/etiologia , Adulto , Anastomose Cirúrgica/efeitos adversos , Humanos , Masculino , Indução de Remissão , Fatores de TempoAssuntos
Fístula Biliar/tratamento farmacológico , Fístula Cutânea/tratamento farmacológico , Fitoterapia , Complicações Pós-Operatórias/tratamento farmacológico , Parede Torácica , Idoso , Diagnóstico Diferencial , Medicamentos de Ervas Chinesas/uso terapêutico , Fístula/tratamento farmacológico , Humanos , Masculino , Medicina Tradicional Chinesa , Pessoa de Meia-Idade , Coxa da PernaRESUMO
The effects of locally deposited fibrin and of tranexamic acid-induced antifibrinolysis on forming granulation tissue were studied in the light of a recently developed method for treatment of postoperative fistulas by occlusion with a fibrin clot. Perforated teflon cylinders, either empty or fibrin-filled, were implanted subcutaneously in rats and extracted after 2 weeks. Fibrin deposition was found to stimulate granulation tissue ingrowth into the cylinders but it did not change the fibrinolytic activity in the granulation tissue. A significantly higher fibrinolytic activity was, however, found in the tissue fluid collected from the space between the granulation tissue and the implanted fibrin clot compared to tissue fluid from cylinders implanted empty. Tranexamic acid significantly reduced the fibrinolytic activity on the granulation tissue and delayed lysis of the implanted fibrin clot. It also reduced granulation tissue ingrowth but it did not abolish the positive effects of the clot on granulation tissue formation.