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1.
Cir Cir ; 87(S1): 77-80, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31501634

RESUMO

We report an unusual case of a 53-year-old male with fistula, ectropion and lagophthalmos due to lateral frontal rhinosinusitis. Two years ago, he presented soft erythematous swelling at internal epicanthus. A year and a half before, he presented upper eyelid fistula secretion drainage, cicatricial ectropion and lagophthalmos. No otorhinolaryngological or visual discomfort was reported. Ophthalmology performed ectropion surgical repair using skin grafting, with no improvement. They requested magnetic resonance imaging which showed a suggestive image of frontal lateral sinusitis, being transferred to the Otorhinolaryngology service. External and endoscopic nasal surgery was performed, which resolved the sinus pathology with good evolution.


Assuntos
Ectrópio/etiologia , Endoscopia/métodos , Doenças Palpebrais/etiologia , Fístula/etiologia , Sinusite Frontal/complicações , Rinite/complicações , Ectrópio/cirurgia , Doenças Palpebrais/cirurgia , Fístula/cirurgia , Sinusite Frontal/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Rinite/cirurgia
2.
Schweiz Arch Tierheilkd ; 161(9): 553-557, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488396

RESUMO

INTRODUCTION: A 2-year-old Holstein Friesian bull with a penile tumour was referred to the University of Veterinary Medicine Hannover, Foundation, Germany, where the tumour was resected and diagnosed as a fibropapilloma. A urethral fistula was diagnosed eight days postoperatively and was present nine months later, although the bull had normal copulation behaviour and satisfactory fertility. Surgical removal of fibropapillomas in close proximity to the urethra is an effective treatment. A urethral fistula, which may occur as a postsurgical complication, did not have an adverse effect on copulation capacity and fertility of the bull.


Assuntos
Fístula/veterinária , Papiloma/veterinária , Animais , Bovinos , Doenças dos Bovinos/patologia , Doenças dos Bovinos/cirurgia , Fístula/etiologia , Fístula/patologia , Alemanha , Masculino , Papiloma/complicações , Papiloma/patologia , Papiloma/cirurgia , Pênis/patologia , Pênis/cirurgia , Uretra/patologia
3.
Cir Pediatr ; 32(3): 150-153, 2019 Jul 29.
Artigo em Espanhol | MEDLINE | ID: mdl-31486308

RESUMO

INTRODUCTION: Colopericardial fistula is a rare complication of colonic replacement surgery whose incidence is unknown. Therefore, we present the following case and perform a literature review. CLINICAL CASE: 17-year-old female patient of age consults for respiratory distress and precordial pain of 5 days of evolution. Background: Long gap esophageal atresia (esophagostoma and feeding gastrostomy, subsequent colonic graft). Bilateral pneumonia is initially diagnosed. It rapidly evolves to a state of sepsis. On chest x-ray, pneumopericardium is observed. Water-soluble contrasted study confirms diagnosis of colopericardial fistula. Surgical treatment is established, despite this the patient dies due to respiratory distress. COMMENT: Colopericardial fistula is a very serious entity with a high mortality rate. The clinical presentation and the complementary methods of diagnostic confirmation must be known in order to carry out the appropriate treatment.


Assuntos
Doenças do Colo/diagnóstico , Esôfago/cirurgia , Fístula/diagnóstico , Adolescente , Doenças do Colo/etiologia , Doenças do Colo/cirurgia , Atresia Esofágica/cirurgia , Evolução Fatal , Feminino , Fístula/etiologia , Fístula/cirurgia , Gastrostomia/métodos , Humanos , Pneumopericárdio/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico
4.
J Int Adv Otol ; 15(2): 283-288, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31257189

RESUMO

OBJECTIVES: To assess and monitor lateral semicircular canal (LSC) function over time in patients affected by chronic otitis media with cholesteatoma (CHO) complicated by fistula of LSC (LSC-F) before and after surgery using video Head Impulse Test (vHIT). MATERIALS AND METHODS: Eight patients aged 18-67 years affected by CHO with imaging-ascertained LSC-F were included in this preliminary prospective study. The following protocol has been applied: oto-microscopic diagnosis with patient's history; computed tomography scan of the temporal bone; surgery with concomitant resurfacing of LSF-F; audiological and vestibular evaluation before surgery (T0) and at 30 days (T1), 6 months (T2), and 1 year after surgery (T3). vHIT was used to assess vestibulo-ocular reflex (VOR) in LSC. RESULTS: None of the patients showed deterioration of bone conduction hearing levels during the different time of evaluation. Three patients showed a reduced VOR gain and catch-up saccades at T0, with VOR gain normalization at T2. This finding remained stable at the 1-year follow-up. The VOR gain in the nonaffected side generally experienced an increase, paralleled by the normalization on the affected side, with statistically significant correlation. The subjects with normal vHIT before surgery did not show any variation following surgery. CONCLUSION: vHIT allows the assessment of LSC function in case of fistula. The adopted surgical fistula repair did not induce deterioration of the auditory or LSC function, but indeed, it could prevent worsening and help promoting recovery to the normal function.


Assuntos
Colesteatoma da Orelha Média/complicações , Fístula/etiologia , Doenças do Labirinto/etiologia , Adolescente , Adulto , Idoso , Condução Óssea/fisiologia , Colesteatoma da Orelha Média/fisiopatologia , Colesteatoma da Orelha Média/cirurgia , Doença Crônica , Feminino , Fístula/fisiopatologia , Fístula/cirurgia , Teste do Impulso da Cabeça/métodos , Perda Auditiva/etiologia , Perda Auditiva/fisiopatologia , Humanos , Doenças do Labirinto/fisiopatologia , Doenças do Labirinto/cirurgia , Masculino , Pessoa de Meia-Idade , Otite Média/complicações , Otite Média/fisiopatologia , Estudos Prospectivos , Recuperação de Função Fisiológica/fisiologia , Reflexo Vestíbulo-Ocular , Canais Semicirculares/fisiologia , Osso Temporal/fisiologia , Adulto Jovem
5.
Surg Technol Int ; 35: 441-446, 2019 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-31282983

RESUMO

To clarify outcomes and develop a novel classification according to CSF fistula in a selective cohort with intraoperative spinal dural tear, we examined 72 consecutive patients who underwent spinal dural repair after microdiscectomy (n=42) or lumbar spinal decompression (n=30). Group 1 consisted of 25 patients with Type I (mild) dural tear who were treated with either tissue-glue-coated collagen sponge or fibrin glue. Group 2 consisted of 26 patients with Type II (moderate) dural tear who were treated with both tissue-glue-coated collagen sponge and fibrin glue. Group 3 consisted of 21 patients with Type III (severe) dural tear who were treated with polypropylene suture along with tissue-glue-coated collagen sponge and/or fibrin glue. Evident postoperative internal or external CSF leak was used to determine the patient's postoperative result. Postoperative internal or external CSF leak was not evident during a minimum 1-year follow-up in Group 1. In contrast, internal CSF leak was evident in both Groups 2 (n=3) and 3 (n=3) during the same follow-up. No external CSF leak was noted in any of the patients. Three patients underwent re-do spinal surgery for CSF leak repair. Patients in all groups satisfactorily avoided CSF leak. According to the intraoperative findings of a distinct dural tear, patients can be treated adequately with a specific surgical technique.


Assuntos
Dura-Máter/lesões , Fístula/cirurgia , Procedimentos Neurocirúrgicos/métodos , Coluna Vertebral/cirurgia , Traumatismos do Sistema Nervoso/classificação , Traumatismos do Sistema Nervoso/cirurgia , Descompressão Cirúrgica/efeitos adversos , Discotomia/efeitos adversos , Dura-Máter/cirurgia , Fístula/etiologia , Humanos , Análise de Intenção de Tratamento , Adesivos Teciduais/uso terapêutico , Traumatismos do Sistema Nervoso/etiologia
6.
J Obstet Gynaecol ; 39(8): 1049-1056, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31195870

RESUMO

In 6.2% of gynaecologic malignancies, vascular involvement is reported. Cytoreductive surgery presents in those cases a higher rate of major complications. Arterial-enteric fistula is a very rare post-surgical complication with serious repercussions on the patient's life due to intestinal haemorrhage and the overlapping sepsis. This is the first case report about iliac-colonic fistula formation in recurrent ovarian cancer with lymph-node metastasis after laparoscopic secondary cytoreductive surgery in a 75-year-old woman and its successful surgical management. A literature review about arterial-enteric fistula formation in gynaecologic cancer treatment, specifically ovarian cancer, is also reported, hypothesising the risk factors of this severe postoperative complication and possible surgical solutions.


Assuntos
Fístula/etiologia , Artéria Ilíaca , Fístula Intestinal/etiologia , Excisão de Linfonodo/efeitos adversos , Recidiva Local de Neoplasia/cirurgia , Neoplasias Ovarianas/cirurgia , Idoso , Colo/cirurgia , Procedimentos Cirúrgicos de Citorredução , Feminino , Fístula/cirurgia , Humanos , Artéria Ilíaca/cirurgia , Fístula Intestinal/cirurgia , Complicações Pós-Operatórias/etiologia , Fatores de Risco , Aderências Teciduais/cirurgia
8.
Biomed Res Int ; 2019: 9265017, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31080835

RESUMO

Esophageal cancer is a very deadly disease, killing more than 15,000 people in the United States annually. Almost 400,000 new cases happen in the worldwide every year. More than 50% esophageal cancer patients are diagnosed at an advanced stage when they need an esophageal stent to open the blocked esophagus for feeding and drinking. Esophageal stents have evolved in stages over the years. Current clinically used stents commonly include stainless steel or nitinol self-expandable metallic stent (SEMS) and self-expandable plastic stent (SEPS). There are many choices of different types of stents and sizes, with fierce competition among manufacturers. However, current stent technology, whether uncovered, partially covered, fully covered SEMS or SEPS, has their own advantages to solve the dysphagia, stricture, and fistula problems, but they also cause some clinical complications. The ideal stent remains elusive. New 3D printing technique may bring new promising potential to manufacturing personalized esophageal stents. Drug-eluting stents could be the new avenue to do more than just pry open a stricture or cover a defect in the esophageal lumen, a possibility of proving local anticancer therapy simultaneously. Additionally, the lack of esophageal cancer animal models also hinders the progress of stent development. This paper reviews these topics for a comprehensive understanding of this field. In a conclusion, the ultimate goal of the future esophageal stent would have multifunction to treat the underlying conditions and restore esophageal function to near normal.


Assuntos
Desenho de Equipamento , Neoplasias Esofágicas/complicações , Esôfago , Cuidados Paliativos/métodos , Stents/classificação , Ligas , Animais , Constrição Patológica/etiologia , Transtornos de Deglutição/etiologia , Stents Farmacológicos , Estenose Esofágica/etiologia , Estenose Esofágica/terapia , Fístula/etiologia , Humanos , Modelos Animais , Plásticos , Impressão Tridimensional , Aço Inoxidável
9.
Urology ; 131: e7-e8, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31132425

RESUMO

OBJECTIVE: To define clinical features and surgical management of urethro-cavernosal fistulas (UCF). METHODS: A literature search was performed using PubMed to identify publications with the key word urethro-cavernosal fistula. RESULTS: We herein describe surgical techniques and long-term outcomes for UCF repair. CONCLUSION: UCFs is a rare urological condition with only 9 cases reported to date. UCFs can be diagnosed with careful history, physical examination, and retrograde urethrography. Surgical management includes basic tenets of fistula repair, including adequate mobilization, tension-free but watertight approximation, multilayered closure with nonoverlapping suture lines, and maximal bladder drainage.


Assuntos
Fístula/etiologia , Fístula/cirurgia , Doenças do Pênis/etiologia , Doenças do Pênis/cirurgia , Uretra/lesões , Doenças Uretrais/etiologia , Doenças Uretrais/cirurgia , Fístula Urinária/etiologia , Fístula Urinária/cirurgia , Adulto , Humanos , Masculino , Fatores de Tempo , Procedimentos Cirúrgicos Urológicos Masculinos/métodos
10.
Urology ; 129: e1, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31009741

RESUMO

Penetrating perineal trauma is an unusual urologic injury. Even less common is a delayed presentation. Herein we present the case of a patient with delayed development of a corporal cutaneous fistula 3 months following perineal trauma.


Assuntos
Fístula Cutânea/etiologia , Fístula/etiologia , Doenças do Pênis/etiologia , Períneo/lesões , Humanos , Masculino , Fatores de Tempo , Adulto Jovem
11.
Am J Otolaryngol ; 40(3): 462-464, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30940403

RESUMO

BACKGROUND: Medialization laryngoplasty is a common procedure for voice rehabilitation in patients with unilateral vocal fold paralysis. Complications are uncommon and delayed infections involving implants are rare. We report a delayed infectious complication following an animal scratch resulting in a laryngocutaneous fistula. METHODS: Case report. RESULTS: A 73-year-old female underwent a successful and uneventful medialization laryngoplasty for idiopathic unilateral vocal fold paralysis using a silastic implant. More than one year after surgery, she presented with an anterior neck infection following an animal scratch with CT neck findings of a left strap muscle abscess. After incision and drainage, cultures grew methicillin-resistant Staphylococcus aureus. Despite culture-directed antibiotic therapy, the neck continued to drain persistently. Laryngoscopy with stroboscopy revealed a medialized vocal fold with no obvious granulation tissue and normal mucosal pliability. The patient underwent neck exploration revealing a laryngocutaneous fistula. Thus, both the fistulous tract and implant were removed. The wound was closed with a strap muscle advancement into the laryngoplasty window. One month after surgery and antibiotics, the patient had no signs of recurrent neck infection, with a well-healing wound and stroboscopic findings of complete glottic closure, symmetric vocal fold oscillation and acceptable phonation with mild supraglottic compression. CONCLUSIONS: Delayed complications of medialization laryngoplasty are rarely reported. This case demonstrates a delayed infection of a laryngeal implant after an animal scratch requiring implant removal, local tissue reconstruction, and culture-directed antibiotic therapy.


Assuntos
Mordeduras e Picadas/complicações , Fístula/etiologia , Doenças da Laringe/etiologia , Laringoplastia/métodos , Complicações Pós-Operatórias/etiologia , Infecções Relacionadas à Prótese/etiologia , Dermatopatias/etiologia , Paralisia das Pregas Vocais/cirurgia , Idoso , Animais , Dimetilpolisiloxanos , Cães , Feminino , Fístula/diagnóstico por imagem , Fístula/terapia , Humanos , Doenças da Laringe/terapia , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/terapia , Próteses e Implantes , Infecções Relacionadas à Prótese/diagnóstico por imagem , Infecções Relacionadas à Prótese/terapia , Dermatopatias/diagnóstico por imagem , Dermatopatias/terapia , Fatores de Tempo
12.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(4): 247-253, abr. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-183175

RESUMO

Introducción: La fístula quilosa (FQ) cervical es excepcional y no existe consenso sobre su tratamiento. El objetivo es analizar la eficacia de los tratamientos conservador y quirúrgico en esta patología. Método: Población a estudio constituida por pacientes con cirugía tiroidea que presentan en la evolución posquirúrgica una FQ. Grupos a estudio: 1) Grupo con tratamiento conservador, formado por FQ con débito inferior a 300cm3/día, tardías o coleccionadas en el cuello; y 2) Grupo con tratamiento quirúrgico, formado por FQ precoces con débito superior a 300cm3/día. Variables a estudio: Se analizan los resultados en cuanto a tasas de curación y la tasa de reconversión a tratamiento quirúrgico. Resultados: Nueve pacientes presentaron una FQ. Todos iniciaron tratamiento conservador; de ellos, el 67% (n=6) con intención curativa, resolviéndose el 50% de los casos (n=3). Los restantes, tras más de 150 días de tratamiento, fueron ingresados para añadir dieta absoluta y nutrición parenteral. Uno de ellos se resolvió, siendo los otros 2 casos remitidos a cirugía. En los casos restantes (33%; n=3) se indicó la cirugía como tratamiento definitivo inicial. El abordaje fue cervical con ligadura y punto transfixivo del conducto torácico. En uno de los pacientes, que asociaba un quilotórax, se asoció una toracoscopia. En los 2 casos en quienes fracasó el tratamiento conservador, se indicó la cirugía mediante cervicotomía, identificando el punto de reflujo linfático. Todos los operados han presentado resolución de la fístula. Conclusiones: El tratamiento conservador es efectivo en el 66% de las FQ de bajo débito. En las fístulas de débito alto, o donde el tratamiento conservador no es efectivo, la cirugía ofrece una resolución efectiva y rápida del cuadro


Introduction: Cervical chyle fistula (CF) is exceptional, and there is no agreement on its treatment. The study objective was to assess the efficacy of conservative and surgical treatment in this condition. Method: Study population: Patients undergoing thyroid surgery who experience CF after the procedure. Study groups: 1) Group with conservative treatment: CF with flow rates less than 300cm3/day, late or collected in the neck; and 2) Group with surgical treatment: early CF with flow rates greater than 300 cm3/day. Study variables: Cure rates and rate of conversion to surgery were analyzed. Results: Nine patients experienced CF. Conservative treatment was started in all of them, in 67% (n=6) with curative intent. Fifty percent of treated cases were resolved (n=3). The remaining patients were hospitalized after more than 150 days of treatment to add absolute diet and parenteral nutrition. The condition resolved in one patient, and the other two were referred for surgery. In the remaining patients (33%, n=3), surgery was indicated as the initial definitive treatment. A cervical approach, with ligature and transfixion stitch of the thoracic duct, was used. In one of the patients, who also had chylothorax, thoracoscopy was also performed. In the two patients where conservative treatment failed, cervicotomy was indicated, identifying in both the lymphatic reflux point. Fistula resolved in all operated patients. Conclusions: Conservative treatment was effective in 66% of low flow CFs. Surgery effectively and rapidly resolves fistulas with a high flow or not responding to conservative treatment


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Tireoidectomia/efeitos adversos , Neoplasias da Glândula Tireoide/cirurgia , Fístula/etiologia , Fístula/terapia
13.
J Pediatr Surg ; 54(10): 1988-1992, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30879755

RESUMO

PURPOSE: A complication of the surgical management of anorectal malformations (ARMs) is a retained remnant of the original fistula (ROOF) formerly called a posterior urethral diverticulum (PUD). A ROOF may have multiple presentations or may be incidentally discovered during the work-up of ARM after previous surgery. We sought to define the entity and the surgical indications for excision of a ROOF when found. METHODS: We performed a retrospective cohort study of all male patients who presented to our center following previous repair for ARM at another institution, who came for evaluation of problems with urinary and/or fecal continence, from 2014 to 2017. Charts were reviewed for symptoms, original type of malformation, preoperative imaging, treatment, and postoperative follow-up. RESULTS: Of 180 referred male patients, 16 had a ROOF. 14 underwent surgical repair to address this and for other redo indications, and 2 did not require intervention. 13 patients had an additional reason for a redo such as anal mislocation or rectal prolapse. Indications for ROOF excision were urinary symptoms (e.g. UTI, dribbling, passage of mucous via urethra, stone formation), to make a smoother posterior urethra for intermittent catheterization, or for prophylactic reasons. Patients were repaired at an average age of 4.2 years, using a PSARP only approach with excision of the ROOF for all except one patient who needed a laparotomy due to abdominal extension of the ROOF. No patient needed a colostomy. The original ARM repairs of the patients were PSARP (9), laparoscopic assisted (4) and abdominoperineal pullthrough (3). Preoperative evaluation included pelvic MRI, VCUG, and cystoscopy. The ROOF was visualized on 14 of 16 MRIs, 10 of 14 VCUGs, and 14 of 15 cystoscopies. Urinary symptoms associated with a ROOF and ease of catheterization were improved in all repaired cases. CONCLUSION: Patients not doing well from a urinary or bowel standpoint post ARM pull-through need a complete evaluation which should include a check for a ROOF. Both modalities MRI and cystoscopy are needed as a ROOF can be missed on either alone. A VCUG was not reliable in identifying a ROOF. Excision is needed in patients to improve urinary symptoms associated with these lesions and to minimize the small but theoretical oncologic risk present in a ROOF. LEVEL OF EVIDENCE: Level III.


Assuntos
Malformações Anorretais/cirurgia , Divertículo/diagnóstico , Fístula/diagnóstico , Laparoscopia/efeitos adversos , Complicações Pós-Operatórias/diagnóstico , Doenças Uretrais/diagnóstico , Malformações Anorretais/fisiopatologia , Pré-Escolar , Cistoscopia , Divertículo/etiologia , Divertículo/cirurgia , Fístula/etiologia , Fístula/cirurgia , Humanos , Lactente , Imagem por Ressonância Magnética , Masculino , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Reoperação , Estudos Retrospectivos , Doenças Uretrais/etiologia , Doenças Uretrais/cirurgia
15.
BMJ Case Rep ; 12(3)2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30826783

RESUMO

Post-traumatic pneumolabyrinth is an uncommon clinical entity, particularly in the absence of temporal bone fracture. We report the case of a patient who presented to our emergency department with a headache, sudden left hearing loss and severe dizziness which began after a traumatic brain injury 3 days earlier. On examination, the patient presented signs of left vestibulopathy, left sensorineural hearing loss and positive fistula test, normal otoscopy and without focal neurological signs. The audiometry confirmed profound left sensorineural hearing loss. Cranial CT revealed a right occipital bone fracture and left frontal subdural haematoma, without signs of temporal bone fracture. Temporal bone high-resolution CT scan revealed left pneumolabyrinth affecting the vestibule and cochlea. Exploratory tympanotomy revealed perilymphatic fistula at the location of the round window. The sealing of defect was performed using lobule fat and fibrin glue. He presented complete resolution of the vestibular complaints, though the hearing thresholds remained stable.


Assuntos
Lesões Encefálicas Traumáticas/complicações , Aqueduto da Cóclea , Doenças Cocleares/etiologia , Fístula/etiologia , Doenças do Labirinto/etiologia , Cóclea , Tontura/etiologia , Cefaleia/etiologia , Perda Auditiva Súbita/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Vestíbulo do Labirinto
16.
J Laryngol Otol ; 133(2): 102-105, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30898189

RESUMO

OBJECTIVE: To measure the outcomes of laser treatment of cholesteatoma covering cochlear and vestibular fistulas. METHODS: Cholesteatoma matrix over the fistula was denatured; the power density was sufficient only to gradually heat, but not vaporise, the keratin-forming matrix. The denaturing speed was controlled so that the integrity of the fistula cover was maintained. The change in bone conduction threshold and the residual rate of cholesteatoma at the fistula were measured. RESULTS: Thirty-six fistulas were assessed. There were seven cochlear fistulas. All were 5 mm or less in maximum length. For the entire group, the average change in bone conduction threshold was -0.3 dB. For cochlear fistulas, the average change in bone conduction was + 0.2 dB. The distribution of hearing results for the entire group was Gaussian; the apparent changes in hearing could be attributed to errors associated with testing. All patients underwent second-stage surgery. In all cases, the cholesteatoma was completely cleared from the fistula site. There were no facial palsies. CONCLUSION: Laser denaturing of cholesteatoma matrix over fistulas measuring 5 mm or less of vestibular apparatus and the cochlea is effective at eliminating cholesteatoma, and is not associated with cochlear hearing loss or facial palsy.


Assuntos
Colesteatoma da Orelha Média/complicações , Cóclea , Fístula/cirurgia , Doenças do Labirinto/cirurgia , Terapia a Laser/métodos , Procedimentos Cirúrgicos Otológicos/métodos , Vestíbulo do Labirinto , Feminino , Fístula/etiologia , Seguimentos , Humanos , Doenças do Labirinto/etiologia , Masculino , Estudos Retrospectivos , Resultado do Tratamento
18.
Clin Imaging ; 56: 47-51, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30878712

RESUMO

Dermoid cysts, or mature cystic teratomas, are complicated by malignant degeneration in only 1-2% of cases. Rarely, dermoid cysts result in complications of small bowel obstruction or entero-ovarian fistula formation. In the current report we present the case of a 59-year-old female with a known dermoid cyst who presented with leukocytosis and was discovered to have a small bowel obstruction at the level of an ileo-ovarian fistula. The patient was taken to the operating room and was treated with total abdominal hysterectomy, bilateral salpingo-oopherectomy, and short segment small bowel resection. Review of the surgical pathology revealed areas of malignant degeneration within the dermoid cyst to squamous cell carcinoma. To our knowledge, this is only the second reported case of an ovarian dermoid cyst complicated by small bowel obstruction, entero-ovarian fistula formation, and malignant degeneration.


Assuntos
Carcinoma de Células Escamosas , Cisto Dermoide/complicações , Fístula/etiologia , Obstrução Intestinal/etiologia , Intestino Delgado/patologia , Neoplasias Ovarianas/complicações , Ovário/patologia , Teratoma/complicações , Carcinoma de Células Escamosas/cirurgia , Coristoma/complicações , Coristoma/patologia , Coristoma/cirurgia , Cisto Dermoide/patologia , Cisto Dermoide/cirurgia , Feminino , Fístula/cirurgia , Humanos , Histerectomia , Obstrução Intestinal/cirurgia , Intestino Delgado/cirurgia , Pessoa de Meia-Idade , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/cirurgia , Ovário/cirurgia , Teratoma/patologia , Teratoma/cirurgia
19.
Zhonghua Bing Li Xue Za Zhi ; 48(2): 112-115, 2019 Feb 08.
Artigo em Chinês | MEDLINE | ID: mdl-30695862

RESUMO

Objective: To elucidate the clinicopathologic characteristics of atypical epithelioid trophoblastic lesions with cyst and fistula formation after cesarean section. Methods: The clinical and pathological data of 4 cases of post-cesarean atypical epithelioid trophoblastic lesions with cyst and fistula formation diagnosed at Women's Hospital, School of Medicine, Zhejiang University during April 2007 to June 2018 were evaluated by hematoxylin and eosin stain and EnVision two-step immunohistochemical staining technique. Results: The age of the 4 patients ranged from 32 to 41 years, with a mean age of 36.5 years. Three patients recieved cystectomy and one underwent subtotal hysterectomy. Histologically, the lesions were well circumscribed and consisted of uniform cells of medium size, irregularly enlarged with hyperchromatic nuclei and 1 to 2 inconspicuous nucleoli embedded in abundant hyalinized matrix with fibrinoid material in the center. The cells exhibited immunohistochemical feature of chorionic-type intermediate trophoblastic cells (CK18+, p63+ and CD146-). All patients were alive without recurrence during follow-up of 1 to 40 months (mean=22 months). Conclusion: Atypical epithelioid trophoblastic lesion with cyst and fistula formation after cesarean section has unique histological features, and its biological behavior and prognosis are still unclear, which need further exploration.


Assuntos
Cesárea/efeitos adversos , Cistos/patologia , Células Epitelioides/patologia , Fístula/patologia , Complicações Pós-Operatórias/patologia , Neoplasias Trofoblásticas/patologia , Neoplasias Uterinas/patologia , Adulto , Cistos/etiologia , Cistos/cirurgia , Feminino , Fístula/etiologia , Fístula/cirurgia , Humanos , Imuno-Histoquímica , Recidiva Local de Neoplasia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Gravidez , Neoplasias Trofoblásticas/etiologia , Neoplasias Trofoblásticas/cirurgia , Doenças Uterinas/etiologia , Doenças Uterinas/patologia , Neoplasias Uterinas/etiologia , Neoplasias Uterinas/cirurgia
20.
Ann Otol Rhinol Laryngol ; 128(6): 569-574, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30693805

RESUMO

OBJECTIVES: Cervical chylous fistula is an uncommon but potentially severe occurrence associated with neck surgery. Methods for treating this problem have inconsistent efficacy and may result in lengthy hospital stays. Negative pressure wound therapy (NPWT) is a highly effective tool in the management of complex wounds. We report 3 cases where NPWT was successfully used to treat chylous fistulas following neck dissection. METHODS: This is a retrospective chart review of 3 patients who developed chylous fistulas after neck dissection and were successfully treated with NPWT. RESULTS: Chylous ouput ceased within 2 to 8 days of proper wound VAC placement. Hospital stays ranged from 6 to 47 days. Patients received altered diets, including TPN for 1 patient with high-flow output and nil-per-os (NPO) or clear liquids for the others. Patients received octreotide throughout their hospitalization. CONCLUSION: NPWT shows potential as a treatment option for both high-volume and low-volume chylous fistulas following neck dissection.


Assuntos
Fístula Cutânea/terapia , Fístula/terapia , Esvaziamento Cervical/efeitos adversos , Pescoço , Tratamento de Ferimentos com Pressão Negativa , Ducto Torácico , Idoso , Carcinoma de Células Escamosas/cirurgia , Quilo , Fístula Cutânea/etiologia , Feminino , Fístula/etiologia , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/terapia , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/cirurgia
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