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At least 271 records · Page 15Linked to original sources
PubMed2006

Endoscopic management of liver abscesses and cysts that communicate with intrahepatic bile ducts.

BACKGROUND AND STUDY AIMS: The formation of a communication between liver abscesses or cysts and intrahepatic bile ducts is an uncommon cause of significant bile leak. Surgical management of biliary fistulas is associated with high morbidity and mortality. We performed a prospective study of endoscopic management of this type of biliary fistula. PATIENTS AND METHODS: We studied 26 patients who had either liver abscesses or hepatic cysts that had ruptured into the intrahepatic bile ducts. The presence of a biliary fistula was suspected by jaundice and/or by the appearance of bile in percutaneous drainage effluent from a liver abscess and was confirmed by endoscopic retrograde cholangiopancreatography. Once the route of the fistula between the liver abscess or cyst and the intrahepatic bile duct had been defined by cholangiography, patients underwent treatment by sphincterotomy, and either biliary stenting or nasobiliary drainage. Nasobiliary drains or biliary stents (both 7 Fr) were placed according to standard techniques. Nasobiliary drains were removed when bile leakage stopped and closure of the fistula was confirmed by cholangiography; stents were removed after an interval of 4-6 weeks. RESULTS: Of a total of 525 patients with hepatic abscesses or cysts who were seen over a 5-year period, there were 26 patients who developed a demonstrable communication between liver abscesses (n = 20; 16 amebic, four pyogenic) or hydatid cysts (n = 6) and intrahepatic bile ducts (right intrahepatic bile ducts in 22 patients, left intrahepatic bile ducts in four patients). We performed either sphincterotomy with insertion of a nasobiliary drain (n = 20) or sphincterotomy with biliary stenting (n = 6). The fistulas healed in all patients after a mean time of 4 days (range 2-20 days) after endoscopic treatment. We were able to remove the nasobiliary drainage catheters and stents 6-34 days after their placement. CONCLUSIONS: In this case series, endoscopic therapy appears to be an effective mode of treatment for biliary fistulas complicating liver abscesses and cysts.

Adult↗
PubMedDate not supplied

[Biliary-colonic fistulas. Analysis of 2 cases and literature review].

BACKGROUND: Bilioenteric fistulas are entities whose etiology can be diverse. OBJECTIVE: The aim of this paper was to present two cases of biliary-colonic fistulas with different presentations and to review existing literature regarding etiology, diagnosis, and management of these patients. METHODS: Two cases of biliary-colonic fistulas were reviewed. RESULTS: Case 1. A 48-year-old woman presented with lower gastrointestinal bleeding secondary to cholecystocolonic fistula in context of cholelithiasis. Case 2. A 60-year-old woman with multiple hepatic abscess associated with biliary-colonic fistula secondary to adenocarcinoma of gallbladder. CONCLUSIONS: Biliary-colonic fistulas are recognized complications of cholelithiasis. Association with neoplasia is less frequent. Preoperative diagnosis is difficult and management must be surgical.

Biliary Fistula↗
PubMed2002

Gastrobronchial fistula repair followed by esophageal leak--rescue by transesophageal drainage of the pleural cavity.

A gastrobronchial fistula (GBF) associated with bilateral aspiration pneumonia was diagnosed six years after an esophagectomy with gastric pull-up. After failed surgical repair, an uncontained esophagopleural leak developed. Fistula closure was attempted by implanting a Wilson-Cook endoprosthesis, which quickly became dislodged. Transesophageal drainage was positioned endoscopically through the suture-line defect and led to closure of the leak after 10 days.

Anastomosis, Surgical↗
PubMed1983

[Cholesterol elimination in the urinary tract].

The case of a 50-year-old female patient who had been passing "calculi" containing cholesterol for 10 years is presented. Previously, abdominal surgical interventions had been carried out several times and therefore a fistula between the digestive and urogenital system was suspected. This, however, could not be confirmed either by radiological or laboratory techniques. A II/a type of hyperlipoproteinemia was found in the serum, but its correlation to the calculi could be excluded.

Cholesterol↗
PubMed1984

Wound amylase levels as an early indicator of orocutaneous fistulae.

The formation of an orocutaneous fistula following ablative head and neck surgery is a common complication. Early fistula detection could permit prompt management, hopefully preventing further wound breakdowns. Amylase is quantitatively the most prominent enzyme in saliva. This study prospectively evaluated whether the amylase content of wound drainage could predict the formation of an orocutaneous fistula earlier than clinically evident. Patients undergoing procedures that required postoperative wound drainage represented the study population. Baseline serum and salivary amylase determinations were obtained. The drainage was assayed for amylase content twice daily. Wound amylase values were then correlated with the patient's clinical course. Results showed wound amylase had a downward trend in uncomplicated postoperative courses. An upward trend of wound amylase was correlated with early fistulization. No pattern was identified in patients with delayed fistulae.

Aged↗