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Results for “ESOPHAGEAL FISTULA”

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At least 19 recordsLinked to original sources
PubMed1990

Cervical esophageal trauma. Incidence and cause of esophageal fistulas.

Esophageal fistulas occurred in 4 (9%) of 46 penetrating esophageal wounds. All four patients with fistulas were victims of gunshot wounds, presented in shock, and underwent an urgent tracheostomy in the emergency department. Shock and urgent tracheostomy were significantly associated with fistula formation. Whether single-layer closures are adequate for esophageal wounds remains unanswered. Our data showed no disadvantage to single-layer closure, since seven of eight were successful. This compares with a success rate for multilayer closures of 32 of 35. Fifty percent of the esophageal fistulas were asymptomatic and were discovered on routine postoperative contrast study. All fistulas closed with nonoperative management. Management recommendations included nonoperative means to establish an airway, meticulous débridement, two-layer closure of the wound, closed-suction drainage, and postoperative esophagography before drain removal.

Adolescent↗
PubMed1996

Surgical management and treatment of esophageal fistula.

Esophageal fistula may involve the respiratory or cardiovascular system. Fistulas involving the respiratory system which originate from esophageal cancers are the most common. Diagnosis is best made with barium esophagogram. ERF of any cause usually leads to repetitive contamination of the respiratory tract, resulting in sepsis and death of the patient if untreated. In the case of MERF, whether from esophageal or lung cancer, only palliative treatment is usually possible. Better results, including cure, may be expected when a MERF is caused by lymphoma. Curative operation with closure of the fistula is usually possible for BERF if the fistula is identified and treated before irreversible damage has been done by infection, sepsis, and malnutrition. Esophagocardiovascular fistulas occur infrequently in comparison with ERF. These may involve the aorta, usually as a result of a thoracic aneurysm. Rarely one may encounter esophageal fistula to the pericardium or heart. Few survivors have been reported, but successful management is possible if early diagnosis is made and prompt surgical management is undertaken.

Aortic Diseases↗
PubMed1987

[Continent tracheo-esophageal fistula by esophageal flap after total laryngectomy].

A new technique of continent tracheo-oesophageal fistula, aimed at facilitating vocal (and therefore global) rehabilitation of patients with total laryngectomy, is described. The fistula method is not new: it carries the expired air from the trachea into the pharynx when the tracheostomy is obstructed, thereby providing possibilities of phonation. What is new in this technique is that it avoids the insertion of prosthesis in the fistula to prevent aspirations. Voice and deglutition were satisfactory in the 3 patients operated upon with this technique.

Esophagus↗
PubMed1996

Malignant tracheo-esophageal fistula: use of esophageal endoprosthesis.

Malignant tracheo-esophageal fistula (TEF) is a serious complication of cancer arising usually in the esophagus, lung, or tracheobronchial tree. Repeated aspiration and pneumonia lead to rapid deterioration and death. The prognosis is dismal and curative resections are curiosities. Surgical bypass of the lesion has been performed but is associated with 25-61% mortality. Other treatments have been employed, such as enterostomies, esophageal endoprostheses, and supportive care. The reported mortality of palliative procedures using endoprostheses, surgical bypass, or exclusion in almost identical. A retrospective review of the data over the past decade revealed a trend toward insertion of endoprostheses. Insertion of endoprostheses can be performed in an endoscopy suite, under sedation, and has fewer major complications than occur with a surgical approach. The periprocedure mortality rate for these patients is 15%, compared to a 29-47% perioperative mortality for patients undergoing surgery. Even so, patients after surgical procedures could survive for 8 months or more, which is better than survival after endoprosthesis intubation. We conclude that insertion of an esophageal endoprosthesis should be the usual preferred option for palliative treatment of malignant TEF. However, for special candidates a surgical procedure is a valid option.

Esophageal Neoplasms↗
PubMed1992

[Recurrent esophago-respiratory tract fistula after repair of esophageal atresia with tracheo-esophageal fistula].

Esophageal atresia is a congenital malformation present in 1 in 4500 live births. 85% of such newborns also have a fistula connecting the distal esophagus with the trachea. Operative management includes closing the fistula by disconnecting the distal esophagus from the trachea and performing end-to-end esophago-esophageal anastomosis. A late complication is a recurrence of the fistula between esophagus and respiratory tract. The recurrent fistula is usually between the esophagus and the trachea, but it may involve the bronchi or lung tissue. This complication causes significant respiratory morbidity, mainly recurrent pneumonia, and sometimes death. The diagnosis of recurrent fistula is usually by barium swallow and/or esphagobronchoscopy. Repair is a surgical challenge. We report 5 infants with recurrent esophago-respiratory tract fistulas out of a total of 68 cases of esophageal atresia with tracheo-bronchial fistula.

Abnormalities, Multiple↗
PubMed1987

Right atrial-esophageal fistula and hydropneumopericardium after esophageal dilation.

Esophagoatrial fistula formation is a rare and heretofore fatal event. A patient presented with esophageal reflux and stricture that later developed into a right atrial-esophageal fistula during biweekly esophageal dilation. Clinical recognition and surgical therapy led to a successful outcome. There were several unique features of this case, including fistulous connection to the right rather than the left atrium, concomitant hydropneumopericardium and esophagoatrial fistula, occurrence during esophageal dilation and surgical cure.

Air↗