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Tumours of the oral cavity and pharynx
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Kunwar S S Bhatia, Ann D King, Robert Hermans
Most surgical complications occur early after treatment and are dealt with on a clinical basis. Imaging may be required in the assessment of haematomas, chylous and serous collections, abscesses, flap dehiscence and necrosis, and fistulae involving the oral cavity and pharynx. The development of complications including fistulae after an initially normal postoperative recovery interval should raise the possibility of tumour recurrence.
Multi-technique Management of Persistent Postintubation Tracheoesophageal Fistula in a Patient with Achalasia
Published in Wickii T. Vigneswaran, Thoracic Surgery, 2019
Nonmalignant recurrent TEFs require meticulous evaluation to determine the reasons for failure to close. It is important to rule out underlying malignancy, granulomatous disease, foreign bodies, or distal obstruction, all of which can prevent healing of the fistula. In the case of our patient, achalasia was identified as a contributing factor for failure of closure of the TEF after two surgical attempts. The delayed esophageal emptying likely elevated the intraluminal esophageal pressure, which was presumed to contribute to the patency of the fistula. We believe that the probability of closure with subsequent repair increased after relieving the distal obstruction by Heller myotomy.
Diagnosis of IBD
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Gregor Novak, Geert D’Haens, Najib Haboubi, John B. Schofield
Haemorrhoids are uncommon in CD. Skin tags are classified into two types. The first type, called ‘elephant ear’ tags, are flat and painless skin tags which may be quite large and can cause perianal hygiene problems. The second type of tags often arises from healed fissures, ulcers or haemorrhoids and is typically oedematous, hard and may be tender.80 Anal fissures are broad based and deep, but usually painless. They tend to be multiple, either eccentrically around the anal canal or in the midline (in contrast to idiopathic anal fissure which usually lie in the midline).81 Anal ulcers are normally (but not always) associated with rectal inflammation. Anal stricture is usually asymptomatic, but if stool consistency improves with treatment it can cause pain and occasionally obstruction requiring dilatation. The main symptoms reported by patients with perianal fistulas are drainage of pus, stool or blood from cutaneous fistula openings and pain associated to perianal swelling and fever in case of abscess formation. When perianal pain is present, an abscess is almost always present. Perianal fistulas may be extensive, forming a network of tracks with openings that can involve the buttocks, labia or scrotum and thighs. In patients with longstanding chronic active perianal disease, faecal incontinence may occur,82 although this is quite uncommon unless surgical interventions such as fistulotomy have been performed.
Acquired lacrimal fistula: classification and management
Published in Orbit, 2022
Nandini Bothra, Monalisa Pattnaik, Mohammad Javed Ali
The acquired fistulae are commonly due to spontaneous rupture of untreated lacrimal abscess, or due to trauma, or iatrogenic cause like a poorly-performed incision and drainage.1,5 Acquired lacrimal fistulae (ALF) can be found anywhere along the lacrimal drainage passage, is often irregular and large with peri-fistulous soft tissue changes.1 Several techniques to treat the acquired lacrimal fistulae have been reported in the literature and include allowing healing by secondary intention, incision along the fistulous pathway and excision of the tract, fistulectomy with skin incision combined with a dacryocystorhinostomy.5–8 The present study classifies these acquired fistulae based on the location, size and nature of the fistula to simplify the decision-making for treatment.
Spontaneous rectouterine fistula in a posterior wall fibroid
Published in Journal of Obstetrics and Gynaecology, 2021
Suzanne Reilly, Eric Nyarko, Tamzin Cuming
A fistula is an abnormal passage between two or more epithelised body structures – in this case described it was between the uterus and the rectum. A spontaneous entero-uterine fistula secondary to benign fibroids has not previously been reported in the literature. The cases described in the literature in which fibroids have caused a utero-enteric fistula have included prior surgery, uterine artery embolisation, underlying inflammatory bowel disease or malignancy (Table S1). Shehata et al. (2016) documented ileo-uterine fistula from a posterior uterine fibroid in a patient, one week post-Caesarean section. However, possible causes of fistula include both trauma and infection. The size and anatomical position of the fibroid alongside the patient’s lack of body fat most likely resulted in direct pressure necrosis of the anterior rectal wall. The histology for our case confirmed abscess formation so it could be postulated that this inflammatory component also played a part.
Treatment of low flow, indirect cavernous sinus dural arteriovenous fistulas with external manual carotid compression – the UK experience
Published in British Journal of Neurosurgery, 2020
Pratipal Kalsi, Rajeev Padmanabhan, Manjunath Prasad K. S., Nitin Mukerji
CS-DAVF usually occur in middle aged and elderly females but they can occur in any age group or sex. Clinical symptoms depend on whether the fistula drains anteriorly or posteriorly. Anteriorly draining CS-DAVF often present with visual symptoms, which include conjunctival injection, chemosis, extraocular nerve palsies leading to ohthalmoplegia, proptosis, retro-orbital pain and obtundation if an intracerebral hemorrhage occurs. Some patients may also have a bruit.4,5 Raised episcleral venous pressure may lead to an increase in intracocular pressure and visual loss. Visual loss is less common than in direct CS-DAVF but can occur in up to 30% of patients.6,7 CS-DAVF draining into the superior and inferior petrosal sinuses are usually asymptomatic. These patients don’t usually have ocular symptoms but can present with cranial nerve palsies.8–10 Infrequently posteriorly draining fistulas can cause brainstem congestion and neurological deficits.11 20-50% CS-DAVFs of will close spontaneously.12,13 Intracranial haemorrhage is an extremely rare complication.14