Fistulae
Wesley C. Finegan, Angela McGurk, Wilma O’Donnell, Jan Pederson, Elizabeth Rogerson in Care of the Cancer Patient, 2018
This chapter describes the medical condition of fistula. A fistula is an abnormal connection between two hollow organs, or between a hollow organ and the surface of the body. Fistulae may form as a result of the malignancy itself eating into the tissues, after infection or following surgery or radiotherapy. Once it has formed, a fistula often fails to heal for the following reasons. A Silastic foam plug made from a cast of the fistula and retained by a simple dressing may reduce fluid loss in larger fistulae. A colostomy bag fitted over the opening may help to collect effluent when a fistula develops between the bowel and the abdominal wall. Octreotide administered by subcutaneous injection or syringe driver may help to reduce the volume of secretions from the fistula. A small fistula may be sealed temporarily with an oesophageal tube, but the usual outcome is aspiration pneumonia.
Malignant ulcers and fistulae
Mervyn Dean, Juan-Diego Harris, Claud Regnard, Jo Hockley in Symptom Relief in Palliative Care, 2018
A malignant ulcer can cause disfigurement, altered function, discharge and odor. Its effects may be very visible, as in a head and neck cancer, obvious when it causes odor or discharge, or hidden with psychological symptoms. The psychosocial effects of such wounds are at least as great as their physical effects. Malignant ulcers are colonized by anaerobic bacteria. Some malignant ulcers are associated with an enterocutaneous istula. Unlike acute wounds that need to be kept moist, exudate from chronic wounds needs to be removed. Colostomy bags can be used for fistulae. Dressings that absorb exudate can help, such as hydrogels and polyurethane foam dressings. Food wrap can be placed over dressings to provide an additional barrier to odor. Chemotherapy or hormone therapy can be useful in sensitive tumors. Rectovaginal fistulae may cause stool to pass vaginally. Octreotide is helpful in patients with postoperative small bowel fistulae, and may be useful in other istulae.
Discovering Our ‘Mighty Purpose’
Leanne Rowe, Michael Kidd in Every Doctor, 2018
The power of a 'mighty purpose' is exemplified by Dr Catherine Hamlin and her late husband Dr Reg Hamlin and their work to improve the lives of women in Ethiopia; unmoved by the physical dangers of their environment and bound by the great cause of providing compassionate care. Gynaecologists Catherine Hamlin and her husband Reg left Australia in 1959 to travel to Ethiopia where they established the Addis Ababa Fistula Hospital. They have successfully operated on tens of thousands of women in Ethiopia. They have also advocated for improving the access of women of all backgrounds for fistula repair and safe maternal care at an international level. Since Dr Reg Hamlin passed away in 1993, Dr Catherine Hamlin has continued to pioneer and teach procedures for obstetric fistula repair to surgeons from around the world. Many of her accomplishments have been achieved during times of war in Ethiopia.
Recent advancements in the minimally invasive management of esophageal perforation, leaks, and fistulae
Published in Expert Review of Medical Devices, 2019
Shirin Siddiqi, Dean P. Schraufnagel, Hafiz Umair Siddiqui, Michael J. Javorski, Adam Mace, Abdulrhman S. Elnaggar, Haytham Elgharably, Patrick R. Vargo, Robert Steffen, Saad M. Hasan, Siva Raja
Introduction: Historically, the gold standard management of esophageal perforations, leaks, and fistulae has been traditional open surgery, but it is associated with significant morbidity and mortality. Minimally invasive approaches offer alternatives to surgery in treating hemodynamically stable patients with such defects. In this review article, we will discuss the recent advancements in the minimally invasive management of esophageal perforations, leaks, and fistulas. Areas covered: This review includes information from case reports, case series, and clinical trials on minimally invasive management of esophageal perforations, leaks, and fistulas. The focus is on the devices, outcomes, and application of the technology. Expert commentary: Minimally invasive treatment represents significant progress in the management of esophageal perforations, leaks, and fistulas. Based on current evidence, it seems safe and effective but it is evolving and more studies are needed to help draw definitive conclusions.
Management of rectovaginal fistulas and patient outcome
Published in Expert Review of Gastroenterology & Hepatology, 2017
Mahmoud Abu Gazala, Steven D. Wexner
Introduction: Rectovaginal fistulas are a relatively rare, but debilitating condition which pose a significant treatment challenge. Areas covered: In this manuscript we discuss the etiology, classification as well as the manifestations and evaluation of rectovaginal fistulas. We summarize the different surgical techniques and evaluate their success rates and perioperative considerations according to cited sources. Expert commentary: A deep understanding of the disease, treatment options, and familiarity with the different surgical treatment options available is mandatory for choosing the correct treatment. When the surgical treatment is tailored to the specific fistula and patient, many patients can eventually have successful resolution. This review will address the management and patient outcomes after treatment for rectovaginal fistulas.
Operative approach for right coronary artery to coronary sinus fistula
Published in Baylor University Medical Center Proceedings, 2020
Jonathan Liu, Subbareddy Konda
Coronary artery fistula is a rare congenital heart disease that is defined as an abnormal connection between a coronary artery and a cardiac vessel or cardiac chamber. Most coronary artery fistulas involve the right coronary artery draining into the right-sided heart structures. We present a patient with right coronary artery to coronary sinus fistula diagnosed by coronary angiography. The surgical approach of retrograde cardioplegia and transatrial resection allowed for protection of the myocardium and definitive visualization and closure of the abnormal fistula.
Related Knowledge Centers
- Arteries
- Blood Vessels
- Urinary Tract
- Veins
- Vesicovaginal Fistula
- Vagina
- Anatomical Pathological Conditions