1501
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Regas Bech de Careda JS, Pérez Martínez A, Boix-Ochoa J, Pumarola Segura F, Asensio Llorente M. [Piriform sinus fistula, a new disease]. ANALES ESPANOLES DE PEDIATRIA 1992; 36:467-9. [PMID: 1497229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Pyriform sinus fistula has recently been described as a new, rare and little known pathology. The process develops as latero-cervical suppurative adenitis or acute suppurative thyroiditis, usually on the left side. Radical surgery is mandatory to avoid recurrence. This congenital malformation must be present in the differential diagnosis of recurrent infectious cervical processes, especially in acute thyroiditis. The only curative treatment is complete exeresis of the fistula after meticulous dissection of the fistulous tract. We present three cases of this pathology. The diagnostic approach and surgical treatment are discussed. The recent literature on this topic is reviewed.
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1502
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Giul'magomedov UG. [Experience in the surgical treatment of osteomyelitis]. VESTNIK KHIRURGII IMENI I. I. GREKOVA 1992; 148:349-51. [PMID: 1302990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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1503
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Abstract
A series of 19 patients with a labyrinthine fistula caused by cholesteatoma was analysed. Two patients presented with acute suppurative labyrinthitis and meningitis. A canal wall down procedure was performed in all but one patient. Of the 17 patients with preserved inner-ear function, the cholesteatoma matrix over the fistula was removed in 10 resulting in severe sensorineural hearing loss in one of these. The matrix was left in situ in 7 patients and hearing was maintained or improved in all of them. Post-operatively, 2 patients suffered from vestibular disturbances, the matrix covering the fistula being removed in both of them. It was concluded that preservation of the matrix over the fistula is the safest method of management of this serious complication of cholesteatomatous chronic ear disease.
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1504
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Zanotelli ML, Guerra EE, Costa LF, Vitola SP, Garcia VD, Cantisani GP. Duct-enterostomy as a treatment of pancreatic fistula in a bladder-drained pancreas transplant. Transplant Proc 1992; 24:815-6. [PMID: 1604625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A case of combined pancreaticoduodeno-renal transplant with good graft function was complicated by recurrent episodes of graft pancreatitis treated by vesical catheter drainage. Four months after transplantation, a fistula from the pancreatic body associated with ascitis was identified. Anastomosis between pancreatic fistula and an individualized jejunal loop was performed. The duodenocystostomy was not disconnected. A splint placed inside the wirsung was exteriorized percutaneously through the jejunal loop and removed 30 days after the operation. Both kidney and pancreas grafts are functioning normally 2 years after transplantation.
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1505
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1506
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Chatzis A, Pepper J, Treasure T. Infected interventricular Teflon patch: repair and closure of fistula with omentum. Heart 1992; 67:500-1. [PMID: 1622703 PMCID: PMC1024897 DOI: 10.1136/hrt.67.6.500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
A pericardiocutaneous fistula five years after repair of a rupture of the ventricular septum was managed by removing all foreign material (Teflon). The resulting defect was repaired with part of the central tendon of the diaphragm and a pedicle of omentum was used to cover the heart. This radical approach was found necessary after other measures, including surgical excision of the fistula, had failed.
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1507
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Guertin L, Hamoir M, Brazeau-Lamontagne L, Charlin B. Congenital fistula of the apex of the pyriform sinus: an overlooked phenomenon of debatable origin. THE JOURNAL OF OTOLARYNGOLOGY 1992; 21:174-6. [PMID: 1404566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Fistula of the pyriform sinus apex is an often overlooked entity which generally manifests itself as acute suppurative thyroiditis or recurrent deep neck abscesses in children or young adults. Two cases are reported. Arguments in favor of a fourth pharyngeal pouch origin are stressed and the surgical management is described.
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1508
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Falandry L. [Uretero-vaginal fistulas: diagnosis and operative tactics. Apropos of 19 personal cases]. JOURNAL DE CHIRURGIE 1992; 129:309-16. [PMID: 1474113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Personal experience of the treatment of 19 uretero-vaginal fistulae, observed from september 1987 to june 1991 on 17 patients in Africa is described and analysed. Occurring after gynecological or obstetrical surgery, the main cause is hysterectomy (82.3%). Elements for diagnosis were: the appearance of a urine leak, which in most cases came rapidly, echography, and most important, intravenous urography (IVU). Surgical management in all of the cases was mainly aimed at conservation. One end-to-end anastomosis and 18 cuff reimplantations were performed, combined in 2 cases with a sub-mucus tunnel (Politano), in 14 cases combined with a tubular Boari bladder flap (wherein 1 case was bilateral), 3 combined with a bladder psoas hitch and 2 with an isolated ileal graft (ileo-uretero-cystoplasty). One case of vesicouterine fistula and 4 associated vesicovaginal fistulae benefited from a simultaneous surgical operation. In this study of 17 patients treated, except for one patient deceased 14 months following a neoplastic recurrence, the results were excellent. 16 patients were cured. Follow-up extended to more than a year and have shown the perfect conservation of the excretory ducts in all of the cases studied. The cuffed ureterovesical reimplantation combined with a tubular bladder plasty definitively seem to be a most reliable management technique for all ureter injury encountered. While allowing the preservation of the kidney located just below, it has, in particular, prevented ureter stenosis. If the use of simpler methods (psoas bladder hitch) may be sufficient for some cases, the use of more complex methods (ileo-uretero-cystoplasty) for other cases, may be indispensable.
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1509
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Mottet N, Louis JF, Costa P, Navratil H. [Postoperative rectoprostatic fistulas. Report of 2 cases. Review of the literature]. Prog Urol 1992; 2:442-9. [PMID: 1302084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The authors report two cases of acquired prostatorectal fistulae after TURP, which were treated by a Kraske approach. They review the literature of iatrogenic fistulae and all of the techniques of approaching the prostatorectal region. If the bladder drainage is always necessary and may be sufficient in as much as 34% of the patients, the need for a colostomy and the choice of the approach is discussed.
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1510
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Sullivan TJ, Clarke MP, Morin JD, Pashby RC. The surgical management of congenital lacrimal fistulae. AUSTRALIAN AND NEW ZEALAND JOURNAL OF OPHTHALMOLOGY 1992; 20:109-14. [PMID: 1389127 DOI: 10.1111/j.1442-9071.1992.tb00721.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Congenital lacrimal fistulae are developmental anomalies of the lacrimal apparatus that are usually symptomatic, frequently causing epiphora and occasionally causing fistulitis or dacryocystitis. They may be associated with other abnormalities of the lacrimal system or with systemic anomalies. Complete excision alone, or in combination with nasolacrimal intubation and/or dacryocystorhinostomy is recommended for treatment.
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1511
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Ivanusa SI, Iusupov IN, Aminov VS. [Objective methods for controlling the course of the wound process in the surgical treatment of suppurative fistulae and abscessing epithelial cysts in the sacrococcygeal region]. VESTNIK KHIRURGII IMENI I. I. GREKOVA 1992; 148:174-8. [PMID: 1302950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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1512
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Khauli RB, Mosenthal AC, Caushaj PF. Treatment of lymphocele and lymphatic fistula following renal transplantation by laparoscopic peritoneal window. J Urol 1992; 147:1353-5. [PMID: 1533254 DOI: 10.1016/s0022-5347(17)37563-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Symptomatic lymphoceles that occur after renal transplantation are managed best by surgical marsupialization with drainage into the peritoneal cavity. We report a case of post-transplant lymphocele associated with a cutaneous lymphatic fistula, which was successfully treated using laparoscopic drainage without a major surgical incision. With this new technique we were able to remove an ellipse of peritoneal wall along with the adjacent lymphocele wall and to lyse all internal lymphocele loculations, allowing for the free flow of lymph into the peritoneal cavity and cessation of cutaneous leakage. We believe that, when technically possible, laparoscopic internal peritoneal drainage is an effective procedure for managing simple and complex symptomatic lymphoceles with or without associated lymphatic fistulas, provided there is no evidence of infection.
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1513
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Fry RD, Birnbaum EH, Lacey DL. Actinomyces as a cause of recurrent perianal fistula in the immunocompromised patient. Surgery 1992; 111:591-4. [PMID: 1598681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Actinomycosis is an uncommon bacterial infection that has a characteristic chronic indolent course. Patients with this infection frequently undergo multiple surgical procedures before a correct diagnosis is made. Perianal actinomycosis should be suspected if a nontender perianal mass is found to contain thin purulent material and small yellow particles (sulfur granules). The diagnosis is confirmed by special stains and anaerobic cultures. Recognition of this infection is important because successful treatment requires combined surgical and antibiotic therapy. We report two patients, one with diabetes mellitus and one with human immunodeficiency virus III, who had recurrent perianal abscesses caused by Actinomyces and were treated successfully with surgical drainage and antimicrobial therapy.
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1514
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Gómez Cisneros SC, Monsalve Rodríguez M, Parra Muntaner L, Kilani Elmasri S, Verdú Martínez M, Napal Lecúmberri S, García Alonso J. [Vesico-uterine fistula]. ARCH ESP UROL 1992; 45:372-3. [PMID: 1605695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We report a case of uterovesical fistula that had been diagnosed by cystoscopy, vaginoscopy and ultrasonography. Fistulorrhaphy via the transperitoneal transvesical approach resolved the passage of urine to the vagina. The decision to perform a conservative or more aggressive approach is determined by the site of the fistula.
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1515
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Black FO, Pesznecker S, Norton T, Fowler L, Lilly DJ, Shupert C, Hemenway WG, Peterka RJ, Jacobson ES. Surgical management of perilymphatic fistulas: a Portland experience. THE AMERICAN JOURNAL OF OTOLOGY 1992; 13:254-62. [PMID: 1609855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A comprehensive review of our series of surgical perilymphatic fistula (PLF) repairs, as well as a review of published results from other otologists, suggested an unacceptably high rate of postoperative PLF recurrence. Some recurrences were related to specific events (i.e., coughing, strenuous activity, Valsalva-type maneuvers). However many cases had no apparent cause. Rather, the patients' symptoms recurred spontaneously, and at reoperation the graft was seen to have not "taken," suggesting graft failure rather than "patient failure." After a critical evaluation of current PLF surgical procedures and state-of-the-art concepts of wound healing, we developed a new surgical technique for PLF closure. Combining the use of laser graft-site preparation, an autologous fibrin glue "buttress," and a program of postoperative activity restriction, the new procedure allowed us to achieve statistically significant improvements in graft retention and surgical outcome, with recurrences dropping from 27 percent to 8 percent. In addition, complete resolution or significant symptomatic improvement occurred in 89 percent of patients with vertigo and/or dizziness and in 84 percent with disequilibrium. We conclude that this new surgical technique is an important addition to the otologic surgeon's arsenal for PLF management.
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1516
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Bähr W, Stoll P. Nasal intubation in the presence of frontobasal fractures: a retrospective study. J Oral Maxillofac Surg 1992; 50:445-7. [PMID: 1573479 DOI: 10.1016/s0278-2391(10)80312-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In most cases, surgical management of craniofacial fractures involves correction of occlusion. This requires nasal intubation. In the case of frontobasal fractures with simultaneous cerebrospinal fluid (CSF) fistula, nasal intubation is thought to increase the risk of meningitis. An analysis of the records of 160 patients with frontobasal fractures and CSF fistulae showed that the route of intubation had no influence on the postoperative complication rate. Nasal intubation is therefore not contraindicated in frontobasal fractures with CSF fistulae.
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1517
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Pullen FW. Perilymphatic fistula induced by barotrauma. THE AMERICAN JOURNAL OF OTOLOGY 1992; 13:270-2. [PMID: 1609857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The association between diving, barotrauma, and the production of perilymphatic fistula has been known for almost 20 years. Forty-eight cases of round and oval window fistulas following diving have been reviewed and essentially corroborate previous findings. Any patient with a history of diving and subsequent sensorineural hearing loss within 72 hours should be suspected of having a round or oval window perilymphatic fistula and surgical exploration and closure of the fistula should be undertaken. Patients who have a loss of hearing, vertigo, nausea, or vomiting following a decompression dive should be re-compressed and if symptoms do not clear, exploration should be performed. Surgical treatment should be executed as soon as possible after the diagnosis is suspected for the best possible results.
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1518
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Chu YL. [Congenital coronary artery-cardiac chamber fistula: diagnosis and surgical treatment]. ZHONGHUA WAI KE ZA ZHI [CHINESE JOURNAL OF SURGERY] 1992; 30:301-2, 318. [PMID: 1289010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
From Nov. 1976 to Dec. 1989, 9 patients with congenital coronary artery-cardial chamber fistula were operated upon in our hospital. In this series right coronary artery-right ventricle fistula was found in 3 patients, right coronary artery-left ventricle fistula in 2, left coronary artery-right ventricle fistula in 2, left circumflex artery-right atrium fistula in 1, and bilateral coronary artery-cardiac chamber fistula in 1. Cardiopulmonary bypass was performed in 8. The fistula was closed by interrupted mattress sutures outside the cardiac chamber plus ligation of terminal portion of the coronary artery near the fistula in 5 patients, and by mattress sutures inside the dilated coronary artery or cardiac chamber in other 4. There was no operative death in the 8 patients with single fistula. One patient with bilateral coronary artery fistula died from hypoxemia postoperatively. Late complications or recurrent fistulas were not found in the follow-up period from 3 months to 12 years. The diagnosis, operative indications and technique of closing fistula were discussed.
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1519
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Peeters ME. The treatment of recurrent abscessation in the neck region of the dog, evaluation of 35 patients. TIJDSCHRIFT VOOR DIERGENEESKUNDE 1992; 117 Suppl 1:30S. [PMID: 1585318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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1520
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Bagnato VJ, Ravo B. Modern operative thoracoscopy. G Chir 1992; 13:133-6. [PMID: 1637616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Laparoscopic surgery has demonstrated advantages of less pain, early recovery, and cosmesis. Applying laparoscopic surgical techniques to thoracic procedures may allow for similar advantages. New instrumentation provides for greater versatility in treating thoracic conditions. Described herein is the use of thoracoscopy for a variety of thoracic procedures.
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1521
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Bagnato VJ. Thoracoscopic treatment of spontaneous pneumothorax without pleurodesis: a preliminary report. G Chir 1992; 13:137-9. [PMID: 1637617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Laparoscopy has shown to be associated with less morbidity than laparotomy. General surgeons are realizing that procedures so far performed through traditional incisions can be equally performed effectively by laparoscopy. Likewise it is apparent that some thoracic procedures are amenable to thoracoscopic approach. With the development of new instrumentation thoracoscopy is effective for the treatment of spontaneous pneumothorax. Pleurodesis seems to increase the morbidity associated with the thoracoscopic procedure and may reduce its effectiveness. Results of 17 consecutive cases of spontaneous pneumothorax treated thoracoscopically without pleurodesis are herein presented. No significant complications were encountered and no recurrences have been identified so far. Pleurodesis was omitted chiefly because it increases the morbidity of thoracoscopy.
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1522
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Van Damme H, Belachew M, Damas P, Hosselet JL, Dekoster G, Limet R. Mycotic aneurysm of the upper abdominal aorta ruptured into the stomach. ARCHIVES OF SURGERY (CHICAGO, ILL. : 1960) 1992; 127:478-82. [PMID: 1558503 DOI: 10.1001/archsurg.1992.01420040124022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We report a case of primary aortogastric fistula with erosion of a mycotic aneurysm of the upper abdominal aorta into the stomach. The patient was successfully operated on with an in situ aortoaortic tube graft, incorporating the splanchnic vessels, and direct suture of the gastric erosion.
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1523
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Barman AA, Kerr P. Primary and secondary aortoenteric fistula and thoracic aortic aneurysm. NEW YORK STATE JOURNAL OF MEDICINE 1992; 92:156-8. [PMID: 1594148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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1524
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Snabes MC, Samaniego J, Poindexter AN. Hysterosalpingographic diagnosis of Crohn's disease. A case report. THE JOURNAL OF REPRODUCTIVE MEDICINE 1992; 37:285-8. [PMID: 1564717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A woman presented with abdominal pain, weight loss and a pelvic mass. At the time of laparotomy she had a lower abdominal abscess from perforation of the ileum. Two years later she returned with a tender uterus and purulent cervical discharge. A hysterosalpingogram demonstrated an uteroileal fistula secondary to Crohn's disease, and the patient underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy.
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1525
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Weider DJ. Treatment and management of perilymphatic fistula: a New Hampshire experience. THE AMERICAN JOURNAL OF OTOLOGY 1992; 13:158-66. [PMID: 1599009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
From August of 1975 to June of 1990 the author managed 45 cases of spontaneously occurring perilymphatic fistula. Twenty-nine of the 45 cases were reported in 1988. In the series there were eight patients with bilateral involvement, seven with involvement of both oval and round window in the same ear, and seven with fistulas believed to be of congenital origin. Seventeen patients (38%) required revision surgery. Occasionally adjunct modalities (endolymphatic shunt, labyrinthectomy, blocking a cochlear aqueduct, and streptomycin ablation) were used for symptom control. Diagnosis, treatment, and management of these patients is discussed.
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