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Kaderi SA, Rege SA, Vasa D, Sonewane C, Bhesaniya D, Shah S, Badhe P. Laparoscopic transhiatal stapled closure of spontaneous pleuroesophageal fistula: A case report. J Minim Access Surg 2023; 19:433-436. [PMID: 37282428 PMCID: PMC10449053 DOI: 10.4103/jmas.jmas_138_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 01/05/2022] [Indexed: 06/08/2023] Open
Abstract
Pleuroesophageal (PE) fistula (PEF) is rare and usually presents secondary to tuberculous mediastinal lymphadenopathy, Boerhaave syndrome, penetrating foreign bodies, erosive oesophagitis, post-mediastinal and gastroesophageal surgeries and neoplasm. We present a case of spontaneous PEF, successfully treated laparoscopically with stapling done through the hiatus.
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Affiliation(s)
- Saif Abdeali Kaderi
- Department of General Surgery, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Sameer Ashok Rege
- Department of General Surgery, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Dhaval Vasa
- Department of General Surgery, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Chetan Sonewane
- Department of General Surgery, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Dhaval Bhesaniya
- Department of General Surgery, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Sulay Shah
- Department of General Surgery, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Padma Badhe
- Department of Radiology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Lee S. Endoscopic Histoacryl injection: can simplicity overcome complexity? JOURNAL OF MINIMALLY INVASIVE SURGERY 2023; 26:19-20. [PMID: 36936039 PMCID: PMC10020735 DOI: 10.7602/jmis.2023.26.1.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 03/12/2023] [Accepted: 03/12/2023] [Indexed: 03/18/2023]
Affiliation(s)
- Sangjun Lee
- Department of Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
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Kapoor H, Gulati V, Gulati A, Donuru A, Parekh M. Comprehensive Imaging Review of Pleural Fistulas from Diagnosis to Management. Radiographics 2022; 42:1940-1955. [PMID: 36269669 DOI: 10.1148/rg.220083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Pleural fistula is an abnormal communication between the pleural cavity and an adjacent structure. The interplay of anatomic and physiologic factors including proximity to various intrathoracic structures, deep pleural recesses, and negative pleural pressures makes the pleura an easy victim of fistulization. Iatrogenic creation followed by necrotizing infections and malignancies are the most common causes. While the overall incidence and size of postsurgical pleural fistulas are decreasing with increased adoption of vascularized flaps for high-risk resections, the smaller fistulas that develop in the setting of post-radiation therapy changes, with necrotizing infections in immunosuppressed patients, and with use of newer antiangiogenic chemotherapies can be challenging to visualize directly. Imaging signs in clinical practice are often subtle and indirect. Multimodality imaging and biochemical pleural fluid analysis can offer important adjunctive information when a diagnosis is only suggested with the first imaging study. Certain pleural fistulas are inconsequential, some spontaneously close with or without diversion of flow or use of positive-pressure ventilation, while others carry a higher risk of complications or recurrence. Estimated fistula size, factors that impair healing, and the possibility of diversion are important considerations when deciding between endoscopic or surgical closure. The authors have tailored this article for a general imager or clinical practitioner and review 10 types of pleural fistulas, ranging from routine to rare, with regard to their etiology, pathophysiology, clinical cues, imaging features, nuances of pleural fluid analysis, and management options available today. ©RSNA, 2022.
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Affiliation(s)
- Harit Kapoor
- From the Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (H.K.); Imaging Associates, National Heart Institute, New Delhi, India (V.G.); Department of Radiology, Thomas Jefferson University Hospital, 132 S 10th St, Philadelphia, PA 19107 (A.G., M.P.); and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (A.D.)
| | - Vaibhav Gulati
- From the Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (H.K.); Imaging Associates, National Heart Institute, New Delhi, India (V.G.); Department of Radiology, Thomas Jefferson University Hospital, 132 S 10th St, Philadelphia, PA 19107 (A.G., M.P.); and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (A.D.)
| | - Aishwarya Gulati
- From the Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (H.K.); Imaging Associates, National Heart Institute, New Delhi, India (V.G.); Department of Radiology, Thomas Jefferson University Hospital, 132 S 10th St, Philadelphia, PA 19107 (A.G., M.P.); and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (A.D.)
| | - Achala Donuru
- From the Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (H.K.); Imaging Associates, National Heart Institute, New Delhi, India (V.G.); Department of Radiology, Thomas Jefferson University Hospital, 132 S 10th St, Philadelphia, PA 19107 (A.G., M.P.); and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (A.D.)
| | - Maansi Parekh
- From the Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Tex (H.K.); Imaging Associates, National Heart Institute, New Delhi, India (V.G.); Department of Radiology, Thomas Jefferson University Hospital, 132 S 10th St, Philadelphia, PA 19107 (A.G., M.P.); and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (A.D.)
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