Abstract
IntroductionThe endoscopic fibrin glue or platelet-rich fibrin glue (PRFG) injection is an easy, safe and effective technique for the fistula. So far, the use of fibrin glue has been limited to selected cases.Case reportOur case is a three years old male child with a neck trauma resulting in a Esophago-Cutaneous fistula after a 3 month period of follow up we decided to use PRFG for this lesion after fine debridement of the fistula tract, and the surrounding fibrosed tissue twice with a one week interval. Our visit after two weeks showed complete recovery and normal general condition. A contrast study revealed complete disappearance of the lesion.ConclusionsIn our case the PRFG completely resolved a long-standing fistula resistant to exhaustive conservative management. The treatment with PRFG has been proved to be effective in the selected cases and it seems that traumatic esophago-cutaneous fistula may be one of these selections. Application of fibrin sealant should be considered early in the management of these difficult clinical problems.
Highlights
The sealant has been used to aid hemostasis or to enhance tissue sealing and has found use in a wide variety of circumstances in plastic, orthopedic, vascular and general surgery (1, 2).The endoscopic fibrin glue or platelet-rich fibrin glue (PRFG) injection is an easy, safe and effective technique for the fistula even caused by malignancies, and contributes to the quality of life of these patients (3)
There were cases of esophageal traumatic fistula but all of them connected the esophagus to the nearby trachea and none of them used PRFG as treatment (9-12)
The child’s treatment was a great challenge but as we had the experience of using PRFG in the treatment of congenital trachea esophageal fistulas in our medical center, we decided to use it for this special case as well
Summary
Fibrin sealants were first reported in 1909; their usages adapted extensively in Europe for 20 years, and have received increased interest over the last decade in this country. There are many commercial preparations but most involve two solutions, fibrinogen and thrombin These are applied to the tissue site and in the presence of calcium ions the thrombin cleaves the fibrinogen into fibrin monomers which polymerize to produce the fibrin clot independent of the patient's own coagulation cascade. The sealant has been used to aid hemostasis or to enhance tissue sealing and has found use in a wide variety of circumstances in plastic, orthopedic, vascular and general surgery (1, 2).The endoscopic fibrin glue or platelet-rich fibrin glue (PRFG) injection is an easy, safe and effective technique for the fistula even caused by malignancies, and contributes to the quality of life of these patients (3). Lateral Traumatic Esophago-Cutaneous fistula in a Child; Platelet-Rich Fibrin Glue Challenge. Esophago-Cutaneous Fistula and PRFG isolated from blood bank samples, adverse events (allergic reactions) have rarely been reported there are no documented cases of viral transmission as a result of the use of fibrin sealant (1, 2). The use of fibrin glue has been limited to the treatment of anal, recto-vaginal and enter cutaneous fistula (4)
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