Traumatic Fistula Research Articles

Successful surgical management of traumatic teat fistula in cattle

Successful surgical management of traumatic teat fistula in cattle

Lateral palatal sliding flap for closure of post traumatic oronasal fistula

Lateral palatal sliding flap for closure of post traumatic oronasal fistula

Treatment of Traumatic Direct Carotid-Cavernous Fistula with a BeGraft-Covered Stent.

The widely accepted option for treating traumatic direct carotid-cavernous fistula (dCCF) has been endovascular treatment using detachable balloons, coils, or embolic agents. Covered stent deployment has been applied by a few operators and has shown promising results. This is a retrospective study on patients with dCCF treated by an endovascular approach using BeGraft, a covered stent. In 4 cases, this device was successfully deployed without any complications. Immediate complete occlusion was achieved in 3 patients (75%) after deployment of the covered stents. One patient required transvenous coiling for occlusion of the remaining endoleak. Follow-up imaging demonstrated 100% fistula occlusion with complete internal carotid artery patency. No early or late complications occurred following treatment. In conclusion, the BeGraft-covered stent could be a promising safe and effective alternative option for the endovascular treatment of dCCF.

Reconstruction: External Genitalia and Urotrauma (Including Transgender Surgery and Traumatic Fistula) II (MP64)

Reconstruction: External Genitalia and Urotrauma (Including Transgender Surgery and Traumatic Fistula) II (MP64)

Reconstruction: External Genitalia and Urotrauma (Including Transgender Surgery and Traumatic Fistula) I (PD31)

Reconstruction: External Genitalia and Urotrauma (Including Transgender Surgery and Traumatic Fistula) I (PD31)

Missed Connection: A Traumatic Coronary Cameral Fistula in a Heart Donor Recipient

Missed Connection: A Traumatic Coronary Cameral Fistula in a Heart Donor Recipient

An unusual instance of traumatic occult pharyngeal fistula

Pharyngeal fistula is the most frequent complication after total laryngectomy, which is rare to occur in closed trauma and is also rarely reported in China. Traumatic pharyngeal fistula is a severe and rare disease that remains a diagnostic challenge nowadays.

Traumatic esophageal fistula secondary to self-expandable metal stent placement

Traumatic esophageal fistula secondary to self-expandable metal stent placement

Traumatic thigh AV fistula leading to aneurysmal changes in aorta and iliac arteries

Penetrating traumatic arteriovenous fistulas (AVFs) have the tendency to be clinically silent for many years and could be misdiagnosed as deep venous thrombosis (DVT) on initial presentation. A 52-year-old male underwent a duplex scan to evaluate swelling of the limb, which detected an AVF in the thigh. He was stabbed in the lateral aspect of the thigh 16 years previously. His left leg was larger with a palpable thrill in the thigh. A CT angiogram confirmed the AVF and aneurysmal changes in the common iliac artery (29 mm) and infrarenal aorta (32 mm). A moulding balloon was placed across the AVF by an antegrade puncture of the common femoral artery to control the arterial inflow and outflow. Following disconnection of the AVF, the defect in the side wall of the femoral vein was primarily repaired with Prolene. The defect in the superficial femoral artery was repaired by transection, spatulation and end-to-end anastomosis of the arteries. A Duplex scan performed six months postoperatively showed that the aorta (29 mm) and the common iliac artery (27 mm) had regressed. The authors suggest that, when faced with an AVF with a huge calibre mismatch between the arterial segment proximal and distal to the fistulous tract in a young patient, a hybrid approach should be considered for control and surgical disconnection of the fistula.

Human trafficking risk factors, health impacts, and opportunities for intervention in Uganda: a qualitative analysis

BackgroundHuman trafficking is a global public health issue that is associated with serious short- and long-term morbidity. To address and prevent human trafficking, vulnerabilities to human trafficking and forces sustaining it need to be better understood among specific subpopulations. We aimed to explore risk and protective factors for human trafficking, the health impact of exploitation, and barriers and facilitators of seeking help throughout the human trafficking trajectory among forced labor and sex trafficking victims in Kampala, Uganda.MethodsBetween March and November 2020, in-depth, semi-structured qualitative interviews were conducted with 108 victims of forced labor and sex trafficking who had completed a human trafficking survey conducted by the Uganda Youth Development Link (UYDEL). Participants who experienced various forms of exploitation were purposively invited for qualitative interviews and a convenience sample was interviewed. Interviews explored personal history, trafficking recruitment, experiences of exploitation and abuse, and experiences seeking help. Interviews were analyzed using a combination of deductive and inductive thematic analysis. Themes and subthemes were organized using an adapted conceptual framework of human trafficking.ResultsPoverty and an abusive home life, frequently triggered by the death of a caretaker, underpinned vulnerability to human trafficking recruitment. Limited education, lack of social support, and survival needs pushed victims into exploitative situations. Victims of human trafficking were systematically exploited and exposed to dangerous working conditions. Victims suffered from sexually transmitted diseases, incontinence, traumatic fistulae, musculoskeletal injuries, and mental health symptoms. Lack of awareness of resources, fear of negative consequences, restrictions on movement, and dependence on the trafficker and exploitation income prevented victims from seeking help. The police and healthcare workers were the few professionals that they interacted with, but these interactions were oftentimes negative experiences.ConclusionsTo address and prevent human trafficking, localized interventions are needed at all stages of the human trafficking trajectory. Health impacts of human trafficking are severe. As some of the few professionals trafficking victims interact with, police and healthcare workers are important targets for anti-trafficking training. Improved understanding of human trafficking drivers and barriers and facilitators to seeking help can inform the design of necessary interventions.

Renal Arteriovenous (AV) Fistula after High-Grade Blunt Renal Trauma Caused by Traffic Accidents.

To report a series of three patients with traumatic renal AV fistulas after blunt renal laceration. We retrospectively analyzed the renal trauma cases treated in the Department of Urology of Salzburg University Clinic during a time period of 10 years concerning traumatic AV fistula formation and other clinical parameters. In total, 3 cases of traumatic AV fistula formation were identified in 106 blunt renal trauma patients (2.8%), with a mean age of 39 (17-56) years. All renal traumas were classified as American Association for the Surgery of Trauma (AAST) grade IV. Two patients were primarily treated with ureteral stent; one was managed conservatively. All AV fistulas were diagnosed after a mean time of 7 (1-13) days. Two patients were symptomatic with gross hematuria, and the mean time between trauma and onset of symptoms was 11 (9-13) days. All cases were managed via coil embolization after a mean of 10 (8-13) days. Two patients received a second intervention after a mean of 18 (11-25) days. The mean AV fistula size was 18.7 (12-24) mm. Mean hemoglobin loss was 3.6 g/dL. One patient received one erythrocyte concentrate. Discharge was after a mean time of 13.3 (7-12) days, with the mean time of intensive care treatment being 2.3 (1-3) days. Traumatic renal AV fistula is a rare but severe complication associated with higher-grade renal trauma. It can become evident through hematuria or blood loss several days after the initial trauma. The availability of coil embolization in a trauma center can help kidney preservation management.

Endovascular treatment of traumatic penile arteriospongious fistula in a patient with erectile dysfunction: a case report and literature review

BackgroundAn arteriovenous fistula is an abnormal communication between an artery and a vein. Traumatic penile arteriospongious fistula is a rare complication and has been described as a cause of erectile dysfunction. Clinical evaluation of patients with erectile dysfunction after penile trauma includes a thorough history, physical examination, vascular assessment, and other complementary exams. Treatment consists of endovascular embolization, surgical ligation, or a combination of both techniques.Case presentationA 40-year-old man presented with erectile dysfunction that had persisted since suffering blunt trauma a few months ago. He reported problems with short duration of erection and insufficient penile tumescence. Due to high suspicion of an arteriovenous fistula, he was referred to angiography, which confirmed the diagnosis of an abnormal connection between the pudendal vessels. The patient was treated with the coil embolization technique and the symptoms were successfully resolved after endovascular treatment.ConclusionsThe appearance of a post-traumatic arteriospongious fistula is a rare complication with almost non-existent literature reported. Rapid development in endovascular techniques, in which we use embolic agents to block anomalous blood flow, has allowed safe, effective and less invasive alternative to surgery. Our case demonstrates that endovascular approach is a successful treatment for post-traumatic arteriospongious fistula since the symptoms were resolved, and normal erectile function was regained after the intervention.

Radical approach to traumatic tracheoesophageal fistula: Use of a biliary stent for esophageal repair in an infant

Radical approach to traumatic tracheoesophageal fistula: Use of a biliary stent for esophageal repair in an infant

Traumatic esophageal fistula secondary to self-expandable metal stent placement

Traumatic esophageal fistula secondary to self-expandable metal stent placement

Symptoms: Dizziness and Deafness

Symptoms: Dizziness and Deafness

111. Delayed presentation of Traumatic Carotico-cavernous Fistula (TCCF) in isolated mandibular fracture patient- a rare occurrence and a note of caution

Caroticocavernous fistula is an abnormal communication between carotid artery and cavernous sinus, occurs mostly following trauma to skull base and can lead to life threatening complications.

Laparoscopic Repair of Post-Coital Vaginal Perforation Communicating with the Abdominal Cavity

<h3>Study Objective</h3> The objective of this video is to describe an approach to the work-up and surgical management of postcoital vaginal laceration communicating with the abdominal cavity. <h3>Design</h3> N/A. <h3>Setting</h3> An academic tertiary care hospital. <h3>Patients or Participants</h3> The patient is an 18 y/o G0 who presented 12 hours after intercourse with heavy vaginal bleeding, diffuse abdominal pain, and multiple syncopal episodes. Initial exam was notable for hypotension, diffuse abdominal pain with involuntary guarding, and copious vaginal bleeding from the vagina of unclear origin. <h3>Interventions</h3> A bedside FAST scan demonstrated free fluid in Morrison's pouch. CT scan demonstrated multiple foci of air in the pelvis consistent with vaginal perforation. The patient was taken to the OR for laparoscopic repair of a 4cm full-thickness vaginal perforation communicating with the abdominal cavity, where 300cc of hemoperitoneum was evacuated from the abdominal cavity. An air leak test was performed at the end of the case to ensure no injury to the sigmoid colon. <h3>Measurements and Main Results</h3> The patient received was discharged on POD#1 in stable condition. <h3>Conclusion</h3> Vaginal perforation communicating with the abdominal cavity is a rare complication of intercourse that can have a delayed presentation and occur with hemorrhagic shock. FAST scan can be employed at the bedside to rapidly identify massive hemoperitoneum. Though prior case reports have mainly reported an open repair, a laparoscopic approach is a safe and effective method to repair vaginal defects communicating with the abdominal cavity. Finally, given the high rate of traumatic rectovaginal fistula reported in this population, surgeons should consider the use of an intraoperative air-leak test to confirm colorectal integrity after the repair.

Traumatic Rectovesicular Fistula in a Dog.

A 7 mo old intact male Australian cattle dog presented for evaluation of a suspected urethrorectal fistula after being examined by the primary veterinarian for leaking of urine from the rectum at rest and when posturing to urinate. Advanced imaging identified a caudally retroflexed urinary bladder, several healing pelvic fractures, and a rectovesicular fistula. Primary surgical repair of the fistula was performed. The dog recovered well from surgery and was urinating and defecating normally as of 5 mo after the operation. This is the first report of a traumatic rectovesicular fistula in the veterinary literature.

Surgical Management of Traumatic Teat Fistulas in Crossbred Goats with Polyester Sutures

A total of six goats presented to University Veterinary Hospital (UVH), at Omar Al-Mukhtar University, with traumatic teat fistulas were selected for the present study. Upon preoperative evaluation, the mucosal and muscular layers were sutured separately by a simple continuous suture pattern using polyglactin 910. The skin edges were opposed by using braided and polybutilate-coated polyester sutures. Postoperative evaluation of the reconstructed teat was carried out by morphological evaluation and ultrasonographical evaluation. The quality of milk and milk ability reflected the effectiveness of the technique in regaining the functional capacity of the teat postoperatively. The surgical technique employed for the management of teat wounds with fistula was found to be less effective due to the encountered complications which could be due to the management practices, postoperative care, and the suture material.

Traumatic Subarachnoid–Pleural Fistula with Pneumocephalus

Traumatic subarachnoid-pleural fistula is an uncommon occurrence. We present a case of a patient sustaining a subarachnoid-pleural fistula after a gunshot wound to the neck, which ultimately resulted in substantial pneumocephalus. The patient underwent successful operative repair of the fistula with notable improvement and resolution of pneumocephalus.