A labyrinthine fistula is the most common complication of cholesteatomatous chronic ear disease. Its treatment remains a controversial subject. The present paper reports our approach to the management of this complication. Operations were performed on 1,226 cases of chronic otitis media with cholesteatoma between January 1971 and December 1985. A ...

The foramen of Vesalius is a small, variable but consistently symmetrical structure located anteromedial to the foramen ovale and lateral to the foramen rotundum and vidian canal. It transmits an emissary vein through which the cavernous sinus and pterygoid plexus communicate. Fifty high-resolution CT scans of the skull base and ...

Two women in their early menopausal years were evaluated for a persistent ulcerative lesion located on the vulvar vestibular mucosa at the fourchette. In both cases the ulcer proved to be the vaginal orifice of a small anovaginal fistula of probable cryptogenic origin. Anovaginal fistula should be considered a possible ...

An intrahepatic arterioportal fistula causing portal hypertension was successfully palliated with steel coils. The patient remains well 2 1/2 years after embolization. The 13 previously reported cases of transcatheter embolization of large intrahepatic arterioportal fistulae are reviewed. Percutaneous transcatheter embolization with suitable embolic material should be preferred to surgery in ...

Bowel resection can result in the formation of an arteriovenous fistula at the point of intersection of the feeding vessels. Iatrogenic arteriovenous fistula of the superior mesenteric vessels is rare, with only 11 cases reported in the English language literature. We report a case after small bowel resection, which was ...

We report a case of erosion of the ureter by a prosthetic vascular graft subsequent to an ileofemoral bypass. The diagnosis, etiology, and management from both vascular and urologic points of view are discussed, and the available literature is reviewed. Therapeutic principles include early intervention, ureteric reconstruction or ureteronephrectomy depending ...

The authors report a case of an angiographically occult arteriovenous malformation (AVM) that showed a marked increase in size over a period of 7 years. The importance of accurate diagnosis, follow-up computed tomography and repeated angiography, if needed, is stressed in cases where enlargement of an occult AVM is suspected.

We report 2 rare cases of a spontaneous nephrocutaneous fistula. The diagnosis was made incidentally during hospitalization for other reasons. The role of calculus in the etiological pathogenesis of nephrocutaneous fistula is emphasized. Although classically surgical treatment is indicated a more conservative approach can be advocated in some asymptomatic cases.

A rare case of arteriovenous fistula of the right mammary artery following penetrating chest wound is reported. The patient was treated one week later because of right-sided hemothorax associated with diastolic machinary murmur. Selective digital subtraction angiography showed a fistulous communication connecting the right internal mammary vessels. The fistula was ...

Three cases of hereditary lateral cervical fistulas are reported. The patients had lateral cervical fistulas bilaterally and different types of auricular malformations. The mothers of the patients also had lateral cervical fistulas. Moreover, one mother had bilateral microtias and the other mothers bilateral preauricular fistulas. The literature is reviewed and ...

Two cases of aortoesophageal fistula are presented. The etiology, symptoms, and diagnosis of aortoesophageal fistula are reviewed. Signs and symptoms of gastrointestinal hemorrhage followed by sudden collapse hours to days later should prompt consideration of an aortoesophageal fistula. Accidental ingestion of foreign bodies, particularly by children, is a frequent etiology.

Since episodic vertigo in the pediatric and adolescent age group is unusual and therefore not well known to most otolaryngologists, we present six cases to show some of the various presentations and different underlying causes. These cases covered a wide diagnostic spectrum: meningioma, medulloblastoma, childhood migraine with vestibular symptoms, childhood ...

A bilioportal fistula is rare. We report the case of a patient who had a bilioportal fistula 6 years after a choledochoduodenostomy. Percutaneous transhepatic opacification showed the bilioportal fistula to be associated with a thrombosed portal vein and a cavernous formation. Treatment consisted of separate percutaneous drainage of the portal ...

With the development of improved angiographic techniques, arteriovenous meningeal fistulas are being recognized more and more as an important cause of vascular tinnitus. Vascular tinnitus is generally considered to be objective and pulse-synchronous. This report concerns three cases of vascular tinnitus due to arteriovenous meningeal fistulas. They all could not ...

Two cases of von Recklinghausen neurofibromatosis with a hitherto unreported association of ventriculomegaly and a Chiari type I malformation are described. Both cases had skeletal abnormalities at the cervicomedullary junction, contributing to neurological symptoms in 1. The literature on nontumor-related ventriculomegaly in neurofibromatosis is reviewed. The Chiari type I malformation ...

Pyloric exclusion was first reported in 1977 as a temporary method of providing duodenal decompression in an attempt to protect the duodenum in the early postoperative period during the healing phase, followed by the return of normal gastrointestinal transit. It has been adopted by several trauma centers across the country ...

Carotid cavernous sinus fistulas (CCSFs) are a rare entity occurring as a result of head trauma and also spontaneously. The major threat from these fistulas is loss of vision. The authors reviewed 18 cases of direct and dural CCSFs seen over the last 10 years and compared our results with ...

Two hundred neck dissections performed at Toronto General Hospital over a 3 year period are reviewed. There were six intra-operative lymph leaks and five postoperative chylous fistulae. The postoperative chylous fistulae are analysed in detail and the approach to conservative management of lymph leaks is discussed. Two cases required re-exploration ...

We report a case in which a traditional prosthesis failed to seal a malignant respiratory-esophageal fistula. Removal of the prosthesis and replacement with a new type with an inflatable cuff provided palliation, and allowed the patient to leave the hospital. The cuffed prosthesis provides a custom fit which should seal ...

A retrospective review of 22 infants born with tracheoesophageal fistula (TEF) with in utero sonograms was performed and the literature was reviewed. TEF or esophageal atresia should be considered when there is polyhydramnios and an absent fluid-filled stomach; these findings were seen in 32% of our cases. Amniotic fluid flows ...

A laryngectomized patient who developed massive subcutaneous emphysema, pneumothorax, pneumomediastinum, and esophageal fistula with a retroesophageal collection following the creation of a tracheo-esophageal fistula for alaryngeal voice restoration is presented, together with its management. A review of the literature is made, and possible causes of the three complications are discussed.

The management of chylous fistulae remains controversial. A detailed conservative protocol and guidelines regarding surgical intervention are lacking in the literature. This paper presents our experience in the management of two cases of persistent chylous fistulae by successfully employing topical tetracycline. Our regimen of management is discussed and illustrated with ...

Congenital bronchoesophageal fistulas usually present in infants and may occur with or without esophageal atresia. Twenty cases of congenital bronchoesophageal fistula in adults have been reported in the English literature. Another case of this rare developmental anomaly is presented here. The radiographic, endoscopic, surgical, and pathologic findings are discussed with ...

Esophagopericardial fistula is a rare condition, usually presenting with cardiac tamponade, and is invariably fatal in the adult patient. In our patient the disorder resulted from fistulization secondary to a malignant tumor. Immediate decompression of resultant tense pneumopericardium can be accomplished safely through percutaneous pericardiocentesis without the need for surgery. ...

Benign duodenocolic fistula is a rare, surgically curable, but potentially lethal entity. Etiology, symptomatology, diagnosis and management are discussed. The authors describe the fifth reported case of an iatrogenic cause and review the literature on benign duodenocolic fistula. Early diagnosis and aggressive nutritional and surgical management are necessary to avoid ...

Fistula or deep sinus formation as a complication of xanthogranulomatous pyelonephritis (XPN) has not been described previously in the British literature. We present the clinicopathological features of one case of a nephrodiaphragmatic sinus complicating XPN, and three cases of nephrocolic fistula, including the first recorded case of fistula in childhood ...

Two cases are reported of congenital intrahepatic portacaval shunts in middle-aged women who had encephalopathy or hypoglycemia. Real-time ultrasound (US) investigations revealed vascular communication between the left portal and hepatic veins in one patient and communication between the right portal and hepatic veins in the other. These findings were confirmed ...

Venous aneurysms are extremely rare. They may be congenital or acquired in origin and occasionally related to arteriovenous communications. A 58-year-old man complained of dull left lower quadrant pain and constipation. On physical examination a soft deep mass was palpated. Ultrasonogram and CT scan revealed a cystic formation in the ...

A case of bilateral patent nasopalatine ducts, a rare congenital anomaly, has been described. A review of the literature does not permit dogmatic conclusions about the development and existence of patent nasopalatine ducts in both prenatal and postnatal life. A new, simple method of closing epithelium lined fistulae by instillation ...

The delayed appearance of congenital arteriovenous fistula precipitated by local trauma is a rare event. However, these reports may provide some insight into pathogenetic mechanisms responsible for the opening of subclinical arteriovenous communications. This case of multiple arteriovenous fistulas in a previously "normal" hand followed a sharp, incomplete amputation at ...

Mesenteric-portal arteriovenous fistula is an uncommon complication of gastrectomy. Management of a patient with this entity stimulated a comprehensive review of the 18 previously reported cases in the world literature. While presenting symptoms vary, physical findings are characteristic and include abdominal murmur (100% of patients) and palpable thrill (47%). Arteriography ...

Arteriovenous malformation of the uterus is rare. It is potentially lethal because profuse, uncontrollable bleeding may occur with diagnostic dilatation and curettage. Several cases of localized uterine arteriovenous malformation have been reported on. The condition should be considered during routine vaginal examination with pulsation and thrill in the vaginal fornices, ...

While the development of a spontaneous iliac arteriovenous fistula is an uncommon complication of arteriosclerotic aneurysmal disease, its association with a distinct clinical syndrome allows timely operative intervention for this potentially life-threatening event. A review of cases reported in the literature reveals a triad of symptoms consistently associated with the ...

Fistulas between the pancreas and bronchial tree are uncommon examples of internal pancreatic fistulas. We describe a case of pancreaticobronchial fistula in which the diagnosis was made by bronchoscopy and biochemical analysis of respiratory secretions. Endoscopic retrograde cholangiopancreatography was confirmatory and guided treatment by internal drainage of the pancreatic duct. ...

The clinical, radiologic, and pathologic features of four children with uncommon variations of congenital bronchopulmonary foregut malformations are presented. In each case, the malformation included a persistent communication between lung tissue and the gastrointestinal tract. One case, in which an esophageal bronchus was associated with esophageal atresia and tracheoesophageal fistula, ...

Our experiences with cerebrovascular malformations in Japanese patients have been reviewed, presenting 29 cases of venous malformation, 30 cases of cavernous angiomas and one case of capillary telangiectasis. We also present the data from the 763 cases of AVM obtained in the cooperative studies which were supported by the Ministry ...

In lymphoedema of the extremities arteriovenous shunt circulation develops. Regulation of limb circulation was studied in 28 cases of (primary and secondary) lymphoedema by using the venous isotope dilution method and technetium-macroaggregate perfusion scintigraphy. As a result of lymphoedema, limb circulation (total limb circulation) increases, arteriovenous O2 difference is low ...

Two rare cases of urethro-thigh fistula are described. Both of them occurred following pelvic trauma. We suggest that trauma, hematoma and infection, suppuration, are the etiology for the development of fistula from a torn urethra to the thigh. A review of the English literature failed to reveal other cases of ...

A case of esophago-pericardial fistula is described which was treated successfully by pericardial drainage and closure of the fistula 12 days after perforation. The condition is rare and often fatal. In 29 reported cases there were only 5 survivors. On the basis of our observation and a review of the ...

We report a case of bilateral internuclear ophthalmoplegia due to hydrocephalus associated with Arnold-Chiari malformation. The bilateral internuclear ophthalmoplegia in this case was probably caused by brain stem displacement due to hydrocephalus. This patient was considered to have "arrested" hydrocephalus on the basis of the clinical and computed tomographic findings ...

We report on a quick, safe and simple procedure, the anterior perineal trans-anorectal approach, which was used successfully to treat 2 difficult cases of prostatorectal and membranous urethrorectal fistulas. This method was devised after a review of all techniques to treat these fistulas, which are known to be difficult. Our ...

One peculiar case of giant ameloblastoma of the mandible is reported in this paper. This case is characterized by 2 interesting points: large tumor size of an infant's head, hypoproteinemia caused by leakage of serum protein, especially albumin, via fistula formed in the gum and edema of the body. Problems ...

Arterio-venous fistula following Fogarty catheter embolectomy is a rare but dangerous complication. The case of a male patient in whom such a fistula was repaired surgically is described. Aggressive approach in the treatment of this severe condition to prevent unnecessary limb loss is advocated. The pertinent literature is reviewed.

Angiographically occult arteriovenous malformations not associated with clinically recognizable intracranial hemorrhage appear to be rare. We are reporting three cases of histologically proven arteriovenous malformations of the brain that were angiographically occult. These cases presented with seizures or attacks of dizziness, and were detected by computed tomography scan, radionuclide scan, ...

One hundred and twenty cases of fistula-in-ano were treated in 11 years by fistulectomy and primary closure. Injection of dye into the tract helped in identifying the tract and its ramifications which were excised. A lateral sphincterotomy was added in most cases for relief of postoperative pain and to promote ...

A transposition technique for the management of high anal and anorectal fistulae is described. The method involves re-routing the extrasphincteric portion of the track into an intersphincteric position with immediate repair of the external sphincter. The newly positioned intersphincteric fistula is then dealt with at a later date when the ...

A case of left carotidocavernous fistula with right exophthalmos is reported. It is the thirteenth reported case in the literature since 1907. Mechanism of the exclusively contralateral exophthalmos is discussed. Temporary venous thrombosis of the ipsilateral ophthalmic vein and inferior petrosal sinus is likely. Successful treatment by detachable balloon with ...

The authors present seven cases of dural fistulae selected because of their difficulty in diagnosis or in the approach to treatment. The first case had a "delayed traumatic" CSF rhinorrhea and the diagnosis remained, to the end, presumptive. The second and the third were either "spontaneous" or "delayed traumatic" in ...

The authors report a case in which the great vein of Galen was occluded during removal of a huge meningioma in the pineal region. The patient recovered satisfactorily without any serious neurological deficits after the operation. Preoperative angiography had shown marked stenosis of the great vein of Galen and anastomoses ...

We reviewed 34 patients undergoing repair of urethrocutaneous fistulas. In 85 per cent of the cases fistulas occurred after hypospadias repair. Midshaft fistulas were closed successfully using a multilayered de-epithelialized "pants over vest" technique. Of 19 cases with midshaft fistulas closed by this method there were no recurrences and 13 ...