Cholecystocolic fistula secondary to gallbladder carcinoma is extremely rare and has been reported in very few studies. Most cholecystocolic fistulae are late complications of gallstone disease, but can also develop f...Cholecystocolic fistula secondary to gallbladder carcinoma is extremely rare and has been reported in very few studies. Most cholecystocolic fistulae are late complications of gallstone disease, but can also develop following carcinoma of the gallbladder when the necrotic tumor penetrates into the adjacent colon. Although no currently available imaging technique has shown great accuracy in recognizing cholecystocolic fistula, abdominopelvic computed tomography may show fistulous communication and anatomical details.Herein we report an unusual case of cholecystocolic fistula caused by gallbladder carcinoma, which was preoperatively misdiagnosed as hepatic flexure colon carcinoma.展开更多
A 36-year-old male Asian immigrant with a history of hepatitis B and hepatitis C related unresectable hepatocellular carcinoma in the left lobe of the liver presented with hematemesis and severe anemia.He was diagnose...A 36-year-old male Asian immigrant with a history of hepatitis B and hepatitis C related unresectable hepatocellular carcinoma in the left lobe of the liver presented with hematemesis and severe anemia.He was diagnosed with a liver mass that was resected 8 years ago described as a benign tumor in his home country.He had received trans-arterial chemoembolization(TACE)four months ago after subsequent diagnosis of unresectable hepatoma,and currently was receiving chemotherapy with Sorafenib.After resuscitation,a contrast enhanced computerized tomography was performed which showed fistulization of hepatocellular carcinoma into adjacent stomach.This finding was confirmed during endoscopy with direct visualization of the fistulous opening.Hepatocellular carcinoma(HCC)invading the gastrointestinal(GI)tract is rare.We present a case and literature review of HCC with local invasion of the stomach causing massive upper GI bleeding after receiving TACE.展开更多
Splenic arteriogastric fistula is a rare cause of upper gastrointestinal (GI) hemorrhage, only reported a handful of times in the literature. Herein, we present a case of a 49-year-old woman with metastatic adrenocort...Splenic arteriogastric fistula is a rare cause of upper gastrointestinal (GI) hemorrhage, only reported a handful of times in the literature. Herein, we present a case of a 49-year-old woman with metastatic adrenocortical carcincoma who developed a fistula between the splenic artery and gastric lumen as a result of local invasion of her primary tumor. This fistula led to several episodes of massive upper GI bleeding. Selective splenic artery embolization was successful in ceasing the GI bleed;however, the intervention was not timely enough for the patient to survive the hemorrhage. We outline several clinical and imaging findings to assist physicians with earlier detection of splenic arteriogastric fistulas, and advocate prophylactic selective splenic artery embolization when this rare but highly fatal entity is discovered.展开更多
Aim: This paper aims to report the second case of mucinous carcinoma of the scrotum revealed by scrotal fistulas listed in the literature and highlight the difficulties in the search and difficulties encountered in th...Aim: This paper aims to report the second case of mucinous carcinoma of the scrotum revealed by scrotal fistulas listed in the literature and highlight the difficulties in the search and difficulties encountered in the management of urogenital cancers in developing countries. Case presentation: This was a 62-year-old patient who had consulted for fistulized lesions of the scrotum associated with urinary disorders. Physical examination found budding lesions in the scrotum from which mucus was leaking. The diagnostic assessment carried out consisted of a biopsy sample of the scrotal lesions, a blood analysis and medical imaging, which led to the diagnosis. The mutilating nature of the surgery proposed to the patient after multidisciplinary consultation meeting and the expensive cost of chemotherapy drugs constituted the limits of the patient’s therapeutic management. Conclusion: Mucinous carcinoma of the scrotum is rare and primary lesion should always be sought. The presence of budding lesions of the scrotum with discharge of mucus should suggest the diagnosis.展开更多
The management of postoperative leaks into the mediastinum after esophagectomy remains a challenge. We describe our clinical management of this complication through endoscopic transluminal drainage. Between 2008 and 2...The management of postoperative leaks into the mediastinum after esophagectomy remains a challenge. We describe our clinical management of this complication through endoscopic transluminal drainage. Between 2008 and 2011, 4 patients with esophageal squamous cell carcinoma (ESCC) who underwent McKeown-type esophagectomy with two-field lymphadenectomy experienced complicated anastomotic fistulae in the presence of superior mediastinal sepsis. All 4 patients underwent endoscopic transluminal drainage, and all survived. The mean healing period was 50 days (range, 31 to 58 days), the mean stay in the intensive care unit was 7.3 days (range, 1 to 18 days), and the mean hospital stay was 64.5 days (range, 49 to 70 days). Endoscopically guided transluminal drainage should be considered for ESCC patients with superior mediastinal fistulae after esophagectomy.展开更多
Malignant disease,including mucinous carcinomas of the colorectum,may complicate long-standing Crohn’s disease.An 18-year-old male with extensive small and large bowel involvement with Crohn’s disease developed recu...Malignant disease,including mucinous carcinomas of the colorectum,may complicate long-standing Crohn’s disease.An 18-year-old male with extensive small and large bowel involvement with Crohn’s disease developed recurrent peri-rectal fistulous disease that persisted for more than a decade despite pharmacological and surgical therapy as well as later therapy with biological agents. Eventually,an extensive and difficult-to-detect mucinous carcinoma developed in the fistulous tract.Although fistula cancer is rarely described in Crohn’s disease,use of immunosuppressant and biological agents may play an initiating or exacerbating role in its development or progression.As potent biological agents are frequently used, often to avoid surgical treatment,clinicians should have an increasingly high index of suspicion for this potential complication,especially if fistulous drainage persists and remains refractory to medical therapy.展开更多
Enterovesical fistulae secondary to benign or malignant bowel disease are not uncommonly reported in the literature. However,bladder malignancy as the primary pathology is exceedingly rare. We report a case of muscle ...Enterovesical fistulae secondary to benign or malignant bowel disease are not uncommonly reported in the literature. However,bladder malignancy as the primary pathology is exceedingly rare. We report a case of muscle invasive urothelial carcinoma of bladder with an enterovesical fistula to a loop of small bowel. The patient first presented with signs and symptoms of per rectal bleeding,haematuria,pneumaturia,faecaluria and rectal micturition. Her initial biochemistry test revealed significant metabolic acidosis with normal anion gap and hypokalemia. A computed tomography abdomen/pelvis with rectal contrast demonstrated an enterovesical fistula from the dome of bladder to a loop of small bowel. The patient underwent radical cystectomy with enbloc resection of a loop of involved ileum and sigmoid colon due to the intraoperative findings of the sigmoid colon adherent to the tumour. The published literature is reviewed,focusing on the incidence,diagnostic modality and treatment strategies available for this rare condition.展开更多
Over-the-scope clip(OTSC) system is becoming a new reliable technique which is available for the endoscopic closure of fistulas, bleeding, perforations and so on. We describe the case of a patient with a nonhealing ga...Over-the-scope clip(OTSC) system is becoming a new reliable technique which is available for the endoscopic closure of fistulas, bleeding, perforations and so on. We describe the case of a patient with a nonhealing gastrocutaneous fistula after esophagectomy for esophageal squamous cell carcinoma which was successfully closed using an OTSC system. This is the first report of the use of OTSC to treat a nonhealing gastrocutaneous fistula successfully after esophagectomy. We believe our experience will give such patients an ideal way to cure the fistula without suffering too much and also explore new application of OTSC.展开更多
文摘Cholecystocolic fistula secondary to gallbladder carcinoma is extremely rare and has been reported in very few studies. Most cholecystocolic fistulae are late complications of gallstone disease, but can also develop following carcinoma of the gallbladder when the necrotic tumor penetrates into the adjacent colon. Although no currently available imaging technique has shown great accuracy in recognizing cholecystocolic fistula, abdominopelvic computed tomography may show fistulous communication and anatomical details.Herein we report an unusual case of cholecystocolic fistula caused by gallbladder carcinoma, which was preoperatively misdiagnosed as hepatic flexure colon carcinoma.
文摘A 36-year-old male Asian immigrant with a history of hepatitis B and hepatitis C related unresectable hepatocellular carcinoma in the left lobe of the liver presented with hematemesis and severe anemia.He was diagnosed with a liver mass that was resected 8 years ago described as a benign tumor in his home country.He had received trans-arterial chemoembolization(TACE)four months ago after subsequent diagnosis of unresectable hepatoma,and currently was receiving chemotherapy with Sorafenib.After resuscitation,a contrast enhanced computerized tomography was performed which showed fistulization of hepatocellular carcinoma into adjacent stomach.This finding was confirmed during endoscopy with direct visualization of the fistulous opening.Hepatocellular carcinoma(HCC)invading the gastrointestinal(GI)tract is rare.We present a case and literature review of HCC with local invasion of the stomach causing massive upper GI bleeding after receiving TACE.
文摘Splenic arteriogastric fistula is a rare cause of upper gastrointestinal (GI) hemorrhage, only reported a handful of times in the literature. Herein, we present a case of a 49-year-old woman with metastatic adrenocortical carcincoma who developed a fistula between the splenic artery and gastric lumen as a result of local invasion of her primary tumor. This fistula led to several episodes of massive upper GI bleeding. Selective splenic artery embolization was successful in ceasing the GI bleed;however, the intervention was not timely enough for the patient to survive the hemorrhage. We outline several clinical and imaging findings to assist physicians with earlier detection of splenic arteriogastric fistulas, and advocate prophylactic selective splenic artery embolization when this rare but highly fatal entity is discovered.
文摘Aim: This paper aims to report the second case of mucinous carcinoma of the scrotum revealed by scrotal fistulas listed in the literature and highlight the difficulties in the search and difficulties encountered in the management of urogenital cancers in developing countries. Case presentation: This was a 62-year-old patient who had consulted for fistulized lesions of the scrotum associated with urinary disorders. Physical examination found budding lesions in the scrotum from which mucus was leaking. The diagnostic assessment carried out consisted of a biopsy sample of the scrotal lesions, a blood analysis and medical imaging, which led to the diagnosis. The mutilating nature of the surgery proposed to the patient after multidisciplinary consultation meeting and the expensive cost of chemotherapy drugs constituted the limits of the patient’s therapeutic management. Conclusion: Mucinous carcinoma of the scrotum is rare and primary lesion should always be sought. The presence of budding lesions of the scrotum with discharge of mucus should suggest the diagnosis.
文摘The management of postoperative leaks into the mediastinum after esophagectomy remains a challenge. We describe our clinical management of this complication through endoscopic transluminal drainage. Between 2008 and 2011, 4 patients with esophageal squamous cell carcinoma (ESCC) who underwent McKeown-type esophagectomy with two-field lymphadenectomy experienced complicated anastomotic fistulae in the presence of superior mediastinal sepsis. All 4 patients underwent endoscopic transluminal drainage, and all survived. The mean healing period was 50 days (range, 31 to 58 days), the mean stay in the intensive care unit was 7.3 days (range, 1 to 18 days), and the mean hospital stay was 64.5 days (range, 49 to 70 days). Endoscopically guided transluminal drainage should be considered for ESCC patients with superior mediastinal fistulae after esophagectomy.
文摘Malignant disease,including mucinous carcinomas of the colorectum,may complicate long-standing Crohn’s disease.An 18-year-old male with extensive small and large bowel involvement with Crohn’s disease developed recurrent peri-rectal fistulous disease that persisted for more than a decade despite pharmacological and surgical therapy as well as later therapy with biological agents. Eventually,an extensive and difficult-to-detect mucinous carcinoma developed in the fistulous tract.Although fistula cancer is rarely described in Crohn’s disease,use of immunosuppressant and biological agents may play an initiating or exacerbating role in its development or progression.As potent biological agents are frequently used, often to avoid surgical treatment,clinicians should have an increasingly high index of suspicion for this potential complication,especially if fistulous drainage persists and remains refractory to medical therapy.
文摘Enterovesical fistulae secondary to benign or malignant bowel disease are not uncommonly reported in the literature. However,bladder malignancy as the primary pathology is exceedingly rare. We report a case of muscle invasive urothelial carcinoma of bladder with an enterovesical fistula to a loop of small bowel. The patient first presented with signs and symptoms of per rectal bleeding,haematuria,pneumaturia,faecaluria and rectal micturition. Her initial biochemistry test revealed significant metabolic acidosis with normal anion gap and hypokalemia. A computed tomography abdomen/pelvis with rectal contrast demonstrated an enterovesical fistula from the dome of bladder to a loop of small bowel. The patient underwent radical cystectomy with enbloc resection of a loop of involved ileum and sigmoid colon due to the intraoperative findings of the sigmoid colon adherent to the tumour. The published literature is reviewed,focusing on the incidence,diagnostic modality and treatment strategies available for this rare condition.
基金Supported by National Natural Science Foundation of ChinaNo.81201908
文摘Over-the-scope clip(OTSC) system is becoming a new reliable technique which is available for the endoscopic closure of fistulas, bleeding, perforations and so on. We describe the case of a patient with a nonhealing gastrocutaneous fistula after esophagectomy for esophageal squamous cell carcinoma which was successfully closed using an OTSC system. This is the first report of the use of OTSC to treat a nonhealing gastrocutaneous fistula successfully after esophagectomy. We believe our experience will give such patients an ideal way to cure the fistula without suffering too much and also explore new application of OTSC.
