AIM： TO explore the pathogenesis of the rectovestibular disruption （RVD） defect and to recommend a successful repair, and prevention of it. METHODS： Clinical records of 15 girls, age ranged from 3 to 15 （median, ...AIM： TO explore the pathogenesis of the rectovestibular disruption （RVD） defect and to recommend a successful repair, and prevention of it. METHODS： Clinical records of 15 girls, age ranged from 3 to 15 （median, 7.5） years, with acquired rectovestibular fistula （RVF） mistreated before were retrospectively reviewed. All of them presented an abnormal appearance of perineum and were suffering from some degree of fecal incontinence, and those were graded Ⅲ to IV by Li Zheng＇s Score. Repair of anal sphincters and reconstruction of perineum body and skin by anterior perineal rectoanoplasty were performed in all cases. RESULTS： Operation in all cases was successful. The perin.eum looked practically normal and fecal continence score rose up to VI by Li Zheng＇s Score. CONCLUSION： The conventional treatment for anal fistula, lay-open or string-treatment, should be considered as malpractice of RVF, and certainly leads to the RVD defect, and the anterior perineal rectoanoplasty could cure it satisfactorily.展开更多
Acquired coronary artery fistulas(CCFs)are infrequently detected during conventional coronary angiography.To delineate the characteristics of congenital(first part)and acquired(second part)CCFs in adults,a PubMed sear...Acquired coronary artery fistulas(CCFs)are infrequently detected during conventional coronary angiography.To delineate the characteristics of congenital(first part)and acquired(second part)CCFs in adults,a PubMed search was conducted for papers dealing with congenital or acquired CCFs.None of the publications describing patients with coronary-vascular fistulas were included.Papers dealing with pediatric subjects were excluded.From the world literature,a total of 243adult patients were selected who had congenital(n=159/243,65%)and acquired(n=84/243,35%)CCFs.Among the acquired types(n=72,85.7%)were traumatic(iatrogenic(n=65/72,90%),accidental(n=7/72,10%)and(n=12,14.3%)spontaneously developing in relation to severe coronary atherosclerosis or myocardial infarction.A high incidence of spontaneousresolution of iatrogenic CCFs resulting from endomyocardial biopsy or following post-septal myectomy was reported.Spontaneous CCFs associated with myocardial ischemia or infarction resolved completely in 8%of the subjects.Early surgical intervention was the treatment of choice in acquired traumatic accidental CCFs.The congenital types are addressed in a previous issue of this journal(first part).In this review(second of two parts,partⅡ),we describe the acquired coronarycameral fistulas.展开更多
Double pylorus is one of the rare anomalies of the gastrointestinal tract,it can be congenital or acquired.In this case we report a case of double pylorus because of chronic peptic ulcer.Upper GI endoscopy revealed ga...Double pylorus is one of the rare anomalies of the gastrointestinal tract,it can be congenital or acquired.In this case we report a case of double pylorus because of chronic peptic ulcer.Upper GI endoscopy revealed gastroduodenal fistula located on the lesser curve of the antrum,the patient’s symptoms were improved rapidly by intensive antiulcer treatment.展开更多
Dural arteriovenous fistulas(DAVFs)are rare vascular abnormalities that comprise 10%-15%of all intracranial arteriovenous malformations.The pathogenesis of DAVFs is still uncertain,although growing angiographic eviden...Dural arteriovenous fistulas(DAVFs)are rare vascular abnormalities that comprise 10%-15%of all intracranial arteriovenous malformations.The pathogenesis of DAVFs is still uncertain,although growing angiographic evidence supports the acquired characteristics of this vascular disease.Here,we present the case of a 39-year-old man with incidental bilateral paraophthalmic aneurysms who experienced spontaneous retroocular pressure and mild headache.Magnetic resonance angiography revealed enlargement and a change in the shape of the right paraophthalmic aneurysm.The patient underwent a right pterional craniotomy for the intracranial aneurysms.Five months later,he presented with progressive pulsatile tinnitus.A diagnostic angiogram demonstrated a Cognard type I DAVF of the right sigmoid sinus.Based on this case,angiography monitoring is recommended.Herein we review and summarize postoperative DAVF cases.Common causes of acquired DAVFs and treatment selection are discussed based on relevant literature.展开更多
文摘AIM： TO explore the pathogenesis of the rectovestibular disruption （RVD） defect and to recommend a successful repair, and prevention of it. METHODS： Clinical records of 15 girls, age ranged from 3 to 15 （median, 7.5） years, with acquired rectovestibular fistula （RVF） mistreated before were retrospectively reviewed. All of them presented an abnormal appearance of perineum and were suffering from some degree of fecal incontinence, and those were graded Ⅲ to IV by Li Zheng＇s Score. Repair of anal sphincters and reconstruction of perineum body and skin by anterior perineal rectoanoplasty were performed in all cases. RESULTS： Operation in all cases was successful. The perin.eum looked practically normal and fecal continence score rose up to VI by Li Zheng＇s Score. CONCLUSION： The conventional treatment for anal fistula, lay-open or string-treatment, should be considered as malpractice of RVF, and certainly leads to the RVD defect, and the anterior perineal rectoanoplasty could cure it satisfactorily.
文摘Acquired coronary artery fistulas(CCFs)are infrequently detected during conventional coronary angiography.To delineate the characteristics of congenital(first part)and acquired(second part)CCFs in adults,a PubMed search was conducted for papers dealing with congenital or acquired CCFs.None of the publications describing patients with coronary-vascular fistulas were included.Papers dealing with pediatric subjects were excluded.From the world literature,a total of 243adult patients were selected who had congenital(n=159/243,65%)and acquired(n=84/243,35%)CCFs.Among the acquired types(n=72,85.7%)were traumatic(iatrogenic(n=65/72,90%),accidental(n=7/72,10%)and(n=12,14.3%)spontaneously developing in relation to severe coronary atherosclerosis or myocardial infarction.A high incidence of spontaneousresolution of iatrogenic CCFs resulting from endomyocardial biopsy or following post-septal myectomy was reported.Spontaneous CCFs associated with myocardial ischemia or infarction resolved completely in 8%of the subjects.Early surgical intervention was the treatment of choice in acquired traumatic accidental CCFs.The congenital types are addressed in a previous issue of this journal(first part).In this review(second of two parts,partⅡ),we describe the acquired coronarycameral fistulas.
文摘Double pylorus is one of the rare anomalies of the gastrointestinal tract,it can be congenital or acquired.In this case we report a case of double pylorus because of chronic peptic ulcer.Upper GI endoscopy revealed gastroduodenal fistula located on the lesser curve of the antrum,the patient’s symptoms were improved rapidly by intensive antiulcer treatment.
文摘Dural arteriovenous fistulas(DAVFs)are rare vascular abnormalities that comprise 10%-15%of all intracranial arteriovenous malformations.The pathogenesis of DAVFs is still uncertain,although growing angiographic evidence supports the acquired characteristics of this vascular disease.Here,we present the case of a 39-year-old man with incidental bilateral paraophthalmic aneurysms who experienced spontaneous retroocular pressure and mild headache.Magnetic resonance angiography revealed enlargement and a change in the shape of the right paraophthalmic aneurysm.The patient underwent a right pterional craniotomy for the intracranial aneurysms.Five months later,he presented with progressive pulsatile tinnitus.A diagnostic angiogram demonstrated a Cognard type I DAVF of the right sigmoid sinus.Based on this case,angiography monitoring is recommended.Herein we review and summarize postoperative DAVF cases.Common causes of acquired DAVFs and treatment selection are discussed based on relevant literature.
