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Weixun Zhou - One of the best experts on this subject based on the ideXlab platform.
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rare intestinal Fistula caused by primary lymphoma of the gastrointestinal tract two case reports and literature review
Medicine, 2018Co-Authors: Nan Zhuang, Qingli Zhu, Miaoqian Wang, Qian Yang, Wei Liu, Hong Yang, Weixun ZhouAbstract:RATIONALE Primary lymphoma that arises from the intestine is an uncommon malignant tumour, while intestinal Fistula caused by primary lymphoma is even rarer. Non-specific clinical performance makes early diagnosis difficult, although imaging modalities might play an essential role in the detection of intestinal Fistula. PATIENT CONCERNS Patient 1: A 60-year-old male hospitalized with diarrhoea and abdominal pain for seven months underwent computed tomography enterography (CTE) that demonstrated ileum internal Fistula and ileac-sigmoid Colon Fistula. Ultrasound (US) showed small intestinal wall thickened and development of a Fistula of the sigmoid Colon due to malignance. Patient 2: A 43-year-old male presented with abdominal pain and diarrhoea lasting one year. US revealed a Fistula between the sigmoid Colon and the ileum, and CTE showed that the wall of the partial sigmoid Colon was abnormally thickened and enhanced with an ileal-sigmoid Fistula that strongly suggested the diagnosis of lymphoma. DIAGNOSES Both the two patients were diagnosed as intestinal Fistula caused by primary non-Hodgkin's intestinal lymphoma. INTERVENTIONS The patient 1 underwent surgery followed by chemotherapy. The patient 2 accepted chemotherapy. OUTCOMES Two patients' general conditions remained stable and the imaging revealed no recurrence after follow-up of about 12 months. LESSIONS Cross-sectional imaging, such as US and CT, plays an essential role in intestinal lymphoma Fistula diagnosis.
Biazon,ana Carla Broetto - One of the best experts on this subject based on the ideXlab platform.
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Temporary ileostomy for the preservation of Colon Fistula in patients with postoperative complications: case report
Sociedade Brasileira de Coloproctologia, 2011Co-Authors: Patrício,solaine Chiminácio De Oliveira, Branco Filho,alcides José, Biazon,ana Carla BroettoAbstract:Among the postoperative complications in the digestive system, the Fistulae are the most common ones. The changes resulting from these Fistulae are very important, once they can determine the patient's situation and the development of multiple organic failures. This paper reports the case of a patient who had relevant complications after having undergone temporary ileostomy to maintain the Colon fistulized. About 90 to 95% of the digestive tract Fistulae have spontaneous resolution. In some cases, the general state of the patient compromises the spontaneous closure. In this study, after one month of nutritional support and medicine treatment, the spontaneous closure of the Colon Fistula did not occur, thus, a surgical intervention was necessary to solve the case
Shimin Yang - One of the best experts on this subject based on the ideXlab platform.
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investigation of treatment and analysis of prognostic risk on enterocutaneous Fistula in china a multicenter prospective study
Chinese Journal of Gastrointestinal Surgery, 2019Co-Authors: Tao Zheng, Haohao Xie, Qiang Chi, Feng Wang, Zhenhua Yang, Chaowu Chen, Wei Mai, Suming Luo, Xiaofei Song, Shimin YangAbstract:Objective: To investigate the diagnosis and treatment for enterocutaneous Fistula (ECF) in China, and to explore the prognostic factors of ECF. Methods: A multi-center cross-sectional study was conducted based on the Registration System of Chinese Gastrointestinal Fistula and Intra-Abdominal Infections to collect the clinical data of ECF patients from 54 medical centers in 22 provinces/municipalities from January 1, 2018 to December 31, 2018. The clinical data included patient gender, age, length of hospital stay, intensive care unit (ICU) admission, underlying diseases, primary diseases, direct causes of ECF, location and type of ECF, complications, treatment and outcomes. All medical records were carefully filled in by the attending physicians, and then re-examined by more than two specialists. The diagnosis of ECF was based on the clinical manifestations, laboratory/imaging findings and intraoperative exploration. Results: A total of 1521 patients with ECF were enrolled, including 1099 males and 422 females, with a median age of 55 years. The top three primary diseases of ECF were malignant tumors in 626 cases (41.2%, including 540 gastrointestinal tumors, accounting for 86.3% of malignant tumors), gastrointestinal ulcers and perforations in 202 cases (13.3%), and trauma in 157 cases (10.3%). The direct causes of ECF were mainly surgical operation in 1194 cases (78.5%), followed by trauma in 156 (10.3%), spontaneous Fistula due to Crohn's disease in 92 (6.0%), radiation intestinal injury in 41 (2.7%), severe pancreatitis in 20 (1.3%), endoscopic treatment in 13 (0.9%) and 5 cases (0.3%) of unknown reasons. All the patients were divided into three groups: 1350 cases (88.7%) with simple ECF, 150 (9.9%) with multiple ECF, and 21 (1.4%) with combined internal Fistula. Among the patients with simple ECF, 438 cases (28.8%) were jejuno-ileal Fistula, 313 (20.6%) Colon Fistula, 170 (11.2%) rectal Fistula, 111 (7.3%) duodenal Fistula, 76 (5.0%) ileocecal Fistula, 65 (4.3%) ileocolic anastomotic Fistula, 55 (3.6%) duodenal stump Fistula, 36 (2.4%) gastrointestinal anastomotic Fistula, 36 (2.4%) esophagogastric/esophagojejunal anastomotic Fistula, 29 (1.9%) gastric Fistula and 21 (1.4%) cholangiopancreatiointestinal. Among all the simple ECF patients, 991 were tubular Fistula and 359 were labial Fistula. A total of 1146 patients finished the treatment, of whom 1061 (92.6%) were healed (586 by surgery and 475 self-healing) and 85 (7.4%) died. A total of 1043 patients (91.0%) received nutritional support therapy, and 77 (6.7%) received fistuloclysis. Infectious source control procedures were applied to 1042 patients, including 711 (62.0%) with active lavage and drainage and 331 (28.9%) with passive drainage. Among them, 841 patients (73.4%) underwent minimally invasive procedures of infectious source control (replacement of drainage tube through sinus tract, puncture drainage, etc.), 201 (17.5%) underwent laparotomy drainage, while 104 (9.1%) did not undergo any drainage measures. A total of 610 patients (53.2%) received definitive operation, 24 patients died within postoperative 30-day with mortality of 3.9% (24/610), 69 (11.3%) developed surgical site infection (SSI), and 24 (3.9%) had a relapse of Fistula. The highest cure rate was achieved in ileocecal Fistula (100%), followed by rectal Fistula (96.2%, 128/133) and duodenal stump Fistula (95.7%,44/46). The highest mortality was found in combined internal Fistula (3/12) and no death in ileocecal Fistula. Univariate prognostic analysis showed that primary diseases as Crohn's disease (χ(2)=6.570, P=0.010) and appendicitis/appendiceal abscess (P=0.012), intestinal Fistula combining with internal Fistula (χ(2)=5.460, P=0.019), multiple ECF (χ(2)=7.135, P=0.008), esophagogastric / esophagojejunal anastomotic Fistula (χ(2)=9.501, P=0.002), ECF at ileocecal junction (P=0.012), non-drainage/passive drainage before the diagnosis of intestinal Fistula (χ(2)=9.688, P=0.008), non-drainage/passive drainage after the diagnosis of intestinal Fistula (χ(2)=9.711, P=0.008), complicating with multiple organ dysfunction syndrome (MODS) (χ(2)=179.699, P<0.001), sepsis (χ(2)=211.851, P<0.001), hemorrhage (χ(2)=85.300, P<0.001), pulmonary infection (χ(2)=60.096, P<0.001), catheter-associated infection (χ(2)=10.617, P=0.001) and malnutrition (χ(2)=21.199, P<0.001) were associated with mortality. Multivariate prognostic analysis cofirmed that sepsis (OR=7.103, 95%CI:3.694-13.657, P<0.001), complicating with MODS (OR=5.018, 95%CI:2.170-11.604, P<0.001), and hemorrhage (OR=4.703, 95%CI: 2.300-9.618, P<0.001) were independent risk factors of the death for ECF patients. Meanwhile, active lavage and drainage after the definite ECF diagnosis was the protective factor (OR=0.223, 95%CI: 0.067-0.745, P=0.015). Conclusions: The overall mortality of ECF is still high. Surgical operation is the most common cause of ECF. Complications e.g. sepsis, MODS, hemorrhage, and catheter-associated infection, are the main causes of death. Active lavage and drainage is important to improve the prognosis of ECF.
Nan Zhuang - One of the best experts on this subject based on the ideXlab platform.
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rare intestinal Fistula caused by primary lymphoma of the gastrointestinal tract two case reports and literature review
Medicine, 2018Co-Authors: Nan Zhuang, Qingli Zhu, Miaoqian Wang, Qian Yang, Wei Liu, Hong Yang, Weixun ZhouAbstract:RATIONALE Primary lymphoma that arises from the intestine is an uncommon malignant tumour, while intestinal Fistula caused by primary lymphoma is even rarer. Non-specific clinical performance makes early diagnosis difficult, although imaging modalities might play an essential role in the detection of intestinal Fistula. PATIENT CONCERNS Patient 1: A 60-year-old male hospitalized with diarrhoea and abdominal pain for seven months underwent computed tomography enterography (CTE) that demonstrated ileum internal Fistula and ileac-sigmoid Colon Fistula. Ultrasound (US) showed small intestinal wall thickened and development of a Fistula of the sigmoid Colon due to malignance. Patient 2: A 43-year-old male presented with abdominal pain and diarrhoea lasting one year. US revealed a Fistula between the sigmoid Colon and the ileum, and CTE showed that the wall of the partial sigmoid Colon was abnormally thickened and enhanced with an ileal-sigmoid Fistula that strongly suggested the diagnosis of lymphoma. DIAGNOSES Both the two patients were diagnosed as intestinal Fistula caused by primary non-Hodgkin's intestinal lymphoma. INTERVENTIONS The patient 1 underwent surgery followed by chemotherapy. The patient 2 accepted chemotherapy. OUTCOMES Two patients' general conditions remained stable and the imaging revealed no recurrence after follow-up of about 12 months. LESSIONS Cross-sectional imaging, such as US and CT, plays an essential role in intestinal lymphoma Fistula diagnosis.
Ana Carla Broetto Biazon - One of the best experts on this subject based on the ideXlab platform.
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Temporary ileostomy for the preservation of Colon Fistula in patients with postoperative complications: case report
Elsevier, 2011Co-Authors: Solaine Chiminácio De Oliveira Patrício, Alcides José Branco Filho, Ana Carla Broetto BiazonAbstract:Among the postoperative complications in the digestive system, the Fistulae are the most common ones. The changes resulting from these Fistulae are very important, once they can determine the patient's situation and the development of multiple organic failures. This paper reports the case of a patient who had relevant complications after having undergone temporary ileostomy to maintain the Colon fistulized. About 90 to 95% of the digestive tract Fistulae have spontaneous resolution. In some cases, the general state of the patient compromises the spontaneous closure. In this study, after one month of nutritional support and medicine treatment, the spontaneous closure of the Colon Fistula did not occur, thus, a surgical intervention was necessary to solve the case.Dentre as complicações pós-operatórias do aparelho digestório, as fístulas apresentam alta incidência. As alterações decorrentes dessas fístulas são muito importantes, pois podem determinar o agravamento do estado geral do paciente e o desenvolvimento de insuficiências orgânicas múltiplas. O presente trabalho relata o caso de um paciente com complicações relevantes após a realização de uma ileostomia temporária para preservação do cólon fistulizado. A maioria (90-95%) das fístulas do trato digestório tem resolução espontânea; entretanto, em alguns casos, o estado geral do paciente compromete o fechamento espontâneo. No caso em estudo, após um mês de suporte nutricional e tratamento medicamentoso, o fechamento espontâneo da fístula de cólon não ocorreu, sendo necessária a intervenção cirúrgica para resolução do caso