Journal of Yeungnam Medical Science

Case report

Stent graft treatment of an ilioenteric fistula secondary to radiotherapy: a case report: Joo Yeon Jang, Ung Bae Jeon, Jin Hyeok Kim, Tae Un Kim, Jae Yeon Hwang, Hwa Seong Ryu; J Yeungnam Med Sci. 2022;39(1):77-80. Published online July 7, 2021; DOI: https://doi.org/10.12701/yujm.2021.01053

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Fistulas between the arteries and the gastrointestinal tract are rare but can be fatal. We present a case of an ilioenteric fistula between the left external iliac artery and sigmoid colon caused by radiotherapy for cervical cancer, which was treated with endovascular management using a stent graft. A 38-year-old woman underwent concurrent chemoradiotherapy for cervical cancer recurrence. Approximately 9 months later, the patient suddenly developed hematochezia. On her first visit to the emergency room of our hospital, computed tomography (CT) images did not reveal extravasation of contrast media. However, 8 hours later, she revisited the emergency room because of massive hematochezia with a blood pressure of 40/20 mmHg and a heart rate of 150 beats per minute. At that time, CT images showed the presence of contrast media in almost the entire colon. The patient was referred to the angiography room at our hospital for emergency angiography. Inferior mesenteric arteriography did not reveal any source of bleeding. Pelvic arteriography showed contrast media extravasation from the left external iliac artery to the sigmoid colon; this was diagnosed as an ilioenteric fistula and treated with a stent graft. When the bleeding focus is not detected on visceral angiography despite massive arterial bleeding, pelvic arteriography is recommended, especially in patients with a history of pelvic surgery or radiotherapy.

Citations

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Resection of sigmoid cancer with bladder invasion using laparoscopic combined with a cystoscopic holmium laser: an innovative surgical procedure
Ronghua Wu, Cong Xu, Xing Liu, Weihua Fu, Yujia Chen, Jingzhen Zhu, Guangsheng Du
Lasers in Medical Science.2023;[Epub] CrossRef

Case Report

Mediastinal pancreatic pseudocyst naturally drained by esophageal fistula: Soo Ho Park, Seung Keun Park, Sang Hyun Kim, Won Kyu Choi, Beom Jin Shim, Hee Ug Park, Chan Woo Jung, Jae Won Choi; Yeungnam Univ J Med. 2017;34(2):254-259. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.254

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Abstract PDF

Mediastinal pancreatic pseudocyst is a rare complication of acute or chronic pancreatitis. Pleural effusion and pneumonia are two of the most common thoracic complications from pancreatic disease, while pancreaticopleural fistula with massive pleural effusion and extension of pseudocyst into the mediastinum is a rare complication of the thorax from pancreatic disease. To the best of our knowledge, there have been no case reports of mediastinal pancreatic pseudocyst-induced esophageal fistula in Korea to date. Here in, we report a case about 43-year-old man of mediastinal pancreatic pseudocyst-induced esophageal fistula presenting with chest pain radiating toward the back and progressive dysphagia. The diagnosis was confirmed by an esophagogastroduodenoscopy and abdomen computed tomography (CT). The patient was treated immediately using a conservative method; subsequently, within 3 days from treatment initiation, symptoms-chest pain and dysphagia-disappeared. In a follow-up gastroscopy 7 days later and abdomen CT 12 days later, mediastinal pancreatic pseudocyst showed signs of improvement, and esophageal fistula disappeared without any complications.

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Pseudocyst of the pancreas masquerading as spontaneous pneumomediastinum
John D L Brookes, Manish Mathew, Charlene P Munasinghe, John C Gribbin, David A Devonshire, Prashant Joshi, Andrew D Cochrane
Journal of Surgical Case Reports.2019;[Epub] CrossRef

Review

Surgical treatment of perianal fistula in Crohn's disease: Sohyun Kim; Yeungnam Univ J Med. 2017;34(2):169-173. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.169

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Abstract PDF: Perianal Crohn's disease is a major problem that impair quality of life. This article reviews the current surgical treatment of Crohn's perianal fistula. Fistulotomy and loose seton are commonly used surgical methods for treatment of perianal Crohn's disease. Mucosal advancement flap and fibrin glue are used in this treatment, despite a lake of controlled trials. Fecal diversion is disturbingly high in complicated complex perianal fistula in Crohn's disease. Ligation of intersphincteric fistula and autologous or allogenic stem cells are new surgical procedures for treatment of Crohn's disease that need further studies. Treatment success might be improved by multimodal treatment and new surgical and medical treatment options.

Case Reports

An Unusual Cause of Gastrointestinal Hemorrhage: Gastrocolic Fistula Caused by Colon Cancer Invasion.: Jeong Hyeon Cho, In Tae Kim, Jin Yi Choi, Song Wook Chun, Beo Deul Kang, Sang Kyun Bae, Hee Man Kim, Ji Sun Song; Yeungnam Univ J Med. 2013;30(1):43-46. Published online June 30, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.1.43

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Abstract PDF: Gastrocolic fistula is a fistulous communication between the stomach and the colon. It is a passage between the gastric epithelium and the colonic epithelium. This uncommon complication is caused by benign and malignant diseases of the stomach or the colon. Its clinical manifestations include weight loss, diarrhea and fecal vomiting; occasionally, anemia, poor oral intake, fatigue and dizziness; and very rarely, gastrointestinal bleeding. In this paper, an unusual case of gastrocolic fistula accompanied by hematochezia, which was revealed to have been caused by colon cancer invasion, is described.

A Case of Recurrent Liver Abscess Due to Choledochoduodenal Fistula.: Jun Ho Hur, Sun Taek Choi, Min Su Sohn, Ji Eun Lee, In Hee Chung, Sung Ho Ki; Yeungnam Univ J Med. 2013;30(1):39-42. Published online June 30, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.1.39

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Abstract PDF: Cholelithiasis, duodenal ulcer, duodenal perforation and tumor invasion may lead to choledochoduodenal fistula (CDF). CDF often has no specific symptoms and may be incidentally detected in an upper gastrointestinal radiographic study or endoscopy; but in some cases, it may be accompanied by recurrent cholangitis and liver abscess. In this paper, a case of recurrent liver abscess caused by CDF is reported. A 62-year-old female was admitted to the authors' hospital because of right upper quadrant pain and fever. The abdominal computed tomography showed a liver abscess in the right lobe. A duodenal fistulous orifice was detected with endoscopy, and a contrast was injected through the duodenal orifice using a catheter under fluoroscopy. The injection of the contrast revealed a fistulous track between the duodenal bulb and the common hepatic duct. In fistulas complicated by recurrent liver abscess, surgery or medical management may be needed. The CDF in this case study was treated via endoscopic clipping.

A Case of Bladder Stone and Vesicovaginal Fistula after McDonald Operation.: Chang Jun Yoon, Ki Hak Moon, Hee Chang Jung; Yeungnam Univ J Med. 2006;23(1):108-112. Published online June 30, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.1.108

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Abstract PDF: The frequency of a bladder foreign body in the female is lower than in the male, and bladder stones attached to foreign bodies such as non-absorbable suture material are not common. Moreover, vesicovaginal fistulas due to migration or puncture of suture materials into the bladder are rare. In this report, we present a case of bladder stone and vesicovaginal fistula formation in a 29-year-old female patient who had been treated with the McDonald operation for an incompetent internal os of the cervix (IIOC) during pregnancy. The patient was successfully treated by cystoscopic removal of the bladder stone with suture material and conservative treatment for the vesicovaginal fistula.

Case reports of bone grafting in unilateral alveolar-palatal cleft patients.: Yun Ho Bae, Jae Hyun Park, Myeong Jin Lee, Chang Gon Lee, Byung Rho Chin, Hee Kyeung Lee; Yeungnam Univ J Med. 1991;8(1):198-205. Published online June 30, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.1.198

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Abstract PDF: We obtained successful functional and esthetic results by grafting of iliac marrow-cancellous bone in 2 cases of alveolar-palatal cleft patients. Bone graft of alveolar-palatal clefts provide bony support to adjacent teeth of cleft area, prevented from relapse of orthodontic arch expansion, closure of oroantral fistula and improvement of speech problem. 1. In one case, extraction of upper right central incisor that was little bone support, alignment of rotated teeth and expansion of collapsed arch segment were done with pre-orthodontic treatment. The other case. Bone grafting was done after removal of prosthesis with no pre-orthodontic treatment. 2. After mucoperiosteal incision in cleft area, the mucosal flap of labial area, palate and nose were separation and the raised nasal mucosa was sutured for closure of oroantral fistula. Then, the iliac marrow-cancellous bones were grafted to cleft site. 3. After 6 months of operation, we had seen the new bone deposition to cleft site in dental radiograph and prosthetic treatment of missing teeth were done.

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