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Interventional management of gastrointestinal fistulas.

Kwon SH, Oh JH, Kim HJ, Park SJ, Park HC - Korean J Radiol (2008 Nov-Dec)

Bottom Line: Gastrointestinal (GI) fistulas are frequently very serious complications that are associated with high morbidity and mortality.GI fistulas can cause a wide array of pathophysiological effects by allowing abnormal diversion of the GI contents, including digestive fluid, water, electrolytes, and nutrients, from either one intestine to another or from the intestine to the skin.In addition, new interventional management techniques continue to emerge.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Radiology, Kyung Hee University Medical Center, Seoul, Korea.

ABSTRACT
Gastrointestinal (GI) fistulas are frequently very serious complications that are associated with high morbidity and mortality. GI fistulas can cause a wide array of pathophysiological effects by allowing abnormal diversion of the GI contents, including digestive fluid, water, electrolytes, and nutrients, from either one intestine to another or from the intestine to the skin. As an alternative to surgery, recent technical advances in interventional radiology and percutaneous techniques have been shown as advantageous to lower the morbidity and mortality rate, and allow for superior accessibility to the fistulous tracts via the use of fistulography. In addition, new interventional management techniques continue to emerge. We describe the clinical and imaging features of GI fistulas and outline the interventional management of GI fistulas.

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Low-output, colo-cutaneous fistula with anastomotic stricture in patient with descending colon segmental resection due to trauma.A. Abdominal CT image shows small air-containing abscess pocket (arrows) and subcutaneous fistula tract formation (arrowheads).B. Initial fistulogram shows colo-cutaneous fistula (arrows) with anastomotic stricture at descending colon.C. Placement of covered metallic stent at descending colon anastomosis site.D. Follow-up image obtained after placement of covered metallic stent shows fully expanded stent with good passage of contrast media without visible fistula tract.
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Figure 4: Low-output, colo-cutaneous fistula with anastomotic stricture in patient with descending colon segmental resection due to trauma.A. Abdominal CT image shows small air-containing abscess pocket (arrows) and subcutaneous fistula tract formation (arrowheads).B. Initial fistulogram shows colo-cutaneous fistula (arrows) with anastomotic stricture at descending colon.C. Placement of covered metallic stent at descending colon anastomosis site.D. Follow-up image obtained after placement of covered metallic stent shows fully expanded stent with good passage of contrast media without visible fistula tract.

Mentions: Classification of fistulas by output volume can be divided into high output and low output fistulas. High output fistulas (Fig. 3) drain between 300 and 4,000 ml per day, and usually arise from a lesion located between the inferior third of the esophagus and the ligament of Treitz. Low-output fistulas (Fig. 4) that drain less than 100 ml per day generally arise from the ileum or colon, except in the case of intestinal malabsorption (4). Recently, the output of pancreatic and intestinal fistulas has been characterized as either high or low output according to the volume of discharge over a 24-hour period (1, 2). Etiologic classification is determined with respect to the underlying disease.


Interventional management of gastrointestinal fistulas.

Kwon SH, Oh JH, Kim HJ, Park SJ, Park HC - Korean J Radiol (2008 Nov-Dec)

Low-output, colo-cutaneous fistula with anastomotic stricture in patient with descending colon segmental resection due to trauma.A. Abdominal CT image shows small air-containing abscess pocket (arrows) and subcutaneous fistula tract formation (arrowheads).B. Initial fistulogram shows colo-cutaneous fistula (arrows) with anastomotic stricture at descending colon.C. Placement of covered metallic stent at descending colon anastomosis site.D. Follow-up image obtained after placement of covered metallic stent shows fully expanded stent with good passage of contrast media without visible fistula tract.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627247&req=5

Figure 4: Low-output, colo-cutaneous fistula with anastomotic stricture in patient with descending colon segmental resection due to trauma.A. Abdominal CT image shows small air-containing abscess pocket (arrows) and subcutaneous fistula tract formation (arrowheads).B. Initial fistulogram shows colo-cutaneous fistula (arrows) with anastomotic stricture at descending colon.C. Placement of covered metallic stent at descending colon anastomosis site.D. Follow-up image obtained after placement of covered metallic stent shows fully expanded stent with good passage of contrast media without visible fistula tract.
Mentions: Classification of fistulas by output volume can be divided into high output and low output fistulas. High output fistulas (Fig. 3) drain between 300 and 4,000 ml per day, and usually arise from a lesion located between the inferior third of the esophagus and the ligament of Treitz. Low-output fistulas (Fig. 4) that drain less than 100 ml per day generally arise from the ileum or colon, except in the case of intestinal malabsorption (4). Recently, the output of pancreatic and intestinal fistulas has been characterized as either high or low output according to the volume of discharge over a 24-hour period (1, 2). Etiologic classification is determined with respect to the underlying disease.

Bottom Line: Gastrointestinal (GI) fistulas are frequently very serious complications that are associated with high morbidity and mortality.GI fistulas can cause a wide array of pathophysiological effects by allowing abnormal diversion of the GI contents, including digestive fluid, water, electrolytes, and nutrients, from either one intestine to another or from the intestine to the skin.In addition, new interventional management techniques continue to emerge.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Radiology, Kyung Hee University Medical Center, Seoul, Korea.

ABSTRACT
Gastrointestinal (GI) fistulas are frequently very serious complications that are associated with high morbidity and mortality. GI fistulas can cause a wide array of pathophysiological effects by allowing abnormal diversion of the GI contents, including digestive fluid, water, electrolytes, and nutrients, from either one intestine to another or from the intestine to the skin. As an alternative to surgery, recent technical advances in interventional radiology and percutaneous techniques have been shown as advantageous to lower the morbidity and mortality rate, and allow for superior accessibility to the fistulous tracts via the use of fistulography. In addition, new interventional management techniques continue to emerge. We describe the clinical and imaging features of GI fistulas and outline the interventional management of GI fistulas.

Show MeSH
Related in: MedlinePlus