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Giant Tuberculous Broncho-nodal Fistula

Kho SS, Chai CS, Ho RL, Yong MC, Chan SK, Tie ST

J Bronchology Interv Pulmonol, 2024 Jan 01;31(1):90-92.
PMID: 37735753 DOI: 10.1097/LBR.0000000000000946
Matched MeSH terms: Esophageal Fistula*
A 52-year-old woman with recurrent hemoptysis

Lim KH, Lim YC, Liam CK, Wong CM

Chest, 2001 Mar;119(3):955-7.
PMID: 11243981
Matched MeSH terms: Esophageal Fistula/complications; Esophageal Fistula/congenital*
Fulltext Use of combined contralateral deltopectoral skin flap and ipsilateral island latissimus dorsi myocutaneous flap for massive cervico-thoracic oesophagus defect repair

Yap CM

Med J Malaysia, 2005 Aug;60(3):364-6.
PMID: 16379194

Restoring the intestinal continuity of an acquired massive cervico-thoracic oesophagus defect is a reconstructive challenge. A case requiring such defect restoration following a failed pedicled colonic interposition bypass graft between the cervical oesophagus and stomach for an intra-thoracic oesophageal perforation is presented. The defect between the oesophagostome at the lower left neck and the stoma of the colonic stump at the lower left chest measured about 20 cm. An ante-thoracic skin-tube neo-esophagus was constructed in two stages using a pedicled contralateral right deltopectoral skin flap and a pedicled ipsilateral island left latissimus dorsi myocutaneous flap (LD MC flap). A normal swallowing mechanism was re-established.

Matched MeSH terms: Esophageal Fistula/surgery*
Fulltext Developing a core outcome set for the health outcomes for children and adults with congenital oesophageal atresia and/or tracheo-oesophageal fistula: OCELOT task group study protocol

Ducey J, Lansdale N, Gorst S, Bray L, Teunissen N, Cullis P, et al.

BMJ Paediatr Open, 2024 Feb 05;8(1).
PMID: 38316469 DOI: 10.1136/bmjpo-2023-002262

INTRODUCTION: Heterogeneity in reported outcomes of infants with oesophageal atresia (OA) with or without tracheo-oesophageal fistula (TOF) prevents effective data pooling. Core outcome sets (COS) have been developed for many conditions to standardise outcome reporting, facilitate meta-analysis and improve the relevance of research for patients and families. Our aim is to develop an internationally-agreed, comprehensive COS for OA-TOF, relevant from birth through to transition and adulthood.
METHODS AND ANALYSIS: A long list of outcomes will be generated using (1) a systematic review of existing studies on OA-TOF and (2) qualitative research with children (patients), adults (patients) and families involving focus groups, semistructured interviews and self-reported outcome activity packs. A two-phase Delphi survey will then be completed by four key stakeholder groups: (1) patients (paediatric and adult); (2) families; (3) healthcare professionals; and (4) researchers. Phase I will include stakeholders individually rating the importance and relevance of each long-listed outcome using a 9-point Likert scale, with the option to suggest additional outcomes not already included. During phase II, stakeholders will review summarised results from phase I relative to their own initial score and then will be asked to rescore the outcome based on this information. Responses from phase II will be summarised using descriptive statistics and a predefined definition of consensus for inclusion or exclusion of outcomes. Following the Delphi process, stakeholder experts will be invited to review data at a consensus meeting and agree on a COS for OA-TOF.
ETHICS AND DISSEMINATION: Ethical approval was sought through the Health Research Authority via the Integrated Research Application System, registration no. 297026. However, approval was deemed not to be required, so study sponsorship and oversight were provided by Alder Hey Children's NHS Foundation Trust. The study has been prospectively registered with the COMET Initiative. The study will be published in an open access forum.

Matched MeSH terms: Esophageal Fistula*; Tracheoesophageal Fistula*
Fulltext Aorto-oesophageal fistula and aortic pseudoaneurysm caused by a swallowed fish bone

Sia KJ, Ashok GD, Ahmad FM, Kong CK

Hong Kong Med J, 2013 Dec;19(6):542-4.
PMID: 24310662 DOI: 10.12809/hkmj133668

We describe a rare case of aorto-oesophageal fistula and aortic pseudoaneurysm in a middle-aged man, who presented with chest pain and haematemesis 1 week after swallowing a fish bone. Oesophagogastroduodenoscopy and computed tomographic angiography findings were consistent with oesophageal perforation, proximal descending aortic pseudoaneurysm, and aorto-oesophageal fistula. Thoracic endovascular aortic repair was performed. The patient died from severe mediastinal sepsis. Early surgical intervention and broad-spectrum antibiotic therapy are crucial in preventing life-threatening mediastinal infection.

Matched MeSH terms: Esophageal Fistula/etiology*; Esophageal Fistula/pathology; Esophageal Fistula/surgery
An unique case of thoracic endovascular aortic repair (TEVAR) graft infection with Streptococcus viridans

Zubaidah NH, Azim MI, Osama MH, Harunarashid H, Das S

Clin Ter, 2012;163(1):27-9.
PMID: 22362230

The incidence of infection following TEVAR is low. To the best of our knowledge, this is the first case report of post thoracic endovascular aortic repair (TEVAR) with Streptococcus viridans graft infection. A 54-year-old male underwent TEVAR for dissecting thoracic aneurysm with spinal ischaemia. He had an eventful recovery with prolonged period of stay in intensive care unit. Three months later, he presented with persistent chest discomfort and fever. Computed tomography (CT) of the thorax revealed evidence of graft infection and the blood culture grew Streptococcus viridans. The rarity of TEVAR graft infection due to Streptococcus viridans and its management are being discussed.

Matched MeSH terms: Esophageal Fistula/etiology; Esophageal Fistula/microbiology; Esophageal Fistula/radiography
Fulltext Spontaneous oesophageal perforation: a case report

Shu Ann Hon, Jan Jan Chai, Lian Thai Lee, Qin Jian Low

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):326-328.
MyJurnal

A 49-year-old gentleman presented with epigastric pain for one day associated with one episode of vomiting and dyspnoea. Respiratory examination showed reduced breath sound over his left lower zone. He was treated as left spontaneous pneumothorax and left lung empyema requiring left chest tube insertion and intravenous antibiotics. His left pleural fluid biochemistry result was exudative while its centrifuge showed empyema. In ward, we noticed food material draining from his left chest tube during feeding. An urgent contrast enhanced computed tomography (CECT) thorax showed a left oesophageal-pleural fistula with possible broncho-oesophageal fistula. During oesoph- agogastroduodenoscopy (OGDS), air bubbles were seen in his left under-water chest drainage during air-insufflation of the oesophagus. The revised diagnosis was Boerhaave syndrome. He was treated with an esophageal stent to cover the perforation and a left lung decortication via video assisted thoracoscopic surgery (VATS) for his left empyema. He improved and was discharged well.

Matched MeSH terms: Esophageal Fistula
Fulltext Mutations in KIF27, GNAS and IFT140 genes in a patient with VACTERL association: a case report

Siti Aishah Sulaiman, Nor Azian Abdul Murad, Chow, Yock Ping, Zam Zureena Mohd Rani, Salwati Shuib, Dayang Anita A. Aziz, et al.

Asia-Pacific Journal of Molecular Medicine, 2018;8(2):1-10.
MyJurnal

VACTERL association is a rare genetic disorder involving at least three of the following congenital
malformations: vertebral defects (V), anal atresia (A), cardiac defects (C), trachea-oesophageal fistula with
or without oesophageal atresia (TE), renal anomalies (R) and limb abnormalities (L). Until now, the
aetiology of VACTERL association is unknown, particularly at the molecular level. Here, we performed
whole exome sequencing (WES) of an infant with VACTERL association. The patient was delivered
prematurely at 30 weeks and had 4/6 of the VACTERL malformations. Trio-WES analysis was performed
using Torrent Suite and ANNOVAR. Polymorphisms with an allele frequency of >0.01 were excluded, and
the remaining variants were filtered based on de novo mutations, autosomal recessive, X-linked and di-genic
inheritance traits. In this patient, no homozygous, compound heterozygous or X-linked mutations was
associated with VACTERL. However, we identified two heterozygous mutations; KIF27
(ENST00000297814: c.3004A> C:p.N1002H) and GNAS (ENST00000371098: c.205C>A:p.H69N) genes that
were inherited from her father and mother respectively. A de novo, IFT140 gene mutation
(ENST00000426508: c.683C>G:p.S228C) was also identified in this patient. The VACTERL phenotype in
this patient may due to heterozygous mutations affecting KIF27 and GNAS genes, inherited via autosomal
recessive trait. In addition, the IFT140 gene mutation may also be involved. These genes are known to be
directly or non-directly involved in the sonic hedgehog signalling that is known to be implicated in
VACTERL. This is the first report of these genetic mutations in association with VACTERL.

Matched MeSH terms: Esophageal Fistula