简介：Objective:Todiscussthediagnosisandmanagementoftraumaticcarotidcavernousfistula(TCCF).Methods:Inall15patientswithTCCFconfirmedbyangiography,8patientsgotearlydiagnosisandcure.WithSeldingertechniqueadpotedinthepunctureoffemoralartery,Magic3F-1.8FBDcatheterscombiningwithballoonwereusedtoembolizethefistulaortheinternalcarotidartery.Results:Earlydiagnosisandcurewereachievedin8patientswithinoneweekandnosequelaeoccurred.Sevenpatientswithdelayeddiagnosiswhowerecuredbeyondoneweekhadsomesequelaesuchashypopsiain5cases,incompleteoculomotorparalysesin3andincompleteabducentparalysesin2.Amongallthe15cases,theinternalcarotidarterywaspreservedin12casesacountingfor80%.Occludingthefistulawithsacrificeoftheinternalcarotidarterywasperformedin3casesandnorepatencyofthefistulaoccurredbyfollowingupbeyondthreemonths.Conclusions:ThepreferredtherapyforTCCFistooccludethefistulausingdetachableballoon.ThediagnosisandtreatmentforTCCFcansignificantlyreduceoccurrencerateofthecomplicationsandsequelae.

简介：AbstractVascular access is the lifeline of hemodialysis patients. There are great differences in the establishment and use of vascular access in different countries and regions around the world. We believe that on the basis of good evaluation and planning, it is recommended that hemodialysis patients choose native arteriovenous fistula first. In view of the new progress of vascular access views domestic and international at home and abroad in recent years, we organized experts to recommend the establishment and maintenance of arteriovenous fistula (AVF) for the Chinese population, including preoperative evaluation and planning of the establishment of AVF, AVF surgery, perioperative drug intervention measures and postoperative maintenance, and put forward suggestions for future research directions. The recommendations in this consensus are general and clinicians need to make treatment decisions based on the actual situation.

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简介：Analfistulaisoneofthethreegreatestanorectaldiseaseswithahighprevalence.Thetraditionaltreatments(e.g.,surgery)forfistulahavelimitationsduetodamagetotheinternalanalsphincterofpatients.Withrecentadvancesinbiomaterials,treatmentsbasedonbiomaterialfilling(e.g.,scleraproteininjection,fistulaplug)haveemergedasnoveltherapiesforfistula.Theanalfistulaplug(e.g.,basedonsmallintestinalsubmucosa(SIS))hasattractedincreasingattentionbecauseofshorttermhealingrateandbiocompatibility.However,challengesremainforthismethodsuchasplugfallingasobservedinclinics.Toaddressthis,thispaperanalyzesthecaseofSISfallingunderphysiologicalconditionfrommechanicalpointofviewusingANSYSsimulation.Itthenproposesthreenewgeometricalstructuresforfistulaplugandcomparestheirmechanicalbehavior(e.g.,axialstress,reactionofconstraint)withthatofclinicallyusedstructure(coneshape).Basedonthesimulation,itoptimizesthegeometricparametersoffistulaplug.Theapproachdevelopedherecanhelptoimprovethedesignoffistulaplugforbetterclinicaltreatments.

简介：Enterovesicalfistulasarenotuncommoninpatientswithinflammatoryormalignantcolonicdisease,however,fistulassecondarytoprimarybladdercarcinomasareextremelyrare.Wehereinreportedapatientpresentingwithintractableurinarytractinfectionduetoenterovesicalfistulaformationcausedbyasquamouscellcarcinomaoftheurinarybladder.Thispatientunderwentenblocresectionofthebladderdomeandinvolvedileum,andrecovereduneventfullywithouturinarycomplaint.Tothebestofourknowledge,thisisthefirstcasereportedintheliterature.

简介：ObjectivesToreportauthors'experiencesinthediagnosisandtreatmentsofcongenitalfirstbranchialfistula(congenitalauriculocervicalfistula).MaterialsandMethodsTwelvecasesofcongenitalfirstbranchialfistulawerereviewed.Ofthese,8underwentfistulectomywithfacialnervedissectionandpartialparotidectomyand4underwentsimplefistulectomy.ResultsTheinneropenings(upperopening)offistulaelayinthefollowingsites:inferioposteriorwallatthejunctionofcartilaginousandbonysegmentsoftheauricularcanalandinferiorwallofcartilaginousauricularcanal.Theouteropenings(loweropening)layalongtheanteriorborderofuppersternocleidomastoidmuscle,atthemastoidtipandposteriortothemandibularangle.Completefistulaeresectionwasachievedinallbutonecase.Elevencaseswerefollowedfor5yearwithnorecurrence.Recurrenceoccurredin1case6monthsaftertheprimarysurgeryandrevisionsurgerywasperformed.ConclusionsPre-operativeradiographyforthelocationandcourseofthefistulaiscrucialforsuccessfulfistularesection,especiallyincaseswithpastinfections.Facialnervedissectionshouldbedoneroutinelyfordeeplylocatedfistulae.

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简介：棘球蚴病被类包虫的幼虫的阶段引起。实时棘球囊能破裂进生理的隧道，免费体腔或邻近的机关。尽管棘球蚴病罐头在人的身体发展在任何地方，肝是最经常深奥的机关，由肺列在后面。怒气的包囊是不平常的。仅仅有在文学的肝棘球囊的自发的皮肤的成瘘2.造瘘术的五份病案报告。但是关于脾的棘球囊引起的皮肤的管没有任何报告。我们报导感染的脾的棘球囊的自发的皮肤的管的第一个案例。一个43岁的人从腹壁腹的疼痛和液体排水地进入我们的紧急情况服务。他一直在受不了为四个月的在腹壁皮肤上的微红的胀大。在白膜从他的腹壁外面被耸出以后，他进入我们的紧急情况服务。在体格检查上，白膜被看见从2厘米x外面耸出umblicus的左上外侧地点上的1个厘米皮肤缺点。9.5厘米直径的大、复杂、膀胱、稳固的质量在ultrasonographic检查上位于怒气。在操作，部分囊切除术和排水被执行。在操作以后，他每albendazole的天被给10mg/kg的剂量，把剂量划分了成三。他被解除在上手术后10(th)d。脾的棘球囊能引起如此的稀罕复杂并发症，这应该被记住。

简介：Objective:Toreportasurgicalmethodforthetreatmentofpre-auricularfistulatolowerpost-operativerecurrencerate.Methods:Clinicaldataof187patientswithpre-auricularfistulawhounderwentenblocresectionattheAffiliatedHospitalofLuzhouMedicalCollegefromAugust2006toNovember2012wereretrospectivelyreviewed.FactorsthatmightaffecttheprognosisfollowingEnblocfistularesectionborderedbythesuperficialtemporalisfascia,helixperichondriumandauriculocephalicsulcuswereinvestigated.Results:Ofthe187patients,181achievedprimaryhealingand6endedupwithdelayedhealing.Duringthefollow-upperiod(onetosevenyears),therewere4casesofrecurrence(2.1%).Conclusions:Cleardemarcationofsurgicalresectioncanfacilitateeasyandthoroughresectionofpreauricularfistulaandleadtolowrecurrencerate.Propertimingandcarefulsearchforpotentialfistulabranchesarethetwocrucialfactorsaffectingprognosis.

简介：AbstractBackground:Carotid cavernous fistula is a rare complication that is typically associated with head trauma and skull base fractures. The traumatic bilateral carotid cavernous fistula are significantly rarer.Case presentations:We report a case of a 61-year-old man presenting with unilateral exophthalmos, swollen eyelids, conjunctival congestion, and edema etiologically associated with severe trauma. Thereafter, the patient demonstrated symptoms of contralateral oculomotor nerve injury caused by skull base fracture, such as ptosis of eyelid, dilated pupils, and eye movement disorder, and was diagnosed with bilateral carotid cavernous fistula.Conclusions:The patient recovered after undergoing endovascular embolization of bilateral cavernous sinus fistulas. The patient demonstrated the classic symptoms of an extremely rare condition known as bilateral carotid cavernous fistula, in only one eye. Reporting and analyzing this case will help us elucidate the underlying mechanisms of this disease.

简介：Endovascularembolismtechniquehasbeendemonstratedtobethebestinitialoptionfortreatmentofcarotidcavernousfistula(CCF).SeverallargeseriesreportshaveshownthatmostCCFscanbesuccessfullyoccludedviatransarterialortransvenousendovascularapproach.1-6ThispaperreportsacaseofCCFrecurredafterendovascularocclusionofinternalcarotidartery(ICA)proximaltothefistula.AnewtechniquehasbeendescribedfortransarterialembolizationwithtungstenmicrocoilsviasurgicalexposuretoICA,whichhasnotbeenreportedpreviouslyintheliteratures.

简介：Aone-year-oldbabygirlwithone-monthhistoryofrecurrentpusfluidexudingfromherleftpreauricularsinusorifice,whofailedmultiplecoursesofsurgicaldrainageoftheabscessandpersistentdebridementforthewound,presentedwithMRSAinfection.Thepatientwastreatedwithlinezolidforthreedays.Herpainandparesthesiaresolved,andC-reactiveproteindecreasedtonormal.

简介：INTRODUCTIONInterventiontherapyhasbecomeoneofthemaintherapiesofhepaticcancer.Theintroductionofhepaticarterialperfusionandembolizationhasprovidedopportunitiesforasecondaryoperationonpatientswithintermediateandadvancedcancer,thusprolonging

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简介：AbstractBackground:Pleural-subarachnoid fistula (PSF) is a rare disease that is difficult to diagnose and treat. Secondary intracranial hypertension and the treatment are seldom mentioned previously among PSF.Case presentation:A 1-year-old boy diagnosed PSF developed into secondary intracranial hypertension after conservative treatment. He was finally cured by down-step treatment of mannitol, avoiding form ventricleperitoneal shunt. Then, we reviewed the literature of pleural-subarachnoid fistula. Fifty-six cases have been reported so far. Most of the cases (51.8%) were caused by surgery; only 17.9% were caused by car accidents. Regarding the treatment, half of the cases cured by surgery and the other by conservative measures. Our case is the first one involving secondary intracranial hypertension and cured by down-step treatment of mannitol.Conclusions:A comprehensive examination should be performed before the treatment to avoid any inappropriate medical strategies. Secondary acute intracranial hypertension may be cured by down step treatment of mannitol, evading from the long-term ventriculoperitoneal shunt.

简介：INTRODUCTIONPulmonaryarteriovenousfistula(PAVF)isararecongenitalpulmonaryvascularmalformationwiththeincidenceof2-3/100,000.Itistheabnormalcommunicationbetweenthepulmonaryarteryandpulmonaryvein.Theclinicalmanifestationsofthisdiseasearevarioussothatitiseasytobemisdiagnosed1.Atpresent,DSAisthegoldstandardforthediagnosisof

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简介：AbstractIncidence of inadvertent arterial puncture secondary to central venous catheter insertion is not common with an arterial puncture rate of <1%. This is due to the advancements and wide availability of ultrasound to guide its insertion. Formation of arteriovenous fistula after arterial puncture is an unexpected complication. Till date, only five cases (including this case) of acquired arteriovenous fistula formation has been described due to inadvertent common carotid puncture. The present case is a 26-year-old man sustained traumatic brain injuries, chest injuries and multiple bony fractures. During resuscitative phase, attempts at left central venous catheter via left internal jugular vein under ultrasound guidance resulted in inadvertent puncture into the left common carotid artery. Surgical neck exploration revealed that the catheter had punctured through the left internal jugular vein into the common carotid artery with formation of arteriovenous fistula. The catheter was removed successfully and common carotid artery was repaired. Postoperatively, the patient recovered and clinic visits revealed no neurological deficits. From our literature review, the safest method for removal is via endovascular and open surgical removal. The pull/push technique (direct removal with compression) is not recommended due to the high risk for stroke, bleeding and hematoma formation.