Fourth branchial pouch anomaly

1990 ◽  
Vol 104 (11) ◽  
pp. 905-907 ◽  
Author(s):  
Toru Takimoto ◽  
Tomokazu Yoshizaki ◽  
Hiromi Ohoick ◽  
Hiofo Sakashita
Keyword(s):  
Contrast Material ◽  
Pyriform Sinus ◽  
Fistula Tract ◽  
Clinical Feature ◽  
Internal Opening ◽  
Neck Abscess ◽  
Computed Tomographic ◽  
Characteristic Clinical Feature ◽  
Lower Neck ◽  
Surgical Aspects

AbstractWe present an extremely rare case of fourth branchial fistula in a 23-year-old male. The characteristic clinical feature was a recurrent left lower neck abscess which did not respond to appropriate medical and surgical therapy. Radiography and a computed tomographic scan with contrast material revealed a fistula running from the apex of the left pyriform sinus (internal opening) to the left lower neck abscess. The fistula tract was excised surgically. Histological examination of the excised fistula revealed a squamous epithelial lining and subepithelial lymphoid tissue. This pyriform sinus fistula is thought to be of fourth pharyngeal pouch origin, because of its surgical aspects and the histologicalfindings of the excised fistula.

Pyriform Sinus Fistula: Management with Chemocauterization of the Internal Opening

2000 ◽  
Vol 109 (5) ◽  
pp. 452-456 ◽  
Author(s):  
Kwang Hyun Kim ◽  
Myung-Whun Sung ◽  
Seung Ha Oh ◽  
Tae-Yong Koh ◽  
In-Sang Kim
Keyword(s):  
Computed Tomography ◽  
Pyriform Sinus ◽  
Fistula Tract ◽  
Barium Swallow ◽  
Internal Opening ◽  
Pyriform Sinus Fistula ◽  
Recurrent Fistula ◽  
Swallow Study ◽  
Barium Esophagography ◽  
Operative Findings

A branchial remnant originating in the pyriform sinus causes a recurrent fistula or abscess in the neck. In spite of excision, recurrence may result from inadequate removal of the fistula tract. We attempted chemocauterization of the internal opening of the fistula tract with trichloroacetic acid (TCA) on direct endoscopy. This is a 6-year review of 18 patients with pyriform sinus fistula. Medical history, barium esophagography, computed tomography scans, operative findings, and treatment results were analyzed. By direct endoscopy, all patients were found to have a fistula opening in the pyriform sinus, exclusively on the left side. In only 9 patients, the fistula tract was identified by barium esophagography before operation. Computed tomography revealed a suspicious fistula tract originating from the pyriform sinus in 8 of 10 patients. Sixteen patients were initially managed by TCA chemocauterization. There were no serious intraoperative or postoperative complications. Four patients had recurrent masses, which were managed by simple excision in 2 patients and repeated TCA cauterization in the other 2 patients with unobliterated internal openings. We recommend barium swallow study and direct endoscopy for all patients presenting with a recurrent lateral neck abscess, especially on the left side. Our results suggest that initial chemocauterization of the internal opening can be a reasonable alternative procedure for the management of pyriform sinus fistula.

scholarly journals A comparative study in the management of fistula in ANO using various modalities

2018 ◽  
Vol 5 (6) ◽  
pp. 2223 ◽  
Author(s):  
Ramachandra M. L. ◽  
Mayank Garg
Keyword(s):  
Fistulous Tract ◽  
Selection Method ◽  
Fistula Tract ◽  
Internal Opening ◽  
Necrotic Tissue ◽  
Fistula In Ano ◽  
Sphincter Function ◽  
Medical College ◽  
Operative Complications ◽  
Comparative Prospective Study

Background: Fistula in ano is a track that connects deeply the anal canal or rectum to the skin around the anus. Fistula in ano most commonly follows an anorectal sepsis1. The main principles of management of anal fistula are closure of internal opening of fistula tract, drainage of infection or necrotic tissue, and eradication of fistulous tract with preservation of sphincter function. The objectives were to compare the various aspects like per operative complications, post-operative complications, mean hospital stay in the treatment of fistula in ano using various modalities like fistulotomy, fistulectomy, setons and lift procedure.Methods: This is a randomised, comparative, prospective study of 80 cases of fistula in ano, presenting at surgical opd of K.R. Hospital, Mysore attached to Mysore Medical College and research Institute. Out of which, 20 cases are treated by fistulectomy, 20 by seton, 20 by fistulotomy and the rest 20 cases by LIFT procedure by random selection method, during period of NOVEMBER 1, 2016 to 31st October 2017.Results: Most common age of presentation is 31-40 years and more common in males then females (M:F= 2.3:1 ). Per operative complications include bleeding seen more in patients undergoing fistulectomy. Per operative course of LIFT procedure patients was complication free. Postoperative pain seen more in patients undergoing setons procedure.Conclusions: we conclude that LIFT procedure and Fistulotomy were acceptable procedures for simple, uncomplicated low lying and high lying fistula.

scholarly journals The landscape of circulating platelet aggregates in COVID-19

2021 ◽  
Author(s):  
Yuqi Zhou ◽  
Masako Nishikawa ◽  
Hiroshi Kanno ◽  
Tinghui Xiao ◽  
Takuma Suzuki ◽  
...  
Keyword(s):  
Large Scale ◽  
Multiorgan Failure ◽  
Young Patients ◽  
Clinical Feature ◽  
Platelet Activity ◽  
Multiple Organs ◽  
Characteristic Clinical Feature ◽  
Circulating Platelet Aggregates ◽  
Platelet Aggregates ◽  
D Dimer

A characteristic clinical feature of COVID-19 is the frequent occurrence of thrombotic events. Furthermore, many cases of multiorgan failure are thrombotic in nature. Since the outbreak of COVID-19, D-dimer testing has been used extensively to evaluate COVID-19-associated thrombosis, but does not provide a complete view of the disease because it probes blood coagulation, but not platelet activity. Due to this limitation, D-dimer testing fails to account for thrombotic events which occur despite low D-dimer levels, such as sudden stroke in young patients and autopsy-identified widespread microthrombi in multiple organs. Here we report the landscape of circulating platelet aggregates in COVID-19 obtained by large-scale single-cell image-based profiling and temporal monitoring of the blood of COVID-19 patients (n = 110). Surprisingly, our analysis shows the anomalous presence of excessive platelet aggregates in nearly 90% of all COVID-19 patients, including those who were not clinically diagnosed with thrombosis and those with low D-dimer levels (less than 1 ug/mL). Additionally, results indicate a strong link between the concentration of platelet aggregates and the severity and mortality of COVID-19. Finally, high-dimensional analysis and comparison with other diseases reveal that COVID-19 behaves as a product of thrombosis (localized) and infectious diseases (systemic), as a cause of systemic thrombosis.

scholarly journals Role of therapeutic phlebotomy in management of case of porphyria cutanea tarda (PCT) admitted in tertiary care hospital Vadodara  

2020 ◽  
Vol 8 (1) ◽  
pp. 4-6
Author(s):  
Ashu Dogra
Keyword(s):  
Aminolevulinic Acid ◽  
Tertiary Care Hospital ◽  
Porphyria Cutanea Tarda ◽  
Tertiary Care ◽  
Skin Lesions ◽  
Clinical Feature ◽  
Care Hospital ◽  
Skin Symptoms ◽  
Characteristic Clinical Feature

Porphyria cutanea tarda is the most frequent type of Porphyria worldwide & presents with skin symptoms mainly. Porphyrias can affect peripheral, autonomic and central nervous system. In Porphyria conditions there is accumulation of heme precursors 5 Aminolevulinic acid, Porphobilinogen and porphyrins which are associated with characteristic clinical feature with acute neurovisceral attacks and skin lesions. This case report summarizes Case of PCT that was successfully managed with Therapeutic Phlebotomy.

scholarly journals Mid-Frequency Hearing Loss Is Characteristic Clinical Feature of OTOA-Associated Hearing Loss

Genes ◽  
2019 ◽  
Vol 10 (9) ◽  
pp. 715 ◽  
Author(s):  
Sugiyama ◽  
Moteki ◽  
Kitajiri ◽  
Kitano ◽  
Nishio ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Clinical Features ◽  
Autosomal Recessive ◽  
Japanese Patients ◽  
Copy Number Variations ◽  
Clinical Feature ◽  
Single Nucleotide Variants ◽  
Characteristic Clinical Feature ◽  
Or Gene ◽  
Homozygous Deletions

The OTOA gene (Locus: DFNB22) is reported to be one of the causative genes for non-syndromic autosomal recessive hearing loss. The copy number variations (CNVs) identified in this gene are also known to cause hearing loss, but have not been identified in Japanese patients with hearing loss. Furthermore, the clinical features of OTOA-associated hearing loss have not yet been clarified. In this study, we performed CNV analyses of a large Japanese hearing loss cohort, and identified CNVs in 234 of 2262 (10.3%, 234/2262) patients with autosomal recessive hearing loss. Among the identified CNVs, OTOA gene-related CNVs were the second most frequent (0.6%, 14/2262). Among the 14 cases, 2 individuals carried OTOA homozygous deletions, 4 carried heterozygous deletions with single nucleotide variants (SNVs) in another allele. Additionally, 1 individual with homozygous SNVs in the OTOA gene was also identified. Finally, we identified 7 probands with OTOA-associated hearing loss, so that its prevalence in Japanese patients with autosomal recessive hearing loss was calculated to be 0.3% (7/2262). As novel clinical features identified in this study, the audiometric configurations of patients with OTOA-associated hearing loss were found to be mid-frequency. This is the first study focused on the detailed clinical features of hearing loss caused by this gene mutation and/or gene deletion.

Chemocauterization of the internal opening with trichloroacetic acid as first-line treatment for pyriform sinus fistula

Head & Neck ◽  
2012 ◽  
Vol 35 (3) ◽  
pp. 431-435 ◽  
Author(s):  
Wonjae Cha ◽  
Sung-Woo Cho ◽  
J. Hun Hah ◽  
Tack-Kyun Kwon ◽  
Myung-Whun Sung ◽  
...  
Keyword(s):  
Trichloroacetic Acid ◽  
Pyriform Sinus ◽  
Internal Opening ◽  
Line Treatment ◽  
First Line ◽  
Pyriform Sinus Fistula ◽  
First Line Treatment

scholarly journals FISTLUA-IN-ANO;

2019 ◽  
Vol 26 (02) ◽  
Author(s):  
Mohammad Zarin ◽  
Muhammad Asim Khan ◽  
Syed Asad Maroof Shah
Keyword(s):  
General Surgery ◽  
Endoscopic Treatment ◽  
Fistula Tract ◽  
Internal Opening ◽  
Internal Fistula ◽  
Surgical Wounds ◽  
Sphincter Saving ◽  
One Year ◽  
Key Steps ◽  
Age Range

Objectives:To determine the frequency ofhealing in patients with high lying fistlua in ano undergoing video assisted anal fistula treatment.Study Design:Descriptive cross sectional.Setting: Department of General Surgery, Khyber Teaching Hospital, Peshawar. Period: One year (1stApril 2014 to 31stMarch 2015). Materials and Methods:Total of 153 patients were observed.Karl Storz Video equipment including MeineroFistuloscope is used. Key steps are visualization of the fistula tract, correct localization of the internal fistula opening under direct vision and endoscopic treatment of the fistula. This is followed by an operative phase of fulguration of the fistula tract with cautery and using glycine solution mixed with manitol, curetting the tract with curette and fistula brush. Internal opening is closed with a Vicryl 1 suture.Results:Our study shows 80% patients were in age range 30-40 years, 17% patients were in age range 41-50 years, 3% patients were in age range 51-60 years. Mean age was 38 years with SD ± 2.03. Seventy seven percent patients were male and 23% patients were female. Seventy percent patients had healing while 30% patients didn’t had healing in the specified duration.Conclusion:The main feature of the VAAFT technique is that the procedure is performed entirely under direct endoluminal vision. Moreover, fistuloscopy helps to identify any possible secondary tracts or chronic abscesses. The VAAFT technique is sphincter-saving, and the surgical wounds are extremely small. Our preliminary results are very promising.

scholarly journals Congenital pyriform sinus fistula presenting as a neck abscess in a newborn

Medicine ◽  
2019 ◽  
Vol 98 (44) ◽  
pp. e17784
Author(s):  
Yishu Teng ◽  
Shuling Huang ◽  
Guowei Chen ◽  
Zhixiong Xian ◽  
Saihong Han ◽  
...  
Keyword(s):  
Pyriform Sinus ◽  
Neck Abscess ◽  
Pyriform Sinus Fistula

COMPARATIVE STUDY BETWEEN LIFT PROCEDURE VERSUS SETON PLACEMENT IN THE MANAGEMENT OF FISTULA IN ANO

2021 ◽  
pp. 61-64
Author(s):  
S. Yashwanth ◽  
T. Praneeth
Keyword(s):  
Postoperative Pain ◽  
Fistula Tract ◽  
Internal Opening ◽  
Fistula In Ano ◽  
Medical College ◽  
Group 12 ◽  
Group A ◽  
Intersphincteric Fistula ◽  
Group B ◽  
Seton Placement

INTRODUCTION: A stula-in-ano, is a chronic abnormal communication, usually lined by granulation tissue, which runs outwards from the anorectal lumen. The standards of anal stula surgery are to obliterate the stula, prevent recurrence and maintain sphincter work. Ligation of Intersphincteric Fistula Tract (LIFT) is the most promising surgical technique based on secure closure of the internal opening and removal of the infected crypto glandular tissue through intersphincteric approach. AIMS: To compare the effectiveness of LIFT over SETON procedure based on Postoperative pain on day 1 and2, Short term recurrence, Healing, Procedural visits PATIENTS AND METHODS: A prospective, single centered, interventional study in 60 patients with stula-in-ano admitted to general surgical wards in Narayana Medical College and Hospital, Nellore. From November 2018 to November 2020. Patients were divided into two groups, group A including patients undergoing LIFT procedure and group B, including patients undergoing SETON placement of Fistula-in- ano. RESULTS: Maximum patients were in 41-60 years in the LIFT Group 18(60%), 51-60 years in the SETON group 12(40%). Maximum patients were male 21 in each group (70%), and female were 9 in each group (30%). In the present study, Visual Analog Scale (0,1,2,3) in LIFT group on POD 1, were 2, 20, 6, 2 and in SETON group on POD 1 were 0, 9, 16, 5 respectively. Similarly, visual analogue scale (0,1,2,3) in LIFT group on POD 2, were 19.8.3.0 and in SETON group on POD 2 were 5, 20, 5, 0respectively. Patients who underwent LIFT procedure had a satisfactory postoperative period and the wound healed in all the cases. CONCLUSION: we conclude that LIFT gives good outcomes in terms of Postoperative pain on day 1 and 2, wound healing rate, single time procedure and recurrence during our short follow-up period of 6 months.

Sign in / Sign up

Export Citation Format

Share Document