Closure of bronchopleural fistula with Angio-Seal

Bronchopleural fistula is rare and occurs most often after trauma or surgery. Conservative management and support comprise the initial treatment, but if unsuccessful, surgical closure is usually required. We describe for what is to our knowledge the first successful use of an Angio-Seal vascular closure device in a patient who was not a candidate for surgery.     

Iatrogenic femoral arteriovenous fistula

Twelve iatrogenic femoral arteriovenous fistulas are reported, 11 of which arose from the superficial or deep femoral arteries. All but two occurred in association with cardiac angiographic procedures. It appears that the femoral crease was used as a landmark to establish the cutaneous entry point for vascular puncture and resulted in an excessively distal puncture site. The femoral crease is an unreliable landmark in many patients. This complication may be minimized by using physical examination to identify the level of the inguinal ligament or fluoroscopy to localize the distal half of the femoral head.     

Iatrogenic intrahepatic arterial-portal fistula

We describe a case of an iatrogenic intrahepatic arterial-portal fistula that developed after percutaneous transhepatic variceal embolization. The fistula led to early recurrent bleeding after embolization and was successfully treated by selective catheter occlusion with the use of a coil spring. The occurrence and management of arterial-portal fistulae in interventional liver procedures and ethanol embolization of gastroesophageal varices are discussed.     

Identification of a bronchopleural fistula by computerized tomography--a case report

A case report is presented of a bronchopleural fistula demonstrated on computed tomography (CT) scan but not identifiable on plain radiographs. The case illustrates the importance of CT in evaluating the pleural space.     

支气管胸膜瘘介入治疗及研究进展

支气管胸膜瘘是肺切除术后严重威胁患者生命的并发症。随着介入放射学的发展,支气管胸膜瘘的介入治疗方法也逐渐多样。本文就支气管胸膜瘘的介入治疗及研究进展进行综述。     

Detection of bronchopleural fistula by ventilation scintigraphy. Based on one case

Bronchopleural fistula (BPF) is a rare but extremely serious complication of lung resection surgery. Its diagnosis is often overlooked in the clinical evolution of the patients undergoing surgery due to the subacute presentation of the picture. The procedures used to detect it are either invasive or have low accuracy. We report the case of a patient with lung carcinoma treated by left pneumonectomy in whom BPF was suspected after an episode of coughing and expectoration. The conventional chest x-ray did not show any significant findings while the (99m)Tc-DTPA ventilation lung scintigraphy demonstrated bronchopleural communication in a very early phase.     

Intrapleural nasogastric tube insertion

A misplaced fine-bore nasogastric tube (NGT) might enter the bronchial tree. Pleural puncture and intrapleural passage of the tube is very uncommon but the location can often be inferred from the frontal chest radiograph. Following recognition of a NGT within the pleural space, progress films should be carefully screened for complications, particularly pneumothorax. This is often not done by staff involved in the monitoring of such patients because the staff frequently do not recognize the signs of intrapleural NGT insertion.     

Retroperitoneal-pericardial fistula caused by a perinephric abscess

A case of a perinephric abscess complicated by a fistulous tract leading to the pericardium is presented. We report herein on the conventional radiological findings.     

Mediastinal pseudotumor, caused by a carotid-jugular fistula

The author presents the case of a mediastinal pseudotumour which can be explained by abnormally elongated and dilated large veins close to the heart. The reason for this rare ectasia of the venous system was a cervical fistula which had been existing for several years between the carotid artery at bifurcation level and the jugular vein following a war injury. Arteriography had originally been conducted because of subarachnoidal bleeding.