Ureteroileal fistula: an unusual complication of Crohn's disease

We report a case of urteroileal fistula in a young 22 year-old-man with Crohn's disease, who presented with microscopic hematuria and severe diarrhea. Excretory urogram and retrograde pyelography showed a fistula between the right ureter and the terminal ileum which was successfully managed with conservative approach using a double J ureteral stent.     

Venobronchial fistula: an unusual complication of long-term central venous access

A venobronchial fistula developed between the azygous vein and the upper aspect of the right main bronchus 12 months after completion of the treatment of a stage IIIB non-small-cell lung cancer in a 54-year-old man. The fistula contained the tip of the catheter placed for chemotherapy perfusion. The reported case presented risk factors previously identified for such a complication. In addition, some clinical particularities were present, suggesting new potent risk factors and some preventive means for safe long-term central venous catheterization.     

Colo-cholecystic fistula: an unusual complication of colonic diverticular disease.

Colonic diverticular disease can lead to various complications. We describe a case of an 81-yr-old man who was found to have intrabiliary air on computed tomography of the abdomen. Endoscopic retrograde cholangiopancreatography and subsequent surgical exploration of the abdomen revealed an ascending colonic diverticulum penetrating into the gall bladder. Colocholecystic fistula is an unusual cause of intrabiliary air and, to our knowledge, this has not been reported in the literature.     

Anomalous right subclavian arterial esophageal fistula: an unusual complication of tracheostomy

Fistula formation between an anomalous right subclavian artery and the esophagus is a heretofore unrecognized cause of massive upper gastrointestinal hemorrhage. This complication may result from overinflation of an adjacent tracheostomy balloon. The following case report illustrates difficulties in diagnosis and describes the use of temporary intestinal exclusion to tamponade the bleeding esophagus.     

Case report: sustained-release verapamil overdose causing stroke: an unusual complication.

A 47-year-old woman ingested 7.2 gm of sustained-release verapamil. She developed hypotension, idioventricular rhythm, mild acidosis, mild hyperglycemia, and aspiration pneumonia that required antibiotics and mechanical ventilatory support. In addition, she had a stroke, which resulted from left cerebral hemispheric damage, an unusual complication. Stroke is reported only once in the literature. Special problems related to slow release medication and the need to be aware of them are discussed.     

Duodenocolic fistula: An unusual complication of duodenal diverticulum

Summary The management of two patients with benign duodenocolic fistula is reported. In both patients, laparotomy clearly demonstrated the origin of a fitulous tract arising from a duodenal diverticulum. Microscopic examination of the diverticula failed to disclose the presence of either gastric or pancreatic tissue.     

Arteriocolic fistula: An unusual cause of gastrointestinal-tract bleeding

Summary An unusual case of acute gastrointestinal hemorrhage secondary to an iliac-artery aneurysm to a sigmoidal fistula is presented. Diagnosis and pathogenesis are discussed, and a plan for treatment is proposed. Read at the meeting of the American Society of Colon and Rectal Surgeons, New Orleans, Louisiana, May 2 to 6, 1976.     

Focal extra strength of a stent causing instent hourglass stenosis: an unusual complication

We report an unusual complication of a 25 mm long stent, which did not expand at all for 1 mm in its proximal segment, while rest of the 24 mm length of the stent got fully expanded. Repeated attempts to expand the extremely focal unexpanded part of the stent at high pressure led to rupture of the stent balloon and its entrapment. We failed to retrieve the balloon using various techniques and the patient had to be sent for coronary artery bypass graft surgery.     

Saphenous vein graft aneurysm fistula formation causing right heart failure: an unusual presentation

Saphenous vein graft aneurysm (SVG) formation after coronary artery bypass grafting is a rare complication of the surgery. We present a case of a 68‐year‐old man with an unusual presentation of such an aneurysm. Thirty‐four years after his initial bypass surgery, the patient presented with a fistula formation into his right atrium from a vein graft aneurysm. Late aneurysm formation is thought to occur secondary to atherosclerotic degeneration of the SVG with background hypertension and dyslipidaemia accelerating the process. Diagnostic modalities used to investigate SVG aneurysms include computed tomography, transthoracic echocardiogram, magnetic resonance imaging and cardiac catheterisation. Aneurysms with fistula formation historically require aggressive surgical intervention. Resection of the aneurysm with subsequent revascularisation if required is the surgical norm. SVG aneurysm with fistula formation into a cardiac chamber is a rare complication of coronary artery bypass grafting (CABG), which can occur with atypical presenting symptoms. Physicians should keep in mind the possibility of this occurring in post‐CABG patients presenting with heart failure and a new murmur.     

Sigmoidoappendiceal fistula—An unusual complication of diverticulitis

A case is reported of a sigmoidoappendiceal fistula due to diverticulitis of the sigmoid colon. Only one case has been reported previously.