A Case Series of Late Gastrointestinal Fistulization in 16 Patients with Walled-Off Necrosis

Rana, Surinder Singh; Sharma, Ravi; Dhalaria, Lovneet; Kang, Mandeep; Gupta, Rajesh

doi:10.1007/s10620-021-06900-y

Cited by 4 publications

(5 citation statements)

References 20 publications

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“…They can develop in a notable proportion of patients who have undergone surgical repair for perforated peptic ulcers, with a reported occurrence ranging from 2% to 7%. Moreover, they are present in approximately 4% of cases of severe acute pancreatitis, 3% after gastrectomy for gastric cancer, and 1% following the diagnostic procedure called endoscopic retrograde cholangiopancreatography (ERCP) [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Reno-Duodenal Fistula as a Complication of Staghorn Stones and Renal Pelvis Tumor: A Case Presentation

Alnefaie,

Alsolumany,

Aljahdali

et al. 2024

Cureus

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Reno alimentary fistula, a rare illness characterized by improper connection between the kidney and digestive tract, can lead to urinary tract infections, abscesses, and severe sepsis. It can also be caused by various factors such as chronic infections, malignancy, cryoablation, or abdominal surgical procedures. We present a case of a 60-year-old man with bilateral staghorn stones who was diagnosed with reno-duodenal fistula and underwent a right simple nephrectomy and fistula closure. The histopathology revealed a well-differentiated squamous cell carcinoma that originated from the renal pelvis.

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Section: Introductionmentioning

confidence: 99%

Reno-Duodenal Fistula as a Complication of Staghorn Stones and Renal Pelvis Tumor: A Case Presentation

Alnefaie,

Alsolumany,

Aljahdali

et al. 2024

Cureus

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“…7,[10][11][12][13] With current changes in treatment strategies, recent studies have shown that minimally invasive percutaneous and endoscopic transcatheter treatment modalities can reduce the proportion of patients with gastrointestinal fistulas undergoing surgery. 14,15 There are relatively few studies of necrotizing pancreatitis complicated by gastrointestinal fistulas receiving step-up therapy, 12,15,16 which consist mainly of small sample studies or case reports; Therefore, we attempted to determine the incidence, specific risk factors, clinical outcomes, and effectiveness of minimally invasive interventions for gastrointestinal fistulas with this large retrospective sample of necrotizing pancreatitis.…”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal Fistulas in Necrotizing Pancreatitis Receiving a Step-Up Approach Incidence, Risk Factors, Outcomes and Treatment

Liu,

Ke,

Xiong

et al. 2023

JIR

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Necrotizing pancreatitis (NP) complicated by gastrointestinal fistula is challenging and understudied. As the treatment of necrotizing pancreatitis changed to a step-up strategy, we attempted to evaluate the incidence, risk factors, clinical outcomes and treatment of gastrointestinal fistulas in patients receiving a step-up approach. Methods: Clinical data from 1274 patients with NP from 2014-2022 were retrospectively analyzed. Multivariable logistic regression analysis was conducted to identify risk factors and propensity score matching (PSM) to explore clinical outcomes in patients with gastrointestinal fistulas. Results: Gastrointestinal fistulas occurred in 8.01% (102/1274) of patients. Of these, 10 were gastric fistulas, 52 were duodenal fistulas, 14 were jejunal or ileal fistulas and 41 were colonic fistulas. Low albumin on admission (OR, 0.936), higher CTSI (OR, 1.143) and invasive intervention prior to diagnosis of gastrointestinal fistula (OR, 5.84) were independent risk factors for the occurrence of gastrointestinal fistula, and early enteral nutrition (OR, 0.191) was a protective factor. Patients who developed a gastrointestinal fistula were in a worse condition on admission and had a poorer clinical outcome (p<0.05). After PSM, both groups of patients had similar baseline information and clinical characteristics at admission. The development of gastrointestinal fistulas resulted in new-onset persistent organ failure, increased open surgery, prolonged parenteral nutrition and hospitalization, but not increased mortality. The majority of patients received only conservative treatment and minimally invasive interventions, with 7 patients (11.3%) receiving surgery for upper gastrointestinal fistulas and 11 patients (26.9%) for colonic fistulas. Conclusion: Gastrointestinal fistulas occurred in 8.01% of NP patients. Independent risk factors were low albumin, high CTSI and early intervention, while early enteral nutrition was a protective factor. After PSM, gastrointestinal fistulas resulted in an increased proportion of NP patients receiving open surgery and prolonged hospitalization. The majority of patients with gastrointestinal fistulas treated with step-up therapy could avoid surgery.

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“…TGI después de la diseminación de la inflamación y de la necrosis pancreática. [6][7] La fistulización al TGI, es una complicación temida del manejo expectante del WON. Su incidencia en WON asintomático o infectado es del 11.5% y 38% respectivamente.…”

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“…4,6 La fístula a estómago representaría entre el 23% y 44% de todos los casos, siendo el colon y el duodeno los sitios más frecuentemente afectados. 4,6,8 La ecoendoscopia es el método de elección para caracterizar el WON, determinar si el abordaje será endoscópico o quirúrgico y prever el número de sesiones endoscópicas requeridas para el drenaje. 9 Hay escasos datos sobre el curso clínico y el resultado de la fistulización del WON.…”

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Necrosectomía endoscópica transmural a través de fístula pancreático gástrica espontánea secundaria a necrosis encapsulada infectada

Ramirez Garcia,

Vargas-Alayza,

Ravelo

2023

ACTA

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La clasificación de Atlanta hace una importante distinción entre las colecciones compuestas sólo por fluidos y las que contienen tejido necrótico. En este último grupo, la necrosis encapsulada o amurallada se refiere a una colección encapsulada de necrosis pancreática y/o peri pancreática que presenta una pared bien definida. Cuando es asintomática el tratamiento es conservador; cuando está infectada requiere drenaje.La ruptura espontánea de la necrosis encapsulada hacia el tracto gastrointestinal es un evento raro. Presentamos el caso de una paciente con una hemorragia digestiva alta secundaria a una fístula pancreático gástrica ocasionada por una necrosis pancreática encapsulada infectada. Días después de realizada la endoscopía alta debido a la hemorragia, se observó un incremento en el diámetro de la fístula, a través de la cual se realizó exitosamente la necrosectomía endoscópica, logrando que la paciente mejorara notablemente luego de la segunda sesión.

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A Case Series of Late Gastrointestinal Fistulization in 16 Patients with Walled-Off Necrosis

Cited by 4 publications

References 20 publications

Reno-Duodenal Fistula as a Complication of Staghorn Stones and Renal Pelvis Tumor: A Case Presentation

Reno-Duodenal Fistula as a Complication of Staghorn Stones and Renal Pelvis Tumor: A Case Presentation

Gastrointestinal Fistulas in Necrotizing Pancreatitis Receiving a Step-Up Approach Incidence, Risk Factors, Outcomes and Treatment

Necrosectomía endoscópica transmural a través de fístula pancreático gástrica espontánea secundaria a necrosis encapsulada infectada

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