Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Percutaneous Treatment of a Jejunovaginal Fistula Using a Combination of the Amplatzer Vascular Plug II and N-Butyl-2-Cyanoacrylate: A Case Report

공장질루의 Amplatzer 혈관폐색장치 II 및 N-Butyl-2-Cyanoacrylate를 이용한 경피적 치료: 증례 보고

  • Lee, Hyun-Kyung (Department of Radiology, Chonbuk National Univesity Medical School and Hospital) ;
  • Kwak, Hyo-Sung (Department of Radiology, Chonbuk National Univesity Medical School and Hospital) ;
  • Han, Young-Min (Department of Radiology, Chonbuk National Univesity Medical School and Hospital) ;
  • Kim, Young-Kon (Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 이현경 (전북의학전문대학원 영상의학과) ;
  • 곽효성 (전북의학전문대학원 영상의학과) ;
  • 한영민 (전북의학전문대학원 영상의학과) ;
  • 김영곤 (성균관의대 삼성서울병원 영상의학과)
  • Published : 2011.04.01
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Abstract

Treatment for an enterovaginal fistula should consider the location of an intestinal fistula. Most rectovaginal fistulas develop in the lower third of the vagina and can be treated surgically. Jejunovaginal fistulas can spontaneously close during conservative management. We report the first use of the Amplatzer vascular plug II (AVP II; AGA Medical Corp, Golden Valley, MN, USA) and the use of an N-butyl-2-cyanoacrylate (NBCA; Histoacryl, Braun, Melsungen, Germany)- iodized oil (Lipiodol Ultra-Fluid, Guerbet, Aulnay-sous-Bois, France) mixture for treatment of a patient with a jejunovaginal fistula which failed to close after conservative management. The patient did not have any vaginal discharge one day later after deployment of the AVP II.

장질루(Endovaginal fistula)의 치료는 질과 연결된 장의 위치에 따라 결정된다. 직장질루(rectovaginal fistula)의 경우 대부분은 질의 하부 1/3에서 발생하고 수술적으로 치료되며 공장질루(jejunovaginal fistula)의 경우 종종 보존적 치료만으로 자연 폐쇄된다. 저자들은 보존적 치료로 호전되지 않는 공장질루를 Amplatzer 혈관폐색장치 II(AVP II; AGA Medical Corp., Golden Valley, MN, USA) 및 N-butyl-2-cyanoacrylate (NBCA; Histoacryl, Braun, Melsungen, Germany)- 요드화유(Lipiodol Ultra-Fluid, Guerbet, Aulnay-sous-Bois, France) 혼합물을 이용하여 성공적으로 치료한 예를 경험하였기에 보고한다.

Keywords

References

  1. Andreani SM, Dang HH, Grondona P, Khan AZ, Edwards DP. Rectovaginal fistula in Crohn's disease. Dis Colon Rectum 2007;50:2215-2222 https://doi.org/10.1007/s10350-007-9057-7
  2. Taylor PM, Johnson RJ, Eddleston B, Hunter RD. Radiological changes in the gastrointestinal and genitourinary tract following radiotherapy for carcinoma of the cervix. Clin Radiol 1990;41:165-169 https://doi.org/10.1016/S0009-9260(05)80960-2
  3. Thorvinger B, Horvath G, Samuelsson L. CT demonstration of fistulas in patients with gynecologic neoplasms. Acta Radiol 1990;31:357-360 https://doi.org/10.1177/028418519003100408
  4. Haddad BR, Usta IM, Khalil A, Mufarrij I. Spontaneous closure of enterovaginal fistula caused by a neglected foreign body. Acta Obstet Gynecol Scand 1994;72:598-600
  5. Zmora O, Tulchinsky H, Gur E, Goldman G, Klausner JM, Rabau M. Gracilis muscle transposition for fistulas between the rectum and urethra or vagina. Dis Colon Rectum 2006;49:1316-1321 https://doi.org/10.1007/s10350-006-0585-3
  6. Boronow RC. Repair of the radiation-induced vaginal fistula utilizing the Martius technique. Word J Surg 1986;10:237-248 https://doi.org/10.1007/BF01658140
  7. Zacharin RF. Grafting as a principle in the surgical management of vesicovaginal and rectovaginal fistulae. Aust N Z J Obstet Gynaecol 1980;20:10-17 https://doi.org/10.1111/j.1479-828X.1980.tb00887.x
  8. Lee BH, Choe DH, Lee JH, Kim KH, Hwang DY, Park SY, et al. Device for occlusion of rectovaginal fistula: clinical trials. Radiology 1997;203:65-69 https://doi.org/10.1148/radiology.203.1.9122417