Cierre de fístula esofago-bronquial refractaria mediante malla de vicryl y cianocrilato
Closure of refractory esophageal-bronchial fistula using vicryl mesh and cyanoacrylate
Rodríguez Martínez S1*, Ozcáriz Zabaleta M1, Labarta Herrera B1, Cuevas Iroz C1, Celay Leoz R1, Fernández-Urien Sain I2.
1 Enfermeras/os Unidad de Endoscopia – Complejo Hospitalario de Navarra.
2 Gastroenterólogo Unidad de Endoscopia – Complejo Hospitalario de Navarra.
Recibido en octubre de 2018; aceptado en febrero de 2019. Disponible en internet desde abril de 2019.
Resumen
Hoy en día las perforaciones esofágicas, fístulas esófago-bronquiales y fugas son cada vez más frecuentes. Hasta ahora la alternativa de elección ante estos problemas, era la colocación de una prótesis metálica esofágica a nivel de la fístula. El problema que tiene esta opción, es la alta capacidad migratoria de una prótesis metálica a esta altura del esófago, a pesar de la fijación con clips y sistemas de sutura. Por ello presentamos este caso clínico, donde el problema no ha podido solucionarse con la colocación hasta en dos ocasiones de prótesis metálica, y que finalmente es solucionado con una exitosa medida alternativa.
Palabras clave:Fístula Esófago-Bronquial, Malla de Vicryl, Cianocrilato, Gastrectomía, Cloaca Mediastínica, Spy-Glass.
Abstract
Between Intestinal Inflammatory Diseases (IBD), Ulcerative Colitis and Crohn’s Disease are the most common chronic gastrointestinal diseases of unknown cause, characterized by an abnormal immune response of the intestine, possibly triggered by a combination of environmental and genetic factors. They are diseases that alternate periods of remission with periods of inflammatory activity (outbreak). Due to their chronic condition, they can be very disabling and have a great impact on the quality of life of the patient and their family members. It also causes important problems in the growth and development (if diagnosed in childhood), education, work life, fertility, psychosocial health, social isolation and emotional overload, with an important impact on using health resources and economic cost. In addition, patients who throughout their lives will experience episodes of symptoms due to their illness and / or complications thereof, entail the requirement of easy access and urgent assistance from the medical team. Taking into account that incidence and prevalence of IBD is increasing and the complex therapeutic approach, leads us to the conclusion that the management of these patients requires a multidisciplinary approach by gastroenterologists, radiologists, surgeons, rheumatologists, dermatologists, psychologists. Among them, nurses specialist on Inflammatory Bowel Disease, do a role endorsed in different consensus documents that provide them skills and knowledge to complement to doctor’s both at assistance and research level…
Keywords: Esophagus-Bronchialfistule, Vicryl Mesh, Cyanocrylate, Gastrectomy, Mediastinal Cloaca, Spy-Glass.
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