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Yang Z, Qin S, Li X. Esophageal foreign body removal under holmium laser-assisted gastroscope: A case report. Front Surg 2023; 10:1094160. [PMID: 36733890 PMCID: PMC9886868 DOI: 10.3389/fsurg.2023.1094160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/03/2023] [Indexed: 01/18/2023] Open
Abstract
As a common clinical emergence, esophageal foreign body can lead to esophageal perforation followed by severe complications including aortic injury, mediastinal abscess and airway obstruction, leading to a high rate of mortality. Therefore, fast and effective diagnosis and treatment are of great necessity. In this case, holmium laser-assisted gastroscopy was adopted to remove the foreign body incarcerated in the esophagus, allowing patients to avoid traumatic and costly surgeries. It is a supplement to traditional methods of foreign body removal. The new combination tried in this report can bring development and innovation inspiration to the development of endoscopic technology.
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Seghers VJ, Kan JH, Somcio R, Sher AC, Paul Guillerman R, Sammer MBK. CT imaging of esophageal foreign bodies in children: a pictorial essay. Jpn J Radiol 2022; 40:262-270. [PMID: 34661860 DOI: 10.1007/s11604-021-01201-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/21/2021] [Indexed: 11/26/2022]
Abstract
Foreign body (FB) ingestion is common in children, particularly from 6 months to 3 years of age. As young children may be unable to provide a clinical history and the ingestion is often unwitnessed, imaging plays an important role in diagnosis, predicting outcomes and detecting complications that require surgical intervention. Since 2015, our institution's diagnostic algorithm for suspected airway foreign bodies has included a noncontrast airway FB CT (FB-CT) with the z-axis coverage spanning from the larynx to the proximal segmental bronchi of the lower lung zones. The effective dose of radiation from this FB-CT airway protocol is typically less than 1 mSv, compared to an effective dose of just under 1 mSv to up to 3 mSv for a fluoroscopic esophagram in children under 10 years of age and 1-3 mSv for a routine pediatric CT chest. In using the FB-CT airway protocol at our institution, we observed that esophageal rather than airway FBs were sometimes encountered on these exams. However, the confidence among radiologists for definitively diagnosing an esophageal foreign body on noncontrast CT was variable. Consequently, we created a teaching module of positive cases for our group of 21 pediatric body radiologists to increase their diagnostic confidence. This pictorial essay illustrates our institutional experience and can help others to confidently diagnose esophageal foreign bodies using a dedicated CT foreign body imaging protocol. At a similar radiation dose to a fluoroscopic esophagram, CT provides the additional advantage of an expedited diagnosis without the need for a radiologist on site.
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Affiliation(s)
- Victor J Seghers
- Singleton Department of Pediatric Radiology, Texas Children's Hospital, 6701 Fannin Street, Houston, TX, 77030, USA.
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA.
| | - J Herman Kan
- Singleton Department of Pediatric Radiology, Texas Children's Hospital, 6701 Fannin Street, Houston, TX, 77030, USA
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA
| | - Ray Somcio
- Singleton Department of Pediatric Radiology, Texas Children's Hospital, 6701 Fannin Street, Houston, TX, 77030, USA
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA
| | - Andrew C Sher
- Singleton Department of Pediatric Radiology, Texas Children's Hospital, 6701 Fannin Street, Houston, TX, 77030, USA
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA
| | - R Paul Guillerman
- Singleton Department of Pediatric Radiology, Texas Children's Hospital, 6701 Fannin Street, Houston, TX, 77030, USA
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA
| | - Marla B K Sammer
- Singleton Department of Pediatric Radiology, Texas Children's Hospital, 6701 Fannin Street, Houston, TX, 77030, USA
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA
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Feinmesser G, Eyal A, Shrot S, Belenky EA, Mansour J, Livneh N, Knoller H, Schindel H, Alon EE. Comparison of lateral neck X-ray to neck CT in patients with suspicious bone impaction: "Old habits die hard". Am J Otolaryngol 2022; 43:103237. [PMID: 34560599 DOI: 10.1016/j.amjoto.2021.103237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 09/11/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Bone impaction (BI) is a common cause for emergency room visits. Among foreign bodies, fish bone is considered the most common. The sensitivity of symptoms in predicting BI is relatively low, making imaging a central tool to aid diagnosis. Current imaging practices include both neck plain film radiography and none-contrast CT scans of the neck. We evaluated the accuracy of neck plain film radiography and CT scans of the neck for the diagnosis of BI. METHODS Retrospective review of all patients who presented to the emergency room between 2009 and 2016 with a suspicious history of BI whom underwent plain film neck radiography or CT. All Images were reviewed by two neuro-radiologist blinded to the clinical symptoms and findings. Symptoms, clinical findings and images results were compared to the final diagnosis. RESULTS 89 patients (30.7%), out of 290 patients who presented with complaints of BI, were diagnosed with BI. Mean age was 44.7 years old. Plain film neck radiography failed to predict BI (sen. 14.4%, spe 89.8% accuracy 63.2%), neck CT has an improved accuracy and sensitivity in locating BI (sen. 83.3%, spe. 94.1% accuracy 92.5%). Interobserver agreement between the two neuro-radiologists was moderate (0.46) and substantial (0.77) in neck radiography and CT images, respectively. Neck radiography missed 60 (out of 61) oropharyngeal BI's. CONCLUSION Neck radiography has high inter-observer variability and low sensitivity for the diagnosis of BI. Neck CT should be the first imaging modality in patients with suspicious complaints for BI and negative physical exam.
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Affiliation(s)
- Gilad Feinmesser
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Tel Hashomer 526200, Israel.
| | - Ana Eyal
- Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer 526200, Israel.
| | - Shai Shrot
- Sackler Faculty of Medicine, Tel Aviv University, 6997802, Israel; Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer 526200, Israel
| | - Eugenia A Belenky
- Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer 526200, Israel.
| | - Jobran Mansour
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Tel Hashomer 526200, Israel; Sackler Faculty of Medicine, Tel Aviv University, 6997802, Israel
| | - Nir Livneh
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Tel Hashomer 526200, Israel
| | - Hadas Knoller
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Tel Hashomer 526200, Israel
| | - Hilla Schindel
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Tel Hashomer 526200, Israel
| | - Eran E Alon
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Tel Hashomer 526200, Israel; Sackler Faculty of Medicine, Tel Aviv University, 6997802, Israel.
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Li SY, Miao Y, Cheng L, Wang YF, Li ZQ, Liu YB, Zou TM, Shen J. Surgical treatment of delayed cervical infection and incomplete quadriplegia with fish-bone ingestion: A case report. World J Clin Cases 2021; 9:7535-7541. [PMID: 34616823 PMCID: PMC8464462 DOI: 10.12998/wjcc.v9.i25.7535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/20/2021] [Accepted: 05/20/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The most commonly ingested foreign body in Asians is fish bone. The vast majority of patients have obvious symptoms and can be timely diagnosed and treated. Cases of pyogenic cervical spondylitis and diskitis with retropharyngeal and epidural abscess resulting in incomplete quadriplegia due to foreign body ingestion have been rarely reported. The absence of pharyngeal or esophageal discomfort and negative computed tomography (CT) findings of fish bone have not been reported. We report the case of an elderly female patient with delayed cervical infection and incomplete quadriplegia who had a history of fish bone ingestion.
CASE SUMMARY A 73-year-old woman presented with right neck pain and weakness of four limbs for a week, and had a history of fish bone ingestion and negative findings on laryngoscopic examination one month previously. She did not complain of any pharyngeal or esophageal discomfort. Cervical magnetic resonance imaging showed C4/C5 spondylitis and diskitis along with retropharyngeal and ventral epidural abscesses. No sign of fish bone was detected on lateral cervical radiography and CT scans. The muscle strength of the patient’s right lower limb receded to grade 1 and other limbs to grade 2 suddenly on the 10th day of hospitalization. Emergency surgery was performed to drain the abscess and decompress the spinal cord by removing the anterior inflammatory necrotic tissue. Simultaneously, flexible esophagogastroduodenoscopy was carried out and a hole in the posterior pharyngeal wall was found. The motor weakness of the right lower limb improved to grade 3 and the other limbs to grade 4 within 2 d postoperatively.
CONCLUSION This rare case highlights the awareness of the posterior pharyngeal or esophageal wall perforation in patients with cervical pyogenic spondylitis along with a history of fish bone ingestion, even though local discomfort symptoms are absent and the radiological examinations are negative.
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Affiliation(s)
- Suo-Yuan Li
- Department of Orthopaedic Surgery, the Affiliated Suzhou Hospital of Nanjing Medical University; Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
| | - Ye Miao
- Department of Orthopaedic Surgery, the Affiliated Suzhou Hospital of Nanjing Medical University; Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
| | - Liang Cheng
- Department of Orthopaedic Surgery, the Affiliated Suzhou Hospital of Nanjing Medical University; Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
| | - Ye-Feng Wang
- Department of Orthopaedic Surgery, the Affiliated Suzhou Hospital of Nanjing Medical University; Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
| | - Zhi-Qiang Li
- Department of Orthopaedic Surgery, the Affiliated Suzhou Hospital of Nanjing Medical University; Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
| | - Yu-Bo Liu
- Department of Orthopaedic Surgery, the Affiliated Suzhou Hospital of Nanjing Medical University; Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
| | - Tian-Ming Zou
- Department of Orthopaedic Surgery, the Affiliated Suzhou Hospital of Nanjing Medical University; Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
| | - Jun Shen
- Department of Orthopaedic Surgery, the Affiliated Suzhou Hospital of Nanjing Medical University; Suzhou Municipal Hospital, Suzhou 215000, Jiangsu Province, China
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Sammer MBK, Kan JH, Somcio R, Sher AC, Hansen CM, Pahlka RB, Guillerman RP, Seghers VJ. Chest CT for the Diagnosis of Pediatric Esophageal Foreign Bodies. Curr Probl Diagn Radiol 2021; 50:566-570. [PMID: 33745769 DOI: 10.1067/j.cpradiol.2021.03.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 03/04/2021] [Indexed: 01/08/2023]
Abstract
Foreign body ingestion is a common problem in children. Radiography is the mainstay of imaging, but many radiolucent items go undetected without further imaging by fluoroscopic esophagram. While studies in adults support the use of computed tomography (CT) for esophageal foreign body ingestion, CT has historically not been used in children given the typically higher radiation doses on CT compared with fluoroscopy. In distinction to an esophagram, CT does not require oral contrast nor presence of an onsite radiologist and can be interpreted remotely. At our institution, a dedicated CT protocol has been used for airway foreign bodies since 2015. Given the advantages of CT over esophagram, we retrospectively reviewed institutional radiation dose data from 2017 to 2020 for esophagrams, airway foreign body CT (FB-CT), and routine CT Chest to compare effective doses for each modality. For ages 1+ years, effective dose was lowest using the FB-CT protocol; esophagram mean dose showed the most variability, and was over double the dose of FB-CT for ages 5+ years. Routine CT chest doses were uniformly highest across all age ranges. Given these findings, we instituted a CT foreign body imaging protocol as the first-line imaging modality for radiolucent esophageal foreign body at our institution.
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Affiliation(s)
- Marla B K Sammer
- Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston TX.; Department of Radiology, Baylor College of Medicine, Houston TX
| | - J Herman Kan
- Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston TX.; Department of Radiology, Baylor College of Medicine, Houston TX
| | - Ray Somcio
- Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston TX.; Department of Radiology, Baylor College of Medicine, Houston TX
| | - Andrew C Sher
- Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston TX.; Department of Radiology, Baylor College of Medicine, Houston TX
| | - Carly M Hansen
- Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston TX
| | - R Benton Pahlka
- Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston TX
| | - R Paul Guillerman
- Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston TX.; Department of Radiology, Baylor College of Medicine, Houston TX
| | - Victor J Seghers
- Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston TX.; Department of Radiology, Baylor College of Medicine, Houston TX..
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Aiolfi A, Ferrari D, Riva CG, Toti F, Bonitta G, Bonavina L. Esophageal foreign bodies in adults: systematic review of the literature. Scand J Gastroenterol 2019; 53:1171-1178. [PMID: 30394140 DOI: 10.1080/00365521.2018.1526317] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Esophageal Foreign Body (FB) impaction represents a major challenge for healthcare providers. Aim of this systematic review was to analyse the current literature evidence on prevalence, presentation, treatment, and outcomes of impacted esophageal FB. MATERIALS AND METHODS Literature search was conducted between 2000 and 30th June 2018 according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. RESULTS Sixty-one studies matched the inclusion criteria. The total number of included patients was 13,092. The cervical esophagus was the most frequent impaction site (67%) and sharp-pointed objects were the most common FB (38.1%). Retrosternal pain (78%), dysphagia (48%), and odynophagia (43.4%) were the most common symptoms. A flexible or rigid endoscopic approach was adopted in 65.1% and 16.8% of patients, respectively. Overall, 17.8% of patients had a complication related to the impacted esophageal FB or to the endoscopic manoeuvers. A surgical approach was required in 3.4% of patients. The overall mortality was 0.85%. CONCLUSIONS Surgery is the upfront treatment in patients with esophageal perforation or endoscopically irretrievable esophageal FB. A minimally invasive approach can be adopted in selected patients. Effective prevention of FB impaction should focus on accurate diagnostic work-up to search for an underlying motility disorder after a first episode of esophageal impaction, even if transient and self-resolving.
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Affiliation(s)
- Alberto Aiolfi
- a Department of Biomedical Science for Health, Division of General Surgery IRCCS Policlinico San Donato , University of Milan , Milan , Italy
| | - Davide Ferrari
- a Department of Biomedical Science for Health, Division of General Surgery IRCCS Policlinico San Donato , University of Milan , Milan , Italy
| | - Carlo Galdino Riva
- a Department of Biomedical Science for Health, Division of General Surgery IRCCS Policlinico San Donato , University of Milan , Milan , Italy
| | - Francesco Toti
- a Department of Biomedical Science for Health, Division of General Surgery IRCCS Policlinico San Donato , University of Milan , Milan , Italy
| | - Gianluca Bonitta
- a Department of Biomedical Science for Health, Division of General Surgery IRCCS Policlinico San Donato , University of Milan , Milan , Italy
| | - Luigi Bonavina
- a Department of Biomedical Science for Health, Division of General Surgery IRCCS Policlinico San Donato , University of Milan , Milan , Italy
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Klein A, Ovnat-Tamir S, Marom T, Gluck O, Rabinovics N, Shemesh S. Fish Bone Foreign Body: The Role of Imaging. Int Arch Otorhinolaryngol 2018; 23:110-115. [PMID: 30647794 PMCID: PMC6331292 DOI: 10.1055/s-0038-1673631] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 07/22/2018] [Indexed: 02/07/2023] Open
Abstract
Introduction
Fish bone foreign body (FFB) impaction in the upper aerodigestive tract is a common cause for emergency department referral. Its management varies in both diagnosis and treatment paradigms. Fish bone foreign bodies are more commonly found in the oropharynx in cases of patients < 40 years old, and in the esophagus in cases of patients > 40 years old. Symptoms are typically non-indicative for the location of the FFB, with the exception of foreign body sensation at/superior to the cervical esophagus. A lack of findings during the physical examination is routinely followed by imaging, with computed tomography (CT) being the preferred modality. In practice, many patients undergo unnecessary imaging studies, including CT scans.
Objectives
To identify patients with suspected fish bone impaction who do not require CT imaging and can be safely discharged.
Data Synthesis
We have searched the PubMed database for the following medical subject headings (MeSH) terms:
fish bone
,
fish foreign body
AND
oropharynx
,
hypopharynx
,
esophagus
,
flexibleesophagoscopy
, and
rigidesophagoscopy
. Our search in the English language yielded 32 papers. Case reports were included, since they highlighted rare and serious complications.
Conclusion
In patients > 40 years old suspected of fish bone impaction, non-contrast CT is recommended and should be urgently performed, even in the presence of ambiguous symptoms. However, in patients < 40 years old presenting within 24 hours from ingestion, imaging has little diagnostic value due to the low probability of esophageal fish bones. For this specific subgroup, in the absence of clinical findings, discharge without imaging studies may be considered safe.
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Affiliation(s)
- Ayala Klein
- Department of Otolaryngology-Head and Neck Surgery, Assuta Ashdod University Hospital, Ashdod, Israel
| | - Sharon Ovnat-Tamir
- Department of Otolaryngology-Head and Neck Surgery, Assuta Ashdod University Hospital, Ashdod, Israel
| | - Tal Marom
- Department of Otolaryngology-Head and Neck Surgery, Assuta Ashdod University Hospital, Ashdod, Israel
| | - Ofer Gluck
- Department of Otolaryngology-Head and Neck Surgery, Assuta Ashdod University Hospital, Ashdod, Israel
| | - Naomi Rabinovics
- Department of Otolaryngology-Head and Neck Surgery, Assuta Ashdod University Hospital, Ashdod, Israel
| | - Shay Shemesh
- Department of Otolaryngology-Head and Neck Surgery, Assuta Ashdod University Hospital, Ashdod, Israel
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Jahshan F, Sela E, Layous E, Levy E, Assadi N, Shilo E, Ibrahim N, Maayan D, Ronen O. Clinical criteria for CT scan evaluation of upper digestive tract fishbone. Laryngoscope 2018; 128:2467-2472. [PMID: 29446458 DOI: 10.1002/lary.27125] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 01/11/2018] [Accepted: 01/16/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To establish clinical criteria for performing computed tomography scan for suspected upper digestive tract fishbone. METHODS This is a prospective study of all adult patients referred to the otolaryngology emergency department at our medical center for suspected fishbone in the upper digestive tract after no fishbone was seen on physical examination. The patients were divided into two groups: 1) The first was a high clinical suspicion group, which included patients with at least one of the following criteria: drooling, accumulation of saliva in the sinus piriformis, fever, referral 24 hours after the ingestion with worsening/continuing symptoms, and readmission. These patients underwent nonenhanced CT scan (NECT) of the neck. 2) The second was a low clinical suspicion group, which included patients discharged with no NECT performed. These patients were followed at 1 week and 3 months. RESULTS One hundred and fourteen patients were included in the study; the median age was 41 years. Half of the patients arrived at the emergency department within 7 hours. There were no false negatives. The negative predictive value and sensitivity were 100%. Positive predictive value and specificity were 28.5% and 65%, respectively. Referral to the emergency department 24 hours after the ingestion with continuing symptoms had the highest false positive rate. CONCLUSIONS Our clinical criteria score for excluding foreign body fishbone in the upper aerodigestive tract was established. According to this score, a NECT can be spared in about 75% of all cases, thus reducing unnecessary ionizing radiation, stay at the emergency department, and costs with a very high NPV of almost 99%. LEVEL OF EVIDENCE 4. Laryngoscope, 2467-2472, 2018.
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Affiliation(s)
- Forsan Jahshan
- Department of Otolaryngology-Head and Neck Surgery, Galilee Medical Center, affiliated with Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Eyal Sela
- Department of Otolaryngology-Head and Neck Surgery, Galilee Medical Center, affiliated with Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Eli Layous
- Department of Otolaryngology-Head and Neck Surgery, Galilee Medical Center, affiliated with Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Einat Levy
- Department of Otolaryngology-Head and Neck Surgery, Galilee Medical Center, affiliated with Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Niddal Assadi
- Department of Otolaryngology-Head and Neck Surgery, Galilee Medical Center, affiliated with Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Etgar Shilo
- Department of Otolaryngology-Head and Neck Surgery, Galilee Medical Center, affiliated with Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Nour Ibrahim
- Department of Otolaryngology-Head and Neck Surgery, Galilee Medical Center, affiliated with Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Dor Maayan
- Department of Otolaryngology-Head and Neck Surgery, Galilee Medical Center, affiliated with Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Ohad Ronen
- Department of Otolaryngology-Head and Neck Surgery, Galilee Medical Center, affiliated with Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
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Sipe A, McWilliams SR, Saling L, Raptis C, Mellnick V, Bhalla S. The red connection: a review of aortic and arterial fistulae with an emphasis on CT findings. Emerg Radiol 2016; 24:73-80. [DOI: 10.1007/s10140-016-1433-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 08/15/2016] [Indexed: 10/21/2022]
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