A 6-year old female, who was operated on for tracheoesophageal fistula at the time of birth, was diagnosed with recurrent TEF, and it was decided to undergo endoscopic management, using cyanoacrylate under general anesthesia. After cuffing, the endotracheal tube was located at the level of the fistula, and endoscopic management was undertaken through the esophagus, using cyanoacrylate. The peak inspiratory pressure was shown to have increased from 18 to 28 cmH2O. We observed partial obstruction of the endotracheal tube end, and partial attachment of the cyanoacrylate to the tracheal wall. The patient's symptoms gradually improved, and no other particular finding was observed during the following two months. We suppose that the cyanoacrylate has been ventilated, and gradually excreted. In manipulation that may cause changes in the tube position, it is recommended to check ventilation via the fistula, and to recheck the tube position.
Anesthesia, General ; Cyanoacrylates ; Esophagus ; Female ; Fistula ; Humans ; Parturition ; Tracheoesophageal Fistula ; Ventilation

Endoscopic variceal ligation is the preferred endoscopic treatment method for esophageal variceal bleeding. The incidence of complications such as chest pain, bleeding, stricture formation, and aspiration pneumonia is low. We report a case wherein a malfunctioning multiple-band ligator could have potentially caused damage to the esophageal varices and massive bleeding. The equipment was safely removed using scissors and forceps. To the best of our knowledge, this is the first published report detailing the management of a case of esophageal variceal bleeding.

There have been a few reports of pneumococcal meningitis complicated by spinal epidural abscess. A 58-year-old female with Streptococcus pneumoniae meningitis underwent a recurrent pleocytosis without apparent clinical deterioration after appropriate antibiotic treatment. Subsequently, she developed a spinal epidural abscess. Spinal epidural abscess is a rare complication of pneumococcal meningitis, and subclinical deterioration of neutrophil-dominant pleocytosis may precede development of a spinal epidural abscess in individuals with bacterial meningitis.
Epidural Abscess* ; Female ; Humans ; Leukocytosis ; Meningitis, Bacterial ; Meningitis, Pneumococcal* ; Middle Aged