Gastroenterology International
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Gastroenterology International 1(1):p 5-12, . | DOI: N/A
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Challenges of Complicated Enterocutaneous Fistulas
Sudershan Kapoor , Sudershan Kapoor
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Gastroenterology International 1(1):p 5-12, . | DOI: N/A
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Abstract
Enterocutaneous Fistulas are a common presentation in general surgical wards, and despite advances in the management of these lesions, they are still responsible for a significant mortality rate, ranging from 5- 0%, due to associated sepsis, nutritional abnormalities, and electrolyte imbalance. Enterocutaneous fistulas are more commonly seen in post-operative setting. An enterocutaneous fistula (ECF) is a potentially catastrophic postoperative complication. It seems prudent, then, for every surgeon to have a thorough grasp of optimal treatment strategies for ECF to minimize their patients’ mortality. Ultimately, the algorithm must begin with prevention. Morbidity associated with fistulas is significant; the principle cause of death are sepsis and malnutrition [9]. Special mention is given in this article to complicated fistulas such as those with high output, abdominal sepsis and large abdominal defects. There is stress on diversion of fecal matter through ileostomy at a normal site of intestines at a distance of fistula site and damage/devitalized and inflammed gut (Proximal loop ileostomy) and fistula repair at comparatively early stage to prevent the further complications of sepsis and malnutrition. This plan gives a framework for the difficult task of successfully treating the postoperative ECF with a multidisciplinary approach.
Keywords: Enterocutaneous Fistula; Nutritional Support; Sepsis; Proximal Loop Ileostomy
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- Sudershan Kapoor
, - Sudershan Kapoor
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