Intestinal fistulas

Intestinal fistulas

Etiology

 - Complication of open abdominal surgery, especially when the bowel is frequently manipulated, with possible disruption of bowel anastomosis, inadvertent enterotomy, or small bowel injury.

 - Can occur as early as 8 days from initial laparotomy

 - Other causes: cancer, irradiation, IBD

Types

Enterocutaneous fistula: abnormal communication between the small or large bowel and the skin
Subtype enteroatmospheric fistula: abnormal communication between GI tract and the atmosphere, associated with high morbidity and mortality


Complications: sepsis, fluid and electrolyte abnormalities, malnutrition

Treatment

Conservative treatment and electrolyte repletion, antibiotics (in case of infections), nutritional support, control of fistula drainage (e.g., ostomy pouch), skin protection
Spontaneous closure occurs in roughly 70% of patients

Surgical Treatment : attempted 1–4 months after trial of conservative therapy if no signs of spontaneous closure

Lysis of adhesions
Resection of abnormal or diseased bowel
Reanastamosis of healthy bowel

Related Questions Gastrointestinal System

Etiology

 - Complication of open abdominal surgery, especially when the bowel is frequently manipulated, with possible disruption of bowel anastomosis, inadvertent enterotomy, or small bowel injury.

 - Can occur as early as 8 days from initial laparotomy

 - Other causes: cancer, irradiation, IBD

Types

Enterocutaneous fistula: abnormal communication between the small or large bowel and the skin
Subtype enteroatmospheric fistula: abnormal communication between GI tract and the atmosphere, associated with high morbidity and mortality


Complications: sepsis, fluid and electrolyte abnormalities, malnutrition

Treatment

Conservative treatment and electrolyte repletion, antibiotics (in case of infections), nutritional support, control of fistula drainage (e.g., ostomy pouch), skin protection
Spontaneous closure occurs in roughly 70% of patients

Surgical Treatment : attempted 1–4 months after trial of conservative therapy if no signs of spontaneous closure

Lysis of adhesions
Resection of abnormal or diseased bowel
Reanastamosis of healthy bowel