Korean J Radiol.  2012 Feb;13(Suppl 1):S17-S20. 10.3348/kjr.2012.13.S1.S17.

Surgical Management of Enterocutaneous Fistula

Affiliations
  • 1Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul 134-727, Korea. leeshdr@khu.ac.kr

Abstract

Enterocutaneous (EC) fistula is an abnormal connection between the gastrointestinal (GI) tract and skin. The majority of EC fistulas result from surgery. About one third of fistulas close spontaneously with medical treatment and radiologic interventions. Surgical treatment should be reserved for use after sufficient time has passed from the previous laparotomy to allow lysis of the fibrous adhesion using full nutritional and medical treatment and until a complete understanding of the anatomy of the fistula has been achieved. The successful management of GI fistula requires a multi-disciplinary team approach including a gastroenterologist, interventional radiologist, enterostomal therapist, dietician, social worker and surgeons. With this coordinated approach, EC fistula can be controlled with acceptable morbidity and mortality.

Keyword

Intestinal fistula; Surgical procedures; Multidisciplinary approach

MeSH Terms

Decision Making
Diagnostic Imaging
Digestive System Surgical Procedures/*methods
Humans
Intestinal Fistula/diagnosis/*surgery
Skin Care/*methods

Figure

  • Fig. 1 Application of vacuum-assisted closure systems in enterocutaneous fistulas.

  • Fig. 2 Application of skin protection appliance after stabilization of enterocutaneous fistula.

  • Fig. 3 Fistulogram with water soluble contrast material provided detailed information regarding anatomy of enterocutaneous fistula.


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