Enterocutaneous fistula: analysis of clinical outcomes from a single Victorian tertiary referral centre

Abstract

Appropriate bundle of care (perioperative care, surgical timing and surgical technique) can produce excellent results in patients with ECF.

Successful treatment of enteroatmospheric fistulas in combination with negative pressure wound therapy: Experience on 3 cases and literature review

“…Enterocuteaneous (ECF) and enteroatmospheric fistulas (EAF) are rare but challenging complications of abdominal surgery. Furthermore, they are associated with high morbidity and mortality and remarkably impair patients' quality of life . EAF is defined as a pathological communication between the intestinal lumen and the surface of an open abdominal wound .…”

“…They can be classified by the amount of daily faecal output (high/low), location in relation to the abdominal cavity (superficial/deep), the involved intestinal segment (proximal/distal), and the number of fistula openings (single/multiple) . Inadequate treatment of laparostomy can also cause EAF . While mortality rates associated with EAF decreased over the last years due to progress in perioperative management, some authors still report mortality rates of up to 40% .…”

“…Inadequate treatment of laparostomy can also cause EAF . While mortality rates associated with EAF decreased over the last years due to progress in perioperative management, some authors still report mortality rates of up to 40% . Some authors report an EAF incidence of up to 10% in patients undergoing open abdomen treatment for peritonitis and abdominal compartment syndrome and of up to 55% for patients suffering from abdominal sepsis .…”

“…It appears obvious that patients undergoing extensive adhesiolysis, even in elective surgery, are at high risk of developing small bowel leakage due to an undetected injury, which can, in the worst case, lead to an EAF. All types of enteric fistulas are medically complex to treat, and their management is time‐ and resource‐consuming …”

“…The most effective, but not always possible, treatment of EAF is resection of the bowel segment harbouring the fistula opening . If this is impossible due to extensive peritoneal adhesions ( frozen abdomen) , bridging therapy is necessary until relaparotomy and elimination of the fistula can be achieved . As spontaneous EAF closure is rare and depends on fistula localisation and output, new treatment options are needed.…”