Treatment of high output entero-cutaneous fistulae associated with large abdominal wall defects: Single center experience

Dionigi, G.; Dionigi, Renzo; Rovera, Francesca; Boni, Luigi; Padalino, P; Minoja, Giulio; Cuffari, Salvatore; Carrafiello, G.

doi:10.1016/j.ijsu.2007.07.006

Cited by 36 publications

(19 citation statements)

References 27 publications

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“…Commonly associated procedures are those carried out for malignancy, inflammatory bowel disease (IBD), adhesions, pancreatitis or abdominal wall hernia repair. Causes include breakdown of an anastomotic suture line, unintentional enterotomy or inadvertent bowel injury at the time of closure [21,22]. Recent series show that the incidence of ECF related to mesh implantation for hernia repair is on the rise [3 • ].…”

Section: Classificationmentioning

confidence: 99%

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Enterocutaneous Fistulas: A Look at Causes and Management

2014

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Despite advances in medical technology and surgical care, the management of enterocutaneous fistulas remains one of the most challenging problems faced by physicians. Success depends on an expert multidisciplinary team, access to long-term enteral and parenteral nutrition support, advanced wound care, optimal medical management and meticulous, methodical, surgical decision-making and technique. Management is complex and multiphasic. Improved survival rates for many morbid problems have resulted in a growing population of patients with increasingly complex fistulas. This article reviews the etiologies as well as classic and evolving management strategies for this problem.

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Section: Classificationmentioning

confidence: 99%

“…They have the advantage of being able to protect the skin in patients with complex fistulas where simpler devices do not suffice [2,21,35] (Figs. 3, 4).…”

Section: Electrolytes and Nutritionmentioning

confidence: 99%

Enterocutaneous Fistulas: A Look at Causes and Management

2014

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“…In five patients, fistulas closed and the abdominal wound healed with these dressings. A series from Italy [14] analyzed 19 patients, mostly from previous surgery for inflammatory bowel disease (IBD) (37%) and abdominal trauma (21%). Most of them were ileal with a median fistula output of 800 ml/day (range 400-1,600 ml/ day).…”

Section: Eafs: Ecfs In An Open Abdomenmentioning

confidence: 99%

Enterocutaneous fistulas: an overview

Whelan

Ivatury

2011

Eur J Trauma Emerg Surg

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Enterocutaneous fistulas remain a difficult management problem. The basis of management centers on the prevention and treatment of sepsis, control of fistula effluent, and fluid and nutritional support. Early surgery should be limited to abscess drainage and proximal defunctioning stoma formation. Definitive procedures for a persistent fistula are indicated in the late postoperative period, with resection of the fistula segment and reanastomosis of healthy bowel. Even more complex are the enteroatmospheric fistulas in the open abdomen. These enteric fistulas require the highest level of multidisciplinary approach for optimal outcomes.

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“…This includes those arising from the esophagus, pancreas, jejunum, duodenal stump, and fistulas arising from the lateral aspect of the GI tract that is in continuity. Also, the presence of free distal flow, a non-epithelialized tract[2 cm, and an enteral defect \1 cm are favorable anatomic conditions for spontaneous closure [4,5].…”

Section: Conservative and Interventional Managementmentioning

confidence: 99%

Anatomy-based surgical strategy of gastrointestinal fistula treatment

Turégano

Marín

2011

Eur J Trauma Emerg Surg

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Anatomic delineation of a gastrointestinal fistula is essential in assessing the likelihood of spontaneous closure or to plan the surgical management. Computed tomography (CT) enterography and/or fistulograms provide invaluable information. The surgical strategy should carefully consider the when and how, as well as the special clinical situations that may arise following radiotherapy, the inaccessible or "frozen abdomen", and enteroatmospheric fistulas (EAFs). New operations like those performed in bariatric surgery, and the wide acceptance of the damage-control philosophy in severe trauma, have given rise to new types of fistulas and increased the occurrence of others. When confronted with this difficult complication, the surgeon must always exercise patience and restraint, and be open-minded about the different surgical alternatives to solve the problem.

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Treatment of high output entero-cutaneous fistulae associated with large abdominal wall defects: Single center experience

Abstract: After optimization of nutritional status surgery with en bloc resection of fistula offers best results. In this series, cancer and sepsis were unfavourable factors for outcome. These fistulas may be successfully managed with a multidisciplinary approach.

Cited by 36 publications

References 27 publications

Enterocutaneous Fistulas: A Look at Causes and Management

Enterocutaneous Fistulas: A Look at Causes and Management

Enterocutaneous fistulas: an overview

Anatomy-based surgical strategy of gastrointestinal fistula treatment

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