J Korean Surg Soc.  2000 Jun;58(6):816-823.

Management of Enterocutaneous Fistula

• Kang DB
• Kim JM
• Kim HS

Abstract

PURPOSE: The aim of this study was to help access the treatment of enterocutaneous fistula patients.
METHODS
We experienced 35 cases of enterocutaneous fistulas at Seoul Red Cross Hospital from January 1993 to December 1997 and we reviewed the patient's charts retrospectively. RESULTS: The ratio of men and women was 1.7 : 1. The most prevalent age group was the 7th decade (12 cases, 34.3%). The most frequent site of the enterocutaneous fistula was the large colon (11 cases,31.4%). The etiology of the all cases was postoperative complication. The most common underlying disease was malignancy (11 cases, 31.4%). The latent period of the fistula after an operation was most commonly 6 to 10 days (18 cases, 51.4%). Fistulography was the most accurate diagnostic method (90.9%). According to the amount of daily drainage, high output fistulas occurred in 10 cases (28.6%), and low output fistulas in 25 cases (71.4%). Twenty five (25) patients (71.4%) were treated conservatively, 10 patients (28.6%) were treated surgically. The methods of operation were bowel resection and anastomosis (6 cases), an fistulectomy (2 cases), and a bypass procedure (2 cases). The overall mortality was 3 cases (8.6%). The most common cause of death was sepsis and multiple organ failure. CONCLUSION: Prevention of an enterocutaneous fistula is of utmost importance, but once it occurs early detection, which is essential to improve the patient's general condition, avoidance of infection, and proper judgment as to the time of operation are important to the survival rate.

Keyword

Enterocutaneous fistula

MeSH Terms

Cause of Death
Colon
Drainage
Female
Fistula
Humans
Intestinal Fistula*
Judgment
Male
Mortality
Multiple Organ Failure
Postoperative Complications
Red Cross
Retrospective Studies
Seoul
Sepsis
Survival Rate