Medical Management of the High-Output Enterostomy and Enterocutaneous Fistula

2011 ◽  
pp. 97-109
Author(s):  
Neha Parekh ◽  
Douglas L. Seidner
Keyword(s):  
Medical Management ◽  
Enterocutaneous Fistula ◽  
High Output

The importance of a holistic approach to stoma care: A case review

WCET Journal ◽  
2019 ◽  
pp. 23-32
Author(s):  
Melanie C Perez
Keyword(s):  
Ileal Conduit ◽  
Enterocutaneous Fistula ◽  
Foley Catheter ◽  
Holistic Approach ◽  
Comprehensive Care ◽  
Case Review ◽  
High Output ◽  
Stoma Care

This case review discusses the importance of providing a holistic approach to the care of a patient with two stomas and an enterocutaneous fistula. In this case, the stomas and fistula significantly affected the patient; not just physically but emotionally and socially. The different challenges that arose in pouching a high-output ileostomy, enterocutaneous fistula and ileal conduit with Foley catheter in situ are explored. It also delves into the various options for discharging a patient with complex ostomy complications requiring different needs and resources. Finally, it aims to highlight the therapeutic comprehensive care the stomal therapy nurse provided to the patient and their family.

scholarly journals Outcome and management of postoperative enterocutaneous fistula

2020 ◽  
Vol 7 (12) ◽  
pp. 4112
Author(s):  
Dinesh Chandra Sharma ◽  
Gaurav Jalendra ◽  
Pugazhenthi M. ◽  
Amit Kumar
Keyword(s):  
Enterocutaneous Fistula ◽  
Electrolyte Imbalance ◽  
Electrolyte Balance ◽  
High Morbidity ◽  
First Line ◽  
Sepsis Management ◽  
Time Treatment ◽  
Fistula Healing ◽  
And Control ◽  
High Output

Background: Approximately 75% of enterocutaneous fistula (ECF) occur following surgery. Due to the high morbidity and mortality associated with ECF, prompt and effective treatment is important. This study was conducted to study the outcome and management of patients with enterocutaneous fistula.Methods: Total 40 patients developing the enterocutaneous fistula following surgery were included. All patients were treated either conservatively or operatively by various means and varying period of time. Treatment was focused on the correction of dehydration, controlling sepsis, management of electrolyte imbalance and nutritional support.Results: Overall 40 patients were included in this observational study, comprising 26 were males and 14 were females. About 97.5% of ECF were postoperative. Ileum was found to be the most common site of ECF. Also, 42.5% of fistulas were high output and 57.5% were low output. Serum albumin levels correlated significantly with fistula healing and mortality. Surgical intervention was required in 37.5% of patients.Conclusions: Conservative management with emphasis on improvement of nutrition, control of sepsis, management of fluid and electrolyte balance and control of fistula output is first line of management. Operative intervention must be done in selectively after cases after aggressive and targeted measures for improvement of nutritional status and control of infection.

Creation of High Output Enterocutaneous Fistula From Self-Mutilation

2018 ◽  
Vol 113 (Supplement) ◽  
pp. S1409
Author(s):  
Ronald Samuel ◽  
Lauren August Clark ◽  
Sheharyar Merwat
Keyword(s):  
Enterocutaneous Fistula ◽  
Self Mutilation ◽  
High Output

Management of a High-Output Postoperative Enterocutaneous Fistula with a Vacuum Sealing Method and Continuous Enteral Nutrition

ASAIO Journal ◽  
2000 ◽  
Vol 46 (4) ◽  
pp. 511-514 ◽  
Author(s):  
Sung H. Hyon ◽  
Jorge A. Martinez-Garbino ◽  
Mario L. Benati ◽  
Marcelo E. Lopez-Avellaneda ◽  
Nicolas A. Brozzi ◽  
...  
Keyword(s):  
Enteral Nutrition ◽  
Enterocutaneous Fistula ◽  
Vacuum Sealing ◽  
High Output

scholarly journals Conservative management of a high output enterocutaneous fistula in abdominal tuberculosis

2011 ◽  
Vol 2011 (may24 2) ◽  
pp. bcr1120103494-bcr1120103494 ◽  
Author(s):  
S. M. Machoki ◽  
H. Saidi ◽  
M. Ahmed
Keyword(s):  
Conservative Management ◽  
Enterocutaneous Fistula ◽  
Abdominal Tuberculosis ◽  
High Output

scholarly journals Enterocutaneous fistula; Management Challenges,Areterospective Review of 11 Patients Treated in our Institute

2021 ◽  
Vol 3 (1) ◽  
pp. 01-08
Author(s):  
Aliya Ishaq ◽  
Muhammad Jamshaid Husain Khan ◽  
Muhammad shadab khan ◽  
Mariya Ishaq ◽  
Abida Parveen ◽  
...  
Keyword(s):  
Large Bowel ◽  
Multidisciplinary Approach ◽  
Enterocutaneous Fistula ◽  
University Hospital ◽  
Female Ratio ◽  
Surgical Closure ◽  
National University ◽  
Systemic Disorder ◽  
Bed Sores ◽  
High Output

Enterocutaneous fistula is a local pathology and systemic disorder. OBJECTIVES: To analyze postoperative outcomes, morbidity, and mortality in patients treated for enterocutaneous fistula in our institute for past 18 months. DESIGN, SETINGS AND PATIENTS: Reterospective review of records of patients presented to Liaquat national university hospital Karachi, Pakistan between Jan 2010 to June 2011 with diagnosis of EC fistula. RESULTS: A total of eleven patients presented with diagnosis of enterocutaneous fistula in our institute in specified duration. Mean age at presentation was 33 years with amle to female ratio of 3:1.72.7 % had high output fistula and 27.2 % had low output fistula. Small bowel was involved in 72.7%, large bowel in 18.18% and 9.0% had both small and large bowel fistula.45.45% patients had single fistula while 54.55 had multiple fistula. Total length of stay varied between 22-150 days .6/11 (54.54%) had nosocomial infection, 3/11(27.27%) had bed sores.2/11(18.18%) had TPN related complications.Spontaneous closure occurred in 8/11(72.77) patients and definitive surgical closure was performed in one patient. Mortality rate was 18.8 %. CONCLUSION: Enterocutaneous fistula is a devastating outcome for both surgeons and patients, sytemetic timely multidisciplinary approach can save lives.

The parachute design as a new extraperitoneal method of closing a recalcitrant high-output enterocutaneous fistula: report of a case

Surgery Today ◽  
2012 ◽  
Vol 42 (7) ◽  
pp. 681-685 ◽  
Author(s):  
Louis de Weerd ◽  
Jørn Kjæve ◽  
Solveig Nergård
Keyword(s):  
Enterocutaneous Fistula ◽  
High Output

scholarly journals ENTEROCUTANEOUS HIGH OUTPUT FISTULAE

2010 ◽  
Vol 17 (04) ◽  
pp. 538-542
Author(s):  
GHULAM MUSTAFA ARAIN ◽  
MUHAMMAD REHMAN GULZAR ◽  
KUSH MUHAMMAD SUHO ◽  
Waseem Sadiq Awan
Keyword(s):  
Enterocutaneous Fistula ◽  
Study Groups ◽  
Spontaneous Closure ◽  
P Value ◽  
Medical College ◽  
Group I ◽  
Design Case Study ◽  
High Output

Enterocutaneous fistula is an abnormal communication between epithelial lined lumen of GI tract & epithelium of an adjacent viscous or skin. Objectives: To find out role of octreotide in the management of high enterocutaneous fistula. Design: Case study. Setting: Department of Surgery Unit-II Punjab Medical College & A & E Department of Jinnah Hospital /AIMC Lahore. Period: From Jan 2007 to Dec 2008. Patients & Methods: 479 laparotomies were carried out due to trauma. Out of these 21 i.e. 4.38% developed high out put enterocutaneous fistula. All patients were put on similar conservative management including, TPN, antibiotics, fluid electrolyte replacement and stoma care. Results: Patients were split into two groups alternatively. There were no statistical difference between the study groups with regard to the age (p-value=0.515). Group I contains 11 patients (octreotide) received additionally 100mg octreotide S/C 8 hourly, showed decrease of volume from 680 to 150ml within 10 days. Spontaneous closure was observed in 8(72.72%) patient & surgery was required in 2(18.18%) patients. Death was 1(9.09%). In Group II remaining 10 patients(without octreotide), fistula discharge volume decreased form 650mg to 150ml in 20 days. Spontaneous closure was noted in 5(50%) cases. Surgery was required in 3(30%), while death rate was 2(20%).Conclusions: It is concluded that Octreotide, an analogue of somatostatin with longer half life is effective in treatment of high output fistula.

VACUUM BASED BARRIER GENERATION FOR THE TREATMENT OF A PROXIMAL. HIGH-OUTPUT ENTEROCUTANEOUS FISTULA

ASAIO Journal ◽  
1999 ◽  
Vol 45 (2) ◽  
pp. 208
Author(s):  
S Hyon ◽  
J Martínez-Garbino ◽  
M Benati ◽  
M López ◽  
N Brozzi ◽  
...  
Keyword(s):  
Enterocutaneous Fistula ◽  
High Output

scholarly journals How to manage a high-output stoma

2021 ◽  
pp. flgastro-2018-101108
Author(s):  
Jeremy M D Nightingale
Keyword(s):  
Small Bowel ◽  
Enterocutaneous Fistula ◽  
Fluid Management ◽  
High Dose ◽  
Short Bowel ◽  
Intestinal Length ◽  
Proximal Small Bowel ◽  
Parenteral Support ◽  
Slow Transit ◽  
High Output

A high-output stoma (HOS) or fistula is when small bowel output causes water, sodium and often magnesium depletion. This tends to occur when the output is >1.5 -2.0 L/24 hours though varies according to the amount of food/drink taken orally. An HOS occurs in up to 31% of small bowel stomas. A high-output enterocutaneous fistula may, if from the proximal small bowel, behave in the same way and its fluid management will be the same as for an HOS.The clinical assessment consists of excluding causes other than a short bowel and treating them (especially partial or intermittent obstruction). A contrast follow through study gives an approximate measurement of residual small intestinal length (if not known from surgery) and may show the quality of the remaining small bowel.If HOS is due to a short bowel, the first step is to rehydrate the patient so stopping severe thirst. When thirst has resolved and renal function returned to normal, oral hypotonic fluid is restricted and a glucose-saline solution is sipped. Medication to slow transit (loperamide often in high dose) or to reduce secretions (omeprazole for gastric acid) may be helpful. Subcutaneous fluid (usually saline with added magnesium) may be given before intravenous fluids though can take 10–12 hours to infuse. Generally parenteral support is needed when less than 100 cm of functioning jejunum remains. If there is defunctioned bowel in situ, consideration should be given to bringing it back into continuity.

Sign in / Sign up

Export Citation Format

Share Document