Enterocutaneous Fistula and Small Bowel Evisceration of Twenty-five Years’ Duration: Successful Surgical and Nutritional Management

2007 ◽  
Vol 52 (11) ◽  
pp. 3209-3213
Author(s):  
Vihas Patel ◽  
Kris M. Mogensen ◽  
Selwyn O. Rogers ◽  
Malcolm K. Robinson
Keyword(s):  
Small Bowel ◽  
Enterocutaneous Fistula ◽  
Nutritional Management

Chyme reinfusion nutritional management for enterocutaneous fistula: first international application of a novel pump technique

2021 ◽  
Author(s):  
Edgardo Solis ◽  
Danette B. Wright ◽  
Greg O’Grady ◽  
Grahame Ctercteko
Keyword(s):  
Enterocutaneous Fistula ◽  
Nutritional Management

scholarly journals Small bowel diverticulum complicated by enterocutaneous fistula and abdominal wall abscess

2018 ◽  
Vol 5 (1) ◽  
Author(s):  
Mutlaq A. Almalki ◽  
Yaseen Waed ◽  
Baatiyyah Mohammed
Keyword(s):  
Small Bowel ◽  
Abdominal Wall ◽  
Enterocutaneous Fistula ◽  
Abdominal Wall Abscess

scholarly journals Role of Deliberate Creation of Control Enterocutaneous Fistula in Patients of Abdominal Tuberculosis with Perforation of Small Bowel and Matted Small Intestine

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Muhammad Hassan Abbas ◽  
Kamran Ali ◽  
Mahbood Bari ◽  
Ahmad W ◽  
Anwer M ◽  
...  
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Surgical Procedure ◽  
Anterior Abdominal Wall ◽  
Enterocutaneous Fistula ◽  
Abdominal Tuberculosis ◽  
Therapeutic Trial ◽  
Life Saving ◽  
Operative Findings

Objective: To study the results after forming the controlled enterocutaneous fistula in the patient of abdominal tuberculosis with matted and perforated small bowel. Design, place and duration of study This study based on therapeutic trial and conducted in one and half years from january1999 to june2001 at Mayo Hospital, Lahore. Patients and methods: All these 20 patients either operated in emergency or on elective list were malnourished, toxic and their operative findings were almost the same , these patients had extensively matted, friable and perforated gut. In these patients it was technically not possible to perform some definite procedure like right haemecolectomy or ileostomy with out increasing the morbidity or mortality. Under these circumstances, minimal surgical procedure which can be life saving is to oppose the anterior abdominal wall to the perforation and thus create a controlled enterocutaneous fistula. In 11 patients fistula closed on its own and in eight patients fistula remained patient and needed re-exploration and repair. Conclusion: This new method of treatment has yielded excellent results. We were able to cure the disease with no mortality. It is recommended that in cases of TB peritonitis with perforation and matted gut making of a controlled enterocutaneous fistula saves the life of the patient.

A CASE OF CONSERVATIVE MANAGEMENT OF AN ENTEROCUTANEOUS FISTULA DUE TO JEJUNAL DIVERTICULOSIS WITH PARTIAL SMV THROMBOSIS

2021 ◽  
pp. 4-5
Author(s):  
Anand M ◽  
Rajnish R. Patel ◽  
Hitendra K. Desai ◽  
Rajesh K. Patel ◽  
Deep N. Patel ◽  
...  
Keyword(s):  
Enterocutaneous Fistula ◽  
Great Majority ◽  
Nutritional Management ◽  
Antibiotic Regimen ◽  
Blood Products ◽  
Acid Base Balance ◽  
Acid Base ◽  
Congenital Infections ◽  
Common Causes ◽  
Base Balance

An enterocutaneous stula (ECF) is an aberrant connection between intra-abdominal gastrointestinal tract and the skin. While great majority are iatrogenic, between 15-25% occur spontaneously. Common causes of spontaneous stula are congenital, infections, inammation, tumour, radiation and ischemia. Mortality associated with ECF has decreased from 40-60% to 15-20% largely attributed to advances in uid, electrolyte, acid-base balance knowledge, administration of blood products, critical care, antibiotic regimen and nutritional management – both enteral and parenteral.

scholarly journals A Silent and Chronic Complication of Percutaneous Endoscopic Gastrostomy Tube: Small Bowel Enterocutaneous Fistula

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Sai Wah Cheung
Keyword(s):  
Small Bowel ◽  
Minimally Invasive ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Enterocutaneous Fistula ◽  
Major Complication ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Delay In Diagnosis ◽  
Endoscopic Gastrostomy ◽  
Chronic Complication ◽  
Lower Morbidity

Percutaneous endoscopic gastrostomy (PEG) has gradually gained the popularity since its invention and become the most preferred method for gastrostomy insertion in recent years. PEG is associated with lower morbidity and mortality and has the advantages of being minimally invasive and more convenient over the conventional open gastrostomy. However, significant rates of major complication still occur. Enterocutaneous fistula is one of the key complications that can be easily neglected due to its asymptomatic nature. We present a case of small bowel enterocutaneous fistula which was only found 8 years after the PEG insertion, being diagnosed after the longest duration of delay in diagnosis reported in literature.

scholarly journals Small bowel enterocutaneous fistulae: is waiting worth?

2017 ◽  
Vol 5 (7) ◽  
pp. 2956
Author(s):  
Mukesh Kumar ◽  
Abhinav Jauhari
Keyword(s):  
Small Bowel ◽  
Patient Outcomes ◽  
Enterocutaneous Fistula ◽  
General Surgeon ◽  
P Value ◽  
Male Population ◽  
Aggressive Approach ◽  
Medical College ◽  
Good Patient ◽  
Aggressive Surgical Approach

Background: Enterocutaneous fistula represents a group of complex intraperitoneal infectious processes. Even with recent advances in Para surgical management, critical care and nutritional support, enterocutaneous fistulas remain great challenges to the general surgeon. Mortality remains high largely due to frequent complications of sepsis and malnutrition. Most enterocutaneous fistulas occur following emergency abdominal surgeries and only 15-25% of spontaneous enterocutaneous fistulas are the result of underlying diseases such as Crohn’s diseases, radiation enteritis or diverticular disease. Expectant treatment consisting of octreotide, TPN, and antibiotics waiting for spontaneous closure is associated with high costs, high mortality and prolonged morbidity. In our country, there is need to abandon expectant lines of management for a more aggressive surgical approach once the fluid and electrolyte disturbance and sepsis have been corrected.Methods: The aim of the present study was to audit the result of an aggressive approach in patients with enterocutaneous fistulas and to identify the time of convalescence prior to restorative surgery thereby reducing the morbidity and mortality associated with them. The focus of this study was to determine whether, in patients with fistulae, early intervention resulted in low mortality and morbidity.Results: In the present study, 64 cases of small bowel enterocutaneous fistulas were taken, which were either operated in Patna medical college and hospital or outside in year 2011-13. Majority of patients were <60 years of age. Out of the total population (n=64), 50 patients were <60 years and 14 patients were ≥60 years, with mean age of 46 years (range 17-75 years). The percentage of male population was 56.2 and that of female was 43.8. Mortality was also higher in patients with sepsis, age>60 years and in patients with preoperative albumin below 3.0g/dl (p value>0.05). Early surgical intervention resulted in good patient outcomes as compared to conservative treatment (p value-0.0418). Mortality was higher in patients with foregut fistulae (p value-0.0178) and high output fistulae (p value-0.0309).Conclusions: This study shows that early surgery can result in good patient outcomes. Initial emphasis should be on the treatment of septic foci, aim to improve to patient’s condition. Rather than following a prolonged conservative line of management, surgical repair should be performed when the patient is stable.

Enteral and Parenteral Nutrition

2017 ◽  
Author(s):  
Kris M. Mogensen ◽  
Malcolm K. Robinson
Keyword(s):  
Small Bowel ◽  
Parenteral Nutrition ◽  
Ethical Issues ◽  
Nutritional Assessment ◽  
Enterocutaneous Fistula ◽  
Pelvic Abscess ◽  
Nutrition Support ◽  
Tube Placement ◽  
Fistula Formation ◽  
Enteral And Parenteral Nutrition

Alternative routes of nutrient administration are available for patients who are unable to eat or digest sufficient food to prevent malnutrition. These routes include enteral (administered through the gastrointestinal tract) and parenteral (administered intravenously). This review details the clinical consequences of malnutrition, nutritional assessment, the benefits of nutrition support therapy,  determining the nutrient prescription, special considerations in nutrition support therapy, aspects of obtaining enteral or parenteral access, monitoring of patients receiving nutrition support therapy, and complications and ethical issues associated with enteral and parenteral nutrition. Figures include algorithms showing the identification of malnutrition, the nutrition support decision process, and the approach to gastric residual monitoring; nasogastric tube displacement leading to pneumothorax; proper placement of a long or “midline” catheter versus a peripherally inserted central catheter; and photographs of a 43-year-old man with Crohn disease complicated by enterocutaneous fistula formation, distal small bowel obstruction, and evisceration of the small bowel after developing a pelvic abscess. Tables list acute illness- or injury-related malnutrition; chronic disease−related malnutrition; social or environmental circumstances−related malnutrition; indications and contraindications to enteral and parenteral nutrition; selected examples of predictive equations; electrolyte provision in parenteral nutrition; parenteral vitamin and trace element requirements; complications associated with enteral and parenteral nutrition; and indications, contraindications, and complications of gastrostomy tube placement. This review contains 6 highly rendered figures, 11 tables, and 167 references.

Sign in / Sign up

Export Citation Format

Share Document