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,
inammation, 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.
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.
Nutritional management of enterocutaneous fistula: a retrospective study at a Malaysian university medical center
