‘Video Vignette’ on how to isolate an enteroatmospheric fistula in the open abdomen

2021 ◽  
Author(s):  
Markku M Haapamäki
2015 ◽  
Vol 87 (10) ◽  
Author(s):  
Rajmund Jaguścik ◽  
Dominik A. Walczak ◽  
Joanna Porzeżyńska ◽  
Piotr W. Trzeciak

AbstractAn enteric fistula that occurs in an open abdomen is called an enteroatmospheric fistula (EAF) and is the most challenging complication for a surgical team to deal with. The treatment of EAF requires a multidisciplinary approach. First of all, sepsis has to be managed. Any fluid, electrolyte and metabolic disorders need to be corrected. Oral intake must be stopped and total parenteral nutrition introduced. The control and drainage of the effluent from the fistula is a separate issue. Since there are no fixed algorithms for the treatment of EAF, surgeons need to develop their own, often highly unconventional solutions.We present the case of a 24-year-old man who developed enteroatmospheric fistula after laparotomy and relaparotomy due to acute necrotic pancreatitis. Both the laparostomy and the fistula were successfully managed using modified negative pressure wound therapy. The literature regarding this issue was also reviewed.


2010 ◽  
Vol 76 (6) ◽  
pp. 637-639 ◽  
Author(s):  
Philip T. Ramsay ◽  
Vicente A. Mejia

There are few complications dreaded more by the general surgeon than the development of an enteroatmospheric fistula in the face of the open abdomen. The open abdomen has become a valuable tool in the treatment of trauma and complex surgical patients. The development of enteroatmospheric fistulae leads to increased cost, morbidity, and mortality. In our case series, we describe the use of Malecot catheters and early mobilization of skin and subcutaneous tissue flaps to manage enteroatmospheric fistulae. All of our patients were discharged from the hospital and did not develop any complications from the procedure. All of our patients’ fistulae ultimately closed. This procedure could lead to decreased cost and morbidity.


2020 ◽  
Vol 13 (8) ◽  
pp. e234207
Author(s):  
Michael Ron Freund ◽  
Petachia Reissman ◽  
Ram M Spira ◽  
Moris Topaz

A 52-year-old super morbidly obese patient underwent elective laparoscopic conversion of a failed silastic ring vertical gastroplasty to a Roux-en-Y gastric bypass. Following surgery, she developed an anastomotic leak which required emergent laparotomy. The patient then suffered from a complex postoperative course during which she developed an intestinal fistula which freely drained into the wound and gradually led to its complete dehiscence. Her course was further complicated by the surfacing of an enteroatmospheric fistula. This devastating complication was managed by employing the TopClosure Tension Relief system. Using the inverse maturation technique, further described in this report, we were able to progressively approximate and invert the edges of the skin around the enteroatmospheric fistula, thereby facilitating its conversion to an easily manageable stoma. Using this technique, we were able to achieve delayed primary wound closure of a grade 4 open abdomen complicated by an enteroatmospheric fistula in just under 5 weeks’ time.


Hernia ◽  
2017 ◽  
Vol 21 (5) ◽  
pp. 809-812 ◽  
Author(s):  
F. Yetisir ◽  
A. E. Sarer ◽  
M. Aldan

Author(s):  
Abdirahaman Nuno ◽  
A. Sinha ◽  
Abdirahaman Nuno ◽  
Mokhtar Eltair

Enterocutaneous and enteroatmospheric fistulas are the most challenging complications of abdominal sepsis to deal with a high mortality. This is even more challenging with a stoma in an open abdomen. In the setting of chronic granulomatous inflammation like abdominal tuberculosis or inflammatory bowel disease, recovery is prolonged and management involves multidisciplinary care. We present a rare case that was a complication of tuberculous peritonitis.


2016 ◽  
Vol 14 (1) ◽  
pp. 255-264 ◽  
Author(s):  
Adam Bobkiewicz ◽  
Dominik Walczak ◽  
Szymon Smoliński ◽  
Tomasz Kasprzyk ◽  
Adam Studniarek ◽  
...  

2016 ◽  
Vol 29 (4) ◽  
pp. 195-200
Author(s):  
Jihun Gwak ◽  
Min A Lee ◽  
Dae Sung Ma ◽  
Kang Kook Choi

2021 ◽  
Vol 7 ◽  
Author(s):  
Jinjian Huang ◽  
Huajian Ren ◽  
Yungang Jiang ◽  
Xiuwen Wu ◽  
Jianan Ren

Enteroatmospheric fistula (EAF) after open abdomen adds difficulties to the management and increases the morbidity and mortality of patients. As an effective measurement, reconstructing gastrointestinal tract integrity not only reduces digestive juice wasting and wound contamination, but also allows expedient restoration of enteral nutrition and intestinal homeostasis. In this review, we introduce several technologies for the temporary isolation of EAF, including negative pressure wound therapy, fistuloclysis, fistula patch, surgical covered stent, three-dimensional (3D) printing stent, and injection molding stent. The manufacture and implantation procedures of each technique with their pros and cons are described in detail. Moreover, the approach in combination with finger measurement, x-ray imaging, and computerized tomography is used to measure anatomic parameters of fistula and design appropriate 3D printer-recognizable stereolithography files for production of isolation devices. Given the active roles that engineers playing in the technology development, we call on the cooperation between clinicians and engineers and the organization of clinical trials on these techniques.


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