ENTEROCUTANOUS FISTULA

Question 1

What is ENTEROCUTANOUS FISTULA fistula

Answer 1

It is abnormal communication or connection between the gut bowels) and skin.

Question 2

Classification

Answer 2

It can be anatomical
A. Based on origin/opening
Internal, external, mixed
B. based on Characteristic of tract Simple, complex/complicated
C. based on affected bowel
Lateral, end
D. part of Intestine affected
Proximal, distal
It can be physiological
High output (> 500mls/24 hrs) Low output (<500mls/24 hrs)

Question 3

Causes of EC fistula

Answer 3

A. Congenital
Umbilical,
anorectal (rectovestibula fistula)

B acquired
Postoperative, spontaneous
malformation
*Common factors that can cause or prolong
fistula
-foreign body
-Radiation of affected part
Infection
-Epithelialization (end fistula) -Neoplasia
-Distal obstruction, DM
-Steroid therapy, Immunology compromised conditions HIV

Question 4

Investigations

Answer 4

Investigations: specimen for m/c/s, FBC, E/U/Cr, abdominopelvic USS, fistlography, barium contrast, abdominal CT or MRI, serum albumin, transferrin, specimen for amylase analysis.

Question 5

Treatment of EC fistula

Answer 5

Fluid rehydration to correct
electrolyte imbalance
Nutritional support and Vitamin supplement Drugs like Octreotide to reduce effluent Antibiotic therapy
For skin excoriation, Vaseline, colostomy -Surgery

Question 6

Complications

Answer 6

sepsis, electrolyte imbalance, malnutrition, unable to work, loss of job, localized abscess or generalized peritonitis, foul smelling wound, dependence on others for care.