Surgical Recall - Ch. 47 Fistulas Flashcards
1
Q
What are the predisposing factors and conditions that maintain patency of a fistula?
A
“HIS FRIEND”
- High output fistula (>500 cc/day)
- Intestinal destruction (>50% of circumference)
- Short segment fistula <2.5 cm
- Foreign body (e.g., G-tube)
- Radiation
- Infection/inflammation
- Epithelization (e.g., colostomy)
- Neoplasm
- Distal obstruction
2
Q
How does a colovesical fistula present?
What is the treatment?
A
- Fecaluria (feces in urine)
- Pneumaturia (air in urine)
- Recurrent UTIs that are refractory to tx
Treatment: Surgery –> segmental colon resection and primary anastomosis
3
Q
What are the possible complications of gastrocolic fistulas?
A
Malnutrition and severe enteritis due to reflux of colonic contents into stomach and small bowel with subsequent bacterial overgrowth
