Pallam Praveen1, N. Krishna Mohan2, D. Devender3
Enterocutaneous fistula is a common complication encountered in the post-operative period. It is the most catastrophic problem resulting in significant morbidity and mortality. Various factors have been detected which play a role in the development of enterocutaneous fistulae like age of the patient, time of presentation, Organ of Origin, pathology of the disease, general condition of the patient, metabolic abnormalities, etc. Identification of these risk factors, early diagnosis and early intervention and decision making will give good outcomes.
AIM
To study the aetiology, risk factors, morbidity and ideal management of enterocutaneous fistulae.
MATERIALS AND METHODS
Study includes thirty two (32) patients treated for enterocutaneous fistulae in our hospital between January 2012 and December 2014.At the time of diagnosis of the fistula, the patients were classified according to the site of the fistula and the volume of output. They were subsequently investigated and managed according to the standard protocol.
RESULTS
Mortality is 50% in 5th decade of life. In the present series, 0% mortality was noted in patients who had duodenum and jejunum as the organ of origin. Ileum and stomach comprised of 25% each in the contribution to mortality while 50% of all the patients with colocutaneous fistulae died subsequently. High output fistula has mortality of 27.77%. Mortality of 20% and 27.41% was noted in patients were managed conservatively and by surgery respectively.
CONCLUSION
Index surgery early admission, an adequate antibiotic cover, vigorous resuscitation replacing fluids and electrolytes, blood transfusions, monitoring of all basic parameters and rightful decompression of the proximal bowel are all important measures to prevent the development of an enterocutaneous fistula. Prevention plays a definitely important role in patients with enterocutaneous fistulae.
