STUDY OF ENTEROCUTANEOUS FISTULA

Abstract

Arti Mitra1, Unmed Chandak2, Prashant Agarwal3, Manish Singh4, Ritesh Satarda5

BACKGROUND: A fistula is defined as abnormal communication between two epithelial surfaces. 1 Enterocutaneous fistula is defined as abnormal communication between hollow organ and skin. They are classified as congenital or acquired. We have excluded congenital and internal fistulas. We have also excluded esophageal, urinary, pancreatic and biliary fistulas as their management is complex and differs significantly from enterocutaneous fistulas.

AIM: 1. Study of aetiology, pathophysiology and management of enterocutaneous fistula. To evaluate previously laid principles of management of enterocutaneous fistula. 2. To assess the feasibility of early intervention safety and outcome as the conservative long term treatment appears to be cost prohibitive. 3. To study morbidity and mortality related to enterocutaneous fistula.

MATERIAL AND METHODS: In all, 50 cases of enterocutaneous fistula were studied during a period from June 2012 to November 2014 at a Government tertiary care Centre. Both, patients referred from other centres with post-operative fistulas and fistulas developed in this institute after surgeries or spontaneously were included in the study after fulfilling the inclusion and exclusion criteria

RESULTS: The maximum numbers of cases were between 39-48 years of age group. Spontaneous closure was achieved in 72.7% and surgical closure in 76.7% of the patients Vacuum assisted closure was achieved in 66.66% of the patients in whom VAC was used. Of the patients in whom octreotide was used closure was achieved in 66.66% of the patients. The association between serum albumin levels and fistula healing and between fistula output and mortality were statistically significant. Overall mortality in this study was 26% with 44.44% among referred cases and 15.625% among institutional cases.

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