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. 2010 Sep;23(3):169-75.
doi: 10.1055/s-0030-1262984.

Enterocutaneous fistula: medical and surgical management including patients with Crohn's disease

Guy R Orangio  1
Affiliations

Enterocutaneous fistula: medical and surgical management including patients with Crohn's disease

Guy R Orangio. Clin Colon Rectal Surg. 2010 Sep.

Abstract

Patients with inflammatory bowel disease (IBD) and especially Crohn's disease can be challenging for even the most seasoned of surgeons. Development of an enterocutaneous fistula (ECF) in these patients further adds a level of complexity that requires a well-planned and defined management strategy. The role of the surgeon in caring for these patients should be as the leader of a multidisciplinary team, directing the care of the other specialists, all while determining if, and when, the patient requires operative intervention. Although medical management has come a long way in these and similar patients, surgery is still needed in a vast majority of patients. Therefore, understanding the evaluation, initial management, and important technical considerations for care of IBD and other complex patients with ECFs is a difficult, yet much needed, task for which the surgeon should be prepared.

Keywords: Crohn's disease; Enterocutaneous fistula; inflammatory bowel disease.

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Figures

Figure 1
Figure 1
Enterocutaneous fistula opening into a midline wound. (Courtesy of Eric K. Johnson, M.D., Department of Surgery, Eisenhower Army Medical Center, Ft. Gordon, GA.)
Figure 2
Figure 2
V.A.C. (Kinetics Concepts Inc., San Antonio, TX) fashioned to aid in stomal device application over the enterocutaneous fistula. (Courtesy of Eric K. Johnson, M.D., Department of Surgery, Eisenhower Army Medical Center, Ft. Gordon, GA.)
Figure 3
Figure 3
V.A.C. (Kinetics Concepts Inc., San Antonio, TX) applied to open abdomen with enterocutaneous fistula on the right. (Courtesy of Eric K. Johnson, M.D., Department of Surgery, Eisenhower Army Medical Center, Ft. Gordon, GA.)
Figure 4
Figure 4
Stomal pouch applied over V.A.C. (Kinetics Concepts Inc., San Antonio, TX) and enterocutaneous fistula. Notice the ability to quantify output and provide skin protection. (Courtesy of Eric K. Johnson, M.D., Department of Surgery, Eisenhower Army Medical Center, Ft. Gordon, GA.)
See this image and copyright information in PMC

References

    1. Datta V, Engledow A, Chan S, Forbes A, Cohen C R, Windsor A. The management of enterocutaneous fistula in a regional unit in the United kingdom: a prospective study. Dis Colon Rectum. 2010;53(2):192–199. - PubMed
    1. Berry S M, Fischer J E. Classification and pathophysiology of enterocutaneous fistulas. Surg Clin North Am. 1996;76(5):1009–1018. - PubMed
    1. Mawdsley J E, Hollington P, Bassett P, Windsor A J, Forbes A, Gabe S M. An analysis of predictive factors for healing and mortality in patients with enterocutaneous fistulas. Aliment Pharmacol Ther. 2008;28(9):1111–1121. - PubMed
    1. Heller L, Levin S L, Butler C E. Management of abdominal wound dehiscence using vacuum assisted closure in patients with compromised healing. Am J Surg. 2006;191(2):165–172. - PubMed
    1. Khan J, Iiboshi Y, Cui L, et al. Alanyl-glutamine-supplemented parenteral nutrition increases luminal mucus gel and decreases permeability in the rat small intestine. JPEN J Parenter Enteral Nutr. 1999;23(1):24–31. - PubMed