How is enterocutaneous fistula treated?

How is enterocutaneous fistula treated?

Treatment. If the enterocutaneous fistula (ECF) doesn’t heal on its own after a few weeks or months, a complex surgery is required to close the fistula and reconnect the gastrointestinal tract. Patients with ECFs often need specialized wound care, nutritional rehabilitation and physical rehabilitation.

How long does enterocutaneous fistula last?

The expected time period for spontaneous closure, if it is to occur at all, varies with the anatomic location of the fistula. Fistulas from the esophagus and duodenum are expected to heal in two to four weeks. Colonic fistulas may heal in 30 to 40 days. Small bowel fistulas may take at least 40 to 60 days.

What is an enterocutaneous fistula?

An enterocutaneous fistula (ECF) is an abnormal connection that develops between the intestinal tract or stomach and the skin. As a result, contents of the stomach or intestines leak through to the skin. Most ECFs occur after bowel surgery.

What is a high-output enterocutaneous fistula?

Most often, a high-output ECF is characterized as one with >500 mL/24 hours, low output <200 mL/24 hours, and a moderate output fistula between 200 and 500 mL/24 hours. While the great majority of ECFs are iatrogenic (75–85%), between 15 and 25% occur spontaneously.

How can I control my fistula drainage?

Drainage can be contained using gauze dressings, pouches, and suction catheters. Fistulas with output of 150 mL or less per day can be managed with protective ointments, skin sealants, and skin barriers. A high-output fistula often is managed using a pouching system.

How can I reduce my fistula output?

Loperamide and codeine phosphate help to slow intestinal transit and may reduce fistula output by this mechanism. Gastric volume secretion is minimized by gastric acid inhibition with proton pump inhibitors, which also has a small effect in reducing electrolyte loss.

How long does it take for a fistula to close?

Fistulae that are small and not infected will often close on their own. Fistulae in the colon can take 30–40 days to close while fistulae in the small intestine are likely to take 40–50 days. Doctors also define fistulae as high- or low-output.

How can fistula be treated without surgery?

Treatment with fibrin glue is currently the only non-surgical option for anal fistulas. It involves the surgeon injecting a glue into the fistula while you’re under a general anaesthetic. The glue helps seal the fistula and encourages it to heal.

When does an enterocutaneous fistula result from surgery?

Enterocutaneous (EC) fistula is an abnormal connection between the gastrointestinal (GI) tract and skin. The majority of EC fistulas result from surgery.

How are fistulas treated in the gastrointestinal tract?

Enterocutaneous (EC) fistula is an abnormal connection between the gastrointestinal (GI) tract and skin. The majority of EC fistulas result from surgery. About one third of fistulas close spontaneously with medical treatment and radiologic interventions.

Is there any surgical treatment for EC fistula?

Treatment of EC fistula remains a surgical challenge despite the recent improvement of supportive patient care. Once EC fistula occurs, adequate stabilization of the patient, a thorough investigation of the fistula anatomy, and non-operative management should intially be attempted.

What does controlled fistula mean in medical terms?

A controlled fistula refers to an EC fistula without evidence of sepsis (high fever, rigors, and hypotension), or localized infection (cellulitis, pneumonia) (5). If the intestinal contents drain out through the matured tract, there is no longer intraperitoneal contamination or fluid accumulation to cause septic problems.