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Management of enterocutaneous fistulas
1Department of Surgery, University of California, San Francisco, San Francisco General Hospital, 1001 Potrero Avenue, Ward 3A17, San Francisco, CA 94110, USA. bschect@sfghsurg.ucsf.edu
Abstract:
Management of enterocutaneous fistulas (ECFs) involves (1) recognition and stabilization, (2) anatomic definition and decision, and (3) definitive operation. Phase 1 encompasses correction of fluid and electrolyte imbalance, skin protection, and nutritional support. Abdominal imaging defines the anatomy of the fistula in phase 2. ECFs that do not heal spontaneously require segmental resection of the bowel segment communicating with the fistula and restoration of intestinal continuity in phase 3. The enteroatmospheric fistula (EAF) is a malevolent condition requiring prolonged wound care and nutritional support. Complex abdominal wall reconstruction immediately following fistula resection is necessary for all EAFs.
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