Tubocutaneous fistula in a premature infant

Fistulous tracts between the uterus and skin were more common in the preantibiotic era and most often occurred after pelvic surgery. Tubocutaneous fistulas constituted a subset of this form of operative complication. With the improvement of operative techniques and use of antibiotics, the incidence of these fistulas is greatly reduced. In cases reported since 1963, the youngest patient to develop a tubocutaneous fistula was 15 years old. Reported here is an infant delivered at 25 weeks' gestation, who developed necrotizing enterocolitis requiring 2 surgical interventions. At the time of insertion of a tunneled central venous catheter, the surgeon noted a mass in the right lower quadrant, which he excised. A noninflamed tubocutaneous fistula was identified pathologically with only the distal portion of the tube present. The child's history is similar to other reports in that she had previous operations and had developed significant fibrous abdominal adhesions. Her history is unique in that she is the youngest reported case and hers is the 1st report of this complication following surgery for necrotizing enterocolitis.