[Parenteral or enteral hyperalimentation in the treatment of enterocutaneous fistulas?]

Occurrence of postoperative wound dehiscence with fistulae in stomach and small intestine is considered to be a severe surgical complication. The question has been raised, if the problem should be therapeutically tackled by means of surgery or medication in the context of intensive care. Retrospective and prospective analyses were made of the author's own cases at the Surgical Department of Graz University, between 1979 and 1985 (n = 31, with pancreas and colon fistulae uncounted). They were treated by two regimes. Group A (twelve patients) received purely parenteral substitution up to occlusion. Group B (19 patients) received a combination of enteral and parenteral nutrition, after their acute symptoms had vanished (ten gastroduodenal fistulae, eleven jejunal fistulae, ten ileum fistulae; seven elective and 24 emergency operations; 95 per cent being high-risk patients).