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Management of Enteroatmospheric Fistulas: What you need to know
Joao B Rezende-Neto1, Charline Ductan, Brian Jurewitsch
1From the Division of General Surgery, Department of Surgery (J.B.R.-N., C.D., B.J.), University of Toronto, St. Michael's Hospital, Toronto, ON, Canada; Department of Surgery (P.R.L.C.), Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Division of Gastroenterology, Department of Medicine (N.C.C., K.K.), University of Toronto, Medical and Diagnostic Imaging Department (M.W., S.A.A.), St. Michael's Hospital; and Division of Gastroenterology, Hepatology, and Nutrition (F.Y.T.), Hospital for Sick Children, Toronto, ON, Canada.
Abstract:
An enteroatmospheric fistula (EAF) is a disastrous complication of abdominal surgery. Most EAFs occur in open abdomens after damage-control procedures in trauma and emergency general surgery. The absence of a defined fistulous tract and abdominal wall coverage preclude spontaneous closure and entail several challenges. Therefore, the primary objective is to manage those challenges to allow for the surgical take down of the fistulized bowel and reestablish gastrointestinal continuity. This work discusses a multidisciplinary approach indicating practical strategies from at least six different disciplines involved in the care of EAF patients.
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