Management of enterocutaneous fistulas: a review of 132 cases

The development of an enterocutaneous fistula has frequently been reported as being attended by a high morbidity and mortality, particularly in patients with inflammatory bowel disease who have high output, small bowel fistulas. We report a series of 114 patients who required treatment for 132 fistulas during the period 1976-1981. Fifty-one fistulas originated in the jejunum and ileum, and forty-eight patients had Crohn's disease. The majority of patients required surgical intervention and parenteral nutrition was required in forty-eight cases. Using an integrated programme of nursing, medical and surgical care, the overall healing rate was 90.9 per cent and the mortality 5.3 per cent. With the therapeutic methods currently available, an unacceptably high mortality rate in these patients can be avoided.