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Small bowel fistulas

A K Tassiopoulos1, G Baum, J D Halverson

  • 1Department of Surgery, State University of New York Health Science Center, Syracuse, USA.

The Surgical Clinics of North America
|October 1, 1996
PubMed
Summary
This summary is machine-generated.

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Treating small bowel fistulas is challenging. Current conservative therapy achieves 30% spontaneous closure in 4-6 weeks, necessitating surgical resection if closure fails.

Area of Science:

  • Gastroenterology
  • Surgical Gastroenterology
  • Abdominal Surgery

Background:

  • Small bowel fistulas present a significant clinical challenge.
  • Current management strategies yield limited spontaneous closure rates.

Purpose of the Study:

  • To review the current therapeutic approaches for small bowel fistulas.
  • To evaluate the efficacy of conservative management and identify indications for surgical intervention.

Main Methods:

  • Review of conservative therapy including bowel rest, total parenteral nutrition (TPN), octreotide, and sepsis control.
  • Assessment of spontaneous fistula closure rates and timeframes.
  • Evaluation of criteria for surgical resection.

Main Results:

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  • Spontaneous closure rates of approximately 30% are observed with conservative therapy.
  • Conservative management typically requires 4 to 6 weeks.
  • Surgical resection is indicated for persistent fistulas beyond this timeframe.

Conclusions:

  • Conservative management of small bowel fistulas is associated with a 30% spontaneous closure rate over 4-6 weeks.
  • Early surgical intervention via resection is warranted for fistulas that do not close with conservative measures.