Enterocutaneous Fistula: Trend, Management & Outcome at a Tertiary Hospital in North India
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2017, Vol 5, Issue 9
Abstract
Abstract:Enterocutaneous fistula is a challenging surgical condition arising most commonly as a complication of surgery or in few instances spontaneously secondary to underlying diseased gastrointestinal tract. The basic management protocol incorporates initial stabilization of patient and control of sepsis and nutritional build up but even though the morbidity and mortality rate remains high. The present study was designed to study the etiology, management and outcome of patients with enterocutaneous fistula presenting at Patna Medical College & Hospital. All patients who developed or presented during the study period with enterocutaneous fistula except oesophageal, biliary, pancreatic and perianal fistulas were included in the study. The etiology, fistula output, clinical course, complications, and outcomes for patients with ECF were studied. A total of 72 patients with ECF were included in the study. 31 patients each were managed conservatively and with surgical intervention. 10 patients were discharged against medical advice or were referred to super specialitycentre. 16 patients out of total 62 patients treated at our centre succumbed to their illness. Most frequent surgical intervention involved exteriorization of fistula site or repair with proximal diversion in 28 patients, resection and anastomosis in 2 patients and primary repair of fistula without diversion procedure. Most of the ECF are encountered as a complication of surgery. Conservative management should be the first line of treatment though surgical intervention may be a secondary option in a subset of patients. Mortality in patients with ECF continues to be alarming. Keywords:Enterocutaneous Fistula, Diversion Surgery, Fistula Surgery
Authors and Affiliations
Anshu Atreya, Mukesh Kumar, Jainendra Kumar
Keywords
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