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  • Author: S. Savin, x
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Abstract

After eventrations’ postoperative cure through alloplastic procedures, intestinal fistulas may occur. The present study is examining a number of possible factors involved in the occurrence of intestinal fistula (type and location of the celiotomy following which appeared the eventration, the type of the net substitutes, co-morbidities and the method of the alloplastic substitution) and its treatment. The analysis was retrospective and it covered 8 (eight) cases of intestinal fistula occurred after the installation of replacement nets for eventration postoperative cure.

Abstract

During a period of three years (01.01.2009-31.12.2011), 17 cases of enterocutaneous fistulas arising from the small intestine were managed.

The majority of the fistulas (76%) resulted from surgical complications. There were 6 females and 11 male patients. The mean age of the patients was 40 years. For 9 out of 17 patients (52%) the fistulae arose from the proximal small gut (duodenum and jejunum) and in the remaining 48%, from the ileum.

Octreotide was used for 11/17 patients (64%). Enteral nutrition was used for 9/17 patients (52%), while re-feed from the proximal gut fistulae was used in 4/9 patients (44%) in order to maintain the nutrition of the above mentioned subjects.

Only one fistula (6%) closed spontaneously. There were 2 deaths (12%) in this study. For 14 out of 17 patients (82%) the surgical intervention at some stage was required for successful closure of intestinal fistula. Aggressive surgical treatment with judicious use of octreotide, nutritional support, stoma care and control of sepsis significantly improves the outcome of small intestinal fistulae.