What is an Enteroatmospheric fistula?
Enteroatmospheric fistula (EAF), a special subset of enterocutaneous fistula (ECF), is defined as a communication between the gastrointestinal (GI) tract and the atmosphere. It is one of the most devastating complications of “damage control” laparotomy (DCL) and results in significant morbidity and mortality.
How is enterocutaneous fistula treated?
Treatment. If the enterocutaneous fistula (ECF) doesn’t heal on its own after a few weeks or months, a complex surgery is required to close the fistula and reconnect the gastrointestinal tract. Patients with ECFs often need specialized wound care, nutritional rehabilitation and physical rehabilitation.
Can a bowel fistula heal without surgery?
In about half of the cases where an abscess has occurred and drained, a fistula will form between the inside or the pocket and the opening where the infection drained. A fistula will not heal without treatment, which involves removing the pocket where the infection started.
Is a fistula a wound?
By definition, a fistula is an abnormal, epithelialized connection between two body structures and can occur anywhere surgical wounds occur.
What is high-output fistula?
A high-output fistula may be defined pragmatically as one with an output of 500 mL/day or more. This may be further refined according to the anatomical site, and the present article focuses on the ECFs.
What causes enterocutaneous fistula?
Most ECFs occur after bowel surgery. Other causes include infection, perforated peptic ulcer and inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis. An ECF may also develop from an abdominal injury or trauma, such as a stabbing or gunshot.
How do you detect enterocutaneous fistula?
Enterocutaneous Fistula Diagnosis
- Abdominal CT scan.
- Barium enema, if the fistula involves the colon.
- Barium swallow, also called an esophagram. This test is a series of X-rays of the esophagus.
- Fistulogram, which involves injecting contrast dye into the opening of the skin of an ECF and taking X-rays.
What to do if you have enteroatmospheric fistula?
Once an EAF occurs, immediate management consists of treatment of sepsis if present; nutrition, fluid, and electrolyte support in the form of parenteral nutrition (PN); and wound/effluent control and protection of surrounding tissues and exposed bowel.
Can a fistula be treated with negative pressure wound therapy?
The management of enteroatmospheric fistula (EAF) in open abdomen (OA) therapy is challenging and associated with a high mortality rate. The introduction of negative pressure wound therapy (NPWT) in open abdomen management significantly improved the healing process and increased spontaneous fistula …
Why is iatrogenic entero-atmospheric fistula so difficult to treat?
Iatrogenic entero-atmospheric fistula is devastating and its management is extremely difficult because it is often associated with fluid and electrolyte disturbances, nutritional problems, and life-threatening sepsis.
Which is a special subset of enterocutaneous fistula?
Enteroatmospheric fistula (EAF), a special subset of enterocutaneous fistula (ECF), is defined as a communication between the gastrointestinal (GI) tract and the atmosphere. It is one of the most devastating complications of “damage control” laparotomy (DCL) and results in significant morbidity and mortality.
