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Enteroatmospheric fistula

Alexander Reinisch, Juliane Liese, Guido Woeste, Wolf Bechstein, Nils Habbe
Enteroatmospheric fistulas (EAFs) represent a challenging problem in patients with an open abdomen (OA). A retrospective, descriptive study was conducted to evaluate the effects of enteral alimentation on wound status and management and nutrition. All patients with an EAF in an OA treated between October 2012 and December 2014 at a university hospital in Germany were included without criteria for exclusions. Demographic and morbidity-related data collected included age, gender, surgeries, OA grading, body mass index (BMI), serum albumin, and serum creatinin...
July 2016: Ostomy/wound Management
Irena Gribovskaja-Rupp, Genevieve B Melton
Management of enterocutaneous fistula represents one of the most protracted and difficult problems in colorectal surgery with substantial morbidity and mortality rates. This article summarizes the current classification systems and successful management protocols, provides an in-depth review of fluid resuscitation, sepsis control, nutrition management, medication management of output quantity, wound care, nonoperative intervention measures, operative timeline, and considerations, and discusses special considerations such as inflammatory bowel disease and enteroatmospheric fistula...
June 2016: Clinics in Colon and Rectal Surgery
Luis Sánchez-Guillén, Ramón López de Los Reyes, Eulalia Vives-Rodríguez, Almudena Mato Iglesias, Ana Cantón-Blanco
No abstract text is available yet for this article.
May 26, 2016: Cirugía Española
Ioannis Mintziras, Michael Miligkos, Detlef Klaus Bartsch
PURPOSE: The aim of this study was to evaluate the efficacy of vacuum-assisted closure therapy in patients with open abdomen due to secondary peritonitis and to identify possible risk factors of fistula formation. METHODS: The hospital OPS-database (time period 2005-2014) was searched to identify patients treated with an open abdomen due to secondary peritonitis, who underwent vacuum-assisted closure therapy. Medical records were retrospectively analyzed for patients' characteristics, cause of peritonitis, duration of vacuum therapy, number of relaparotomies, fascial closure rates, and risk factors of fistula formation...
August 2016: Langenbeck's Archives of Surgery
Daniel E Wainstein, Pablo Sisco, María L Deforel, Mariano Irigoyen, Jorge Devoto, Juan M Zarate
INTRODUCTION: The open abdomen is a widespread therapeutic resource; however, it is also a source of complications, of which the enteroatmospheric fistulas (EAFs) pose one of the greatest problems. The objective of this study was to describe the implemented strategy for handling enteroatmospheric fistulas, and secondarily, to analyze the differential results based on a change in the conservative local treatment specifically designed for the stated complication. MATERIALS AND METHODS: From March 2002 to March 2014, patients treated for EAF were retrospectively analyzed...
April 2016: Surgical Technology International
I T A Pereboom, H S Hofker
No abstract text is available yet for this article.
May 2016: Diseases of the Colon and Rectum
Yu-Hua Huang, You-Sheng Li
The use of open abdomen (OA) as a technique in the treatment of exsanguinating trauma patients was first described in the mid-19(th) century. Since the 1980s, OA has become a relatively new and increasingly common strategy to manage massive trauma and abdominal catastrophes. OA has been proven to help reduce the mortality of trauma. Nevertheless, the OA method may be associated with terrible and devastating complications such as enteroatmospheric fistula (EAF). As a result, OA should not be overused, and attention should be given to critical care as well as special management...
2016: Military Medical Research
Fahri Yetisir, Akgün Ebru Sarer, Hasan Zafer Acar, Gokhan Osmanoglu, Mehmet Özer, Faik Yaylak
Introduction. We report the management of a septic Open Abdomen (OA) patient by the help of negative pressure therapy (NPT) and abdominal reapproximation anchor (ABRA) system in pregnant woman with spontaneous jejunal perforation after emergent cesarean section (C/S) with confounding factor of mild acute pancreatitis (AP). Presentation of Case. A 29-year-old and 34-week pregnant woman with AP underwent C/S. She was arrested after anesthesia induction and responded to cardiopulmonary resuscitation (CPR). There were only ash-colored serosanguinous fluid within abdomen during C/S...
2016: Case Reports in Surgery
Adam Bobkiewicz, Dominik Walczak, Szymon Smoliński, Tomasz Kasprzyk, Adam Studniarek, Maciej Borejsza-Wysocki, Andrzej Ratajczak, Ryszard Marciniak, Michal Drews, Tomasz Banasiewicz
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 closure. Retrospectively, we analysed 16 patients with a total of 31 enteroatmospheric fistulas in open abdomen management who were treated using NPWT in four referral centres between 2004 and 2014. EAFs were diagnosed based on clinical examination and confirmed with imaging studies and classified into low (<200 ml/day), moderate (200-500 ml/day) and high (>500 ml/day) output fistulas...
March 22, 2016: International Wound Journal
M Björck, A W Kirkpatrick, M Cheatham, M Kaplan, A Leppäniemi, J J De Waele
BACKGROUND: In 2009, a classification system for the open abdomen was introduced. The aim of such a classification is to aid the (1) description of the patient's clinical course; (2) standardization of clinical guidelines for guiding open abdomen management; and (3) facilitation of comparisons between studies and heterogeneous patient populations, thus serving as an aid in clinical research. METHODS: As part of the revision of the definitions and clinical guidelines performed by the World Society of the Abdominal Compartment Syndrome, this 2009 classification system was amended following a review of experiences in teaching and research and published as part of updated consensus statements and clinical practice guidelines in 2013...
March 2016: Scandinavian Journal of Surgery: SJS
Rajmund Jaguścik, Dominik A Walczak, Joanna Porzeżyńska, Piotr W Trzeciak
An enteric fistula that occurs in an open abdomen is called an enteroatmospheric fistula (EAF) and is the most challenging complication for a surgical team to deal with. The treatment of EAF requires a multidisciplinary approach. First of all, sepsis has to be managed. Any fluid, electrolyte and metabolic disorders need to be corrected. Oral intake must be stopped and total parenteral nutrition introduced. The control and drainage of the effluent from the fistula is a separate issue. Since there are no fixed algorithms for the treatment of EAF, surgeons need to develop their own, often highly unconventional solutions...
October 2015: Polski Przeglad Chirurgiczny
Scott G Blair, Nicholas J Fayard, Naveed Ahmed, Emily A Rogers, Jon D Simmons
No abstract text is available yet for this article.
March 2015: American Surgeon
Shuang Chen
The aim of this article is to expound on the crossing and influence each other of gastrointestinal surgery and abdominal wall hernia surgery. Although these two departments are independent respectively, but due to the existence of association among anatomy, physiology and pathology, so they are also overlapping. First of all, the abdominal wall and digestive tract are interdependent, and the abdominal wall provides "protection" for gut. In case of large abdominal wall defect, intra-abdominal viscera, breathing, circulation system and spine will change accordingly...
November 2015: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Rifat Latifi
With advances in abdominal surgery and the management of major trauma, complex abdominal wall defects have become the new surgical disease, and the need for abdominal wall reconstruction has increased dramatically. Subsequently, how to reconstruct these large defects has become a new surgical question. While most surgeons use native abdominal wall whenever possible, evidence suggests that synthetic or biologic mesh needs to be added to large ventral hernia repairs. One particular group of patients who exemplify "complex" are those with contaminated wounds, enterocutaneous fistulas, enteroatmospheric fistulas, and/or stoma(s), where synthetic mesh is to be avoided if at all possible...
April 2016: World Journal of Surgery
Kate Willcutts, David Mercer, Jane Ziegler
BACKGROUND: Enteric fistulas can be classified as enterocutaneous and/or enteroatmospheric. Both are devastating complications of bowel disease, abdominal surgery, and/or open abdomen. Enteric fistulas are associated with a mortality rate varying from 1% to 33%; the main cause of death is sepsis. Coordinated and skillful efforts of an interprofessional team are required in customizing successful treatment regimens appropriate to each patient's unique clinical scenario. CASE STUDY: A 65-year-old white woman experienced an enteroatmospheric fistula patient after ventral hernia repair...
September 2015: Journal of Wound, Ostomy, and Continence Nursing
Massimo Sartelli, Fikri M Abu-Zidan, Luca Ansaloni, Miklosh Bala, Marcelo A Beltrán, Walter L Biffl, Fausto Catena, Osvaldo Chiara, Federico Coccolini, Raul Coimbra, Zaza Demetrashvili, Demetrios Demetriades, Jose J Diaz, Salomone Di Saverio, Gustavo P Fraga, Wagih Ghnnam, Ewen A Griffiths, Sanjay Gupta, Andreas Hecker, Aleksandar Karamarkovic, Victor Y Kong, Reinhold Kafka-Ritsch, Yoram Kluger, Rifat Latifi, Ari Leppaniemi, Jae Gil Lee, Michael McFarlane, Sanjay Marwah, Frederick A Moore, Carlos A Ordonez, Gerson Alves Pereira, Haralds Plaudis, Vishal G Shelat, Jan Ulrych, Sanoop K Zachariah, Martin D Zielinski, Maria Paula Garcia, Ernest E Moore
The open abdomen (OA) procedure is a significant surgical advance, as part of damage control techniques in severe abdominal trauma. Its application can be adapted to the advantage of patients with severe abdominal sepsis, however its precise role in these patients is still not clear. In severe abdominal sepsis the OA may allow early identification and draining of any residual infection, control any persistent source of infection, and remove more effectively infected or cytokine-loaded peritoneal fluid, preventing abdominal compartment syndrome and deferring definitive intervention and anastomosis until the patient is appropriately resuscitated and hemodynamically stable and thus better able to heal...
2015: World Journal of Emergency Surgery: WJES
John T Heineman, Luis J Garcia, Mary Anne Obst, Hui Sen Chong, Julia G Langin, Rebecca Humpal, Patrica A Pezzella, David J Dries
No abstract text is available yet for this article.
August 2015: Journal of the American College of Surgeons
Amy Verhaalen, Bruce Watkins, Karen Brasel
UNLABELLED:  Background. The following describes successful isolation of enteroatmospheric fistulae within a negative pressure wound therapy system (V.A.C.®, KCI, San Antonio, TX). METHODS: An impermeable tubular structure was placed around the fistula with a dressing applied to the surrounding wound base, dressed with an impermeable drape and negative pressure, and then an ostomy appliance was placed over the isolated fistula stoma. Cost analysis compared traditional dressings to the NPWT isolation method...
August 2010: Wounds: a Compendium of Clinical Research and Practice
Rahul Gupta, Harjeet Singh, Shibojit Talukder, Ganga Ram Verma
Proximal enteroatmospheric fistulae are difficult to manage and carry high mortality from sepsis and electrolyte imbalances. Conservative management with total parenteral nutrition, exclusion of fistula, resection and anastomosis are conventional methods of treatment with low success rate. Providing muscle cover to manage an enteroatmospheric fistula is a noble concept. A postoperative high-output gastroatmospheric fistula (GAF) was repaired by superior epigastric artery-based rectus abdominis muscle flap (RAMF)...
2015: BMJ Case Reports
Krzysztof Szmyt, Krokowicz Łukasz, Adam Bobkiewicz, Bartosz Cybułka, Witold Ledwosiński, Maciej Gordon, Ahmed Alammari, Tomasz Banasiewicz, Michał Drews
UNLABELLED: Open abdomen technique is a surgical treatment in which the fascia and skin are left open in order to reduce the value of the intra-abdominal pressure. According to the World Society of the Abdominal Compartment Syndrome (WSACS) normal values of the intra-abdominal pressure are between 5 and 7 mm Hg. Intra-abdominal hypertension occurs when the pressure value is equal to or exceeds 12 mm Hg. The aim of the study was to compare the results of the open abdomen treatment using standard methods and negative pressure wound therapy...
January 2015: Polski Przeglad Chirurgiczny
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