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enterocutaneous fistule

Yit J Leang, Stephen W Bell, Peter Carne, Martin Chin, Chip Farmer, Steward Skinner, Roger Wale, Satish K Warrier
BACKGROUND: Enterocutaneous fistulas (ECFs) are complex and can result in significant morbidity and mortality. The study aimed to evaluate ECF outcomes in a single tertiary hospital. METHODS: A retrospective study of all patients treated with ECF between the period of January 2009 and June 2014 was conducted. Baseline demographic data assessed included the primary aetiology of the fistula, site of the fistula and output of the fistula. Outcomes measures assessed included re-fistulation rate, return to theatre, wound complications, fistula closure rate and death over the study period...
July 24, 2016: ANZ Journal of Surgery
G Kamalakar, V Devi Prasad, J Devaratnam, A Ganeshan
A body wall hernia entrapping abomasum and concurrent duodenal fistula in a buffalo calf aged about 8 months, secondary to a dog bite was successfully treated by closure of fistulous orifice and ventro lateral herniorrhaphy.
2015: Open veterinary journal
Kaori Fujiwara, Takuya Inoue, Naoki Yorifuji, Munetaka Iguchi, Taisuke Sakanaka, Ken Narabayashi, Kazuki Kakimoto, Sadaharu Nouda, Toshihiko Okada, Yosuke Abe, Toshihisa Takeuchi, Kazuhide Higuchi
Crohn's disease (CD) is characterized by transmural inflammation of the gastrointestinal tract, which predisposes patients to the formation of a fistula. The efficacy of adalimumab (ADA) for an enterocutaneous fistula remains unclear. In this report, we present a case series of 3 patients with enterocutaneous fistulizing CD treated with ADA. ADA treatment achieved sustained complete fistula closure in one patient. The other two cases, which failed to achieve fistula closure, had intestinal stenosis and were not receiving concomitant azathioprine...
2015: Internal Medicine
Oztekin Cikman, Hasan Ali Kiraz, Omer Faruk Ozkan, Gurhan Adam, Ahmet Celik, Muammer Karaayvaz
No abstract text is available yet for this article.
April 2015: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Xiuwen Wu, Jianan Ren, Xiaoting Li, Song Liu, Qin Wu, Gefei Wang, Guosheng Gu, Huajian Ren, Jieshou Li
BACKGROUND: Bacteria colonizing an enterocutaneous fistula tract have not been clarified. The aims of this study were to investigate the pathogen spectra of fistulous tracts and their resistance to antibiotics in patients with chronic fistulas. METHODS: We conducted a one-year prospective single-center study. In the absence of significant sepsis, consecutively stabilized patients with chronic enterocutaneous fistula were included. Microbiology and antimicrobial susceptibility of isolates from the tracts were analyzed...
June 2015: Surgical Infections
Elroy P Weledji, Marlene A Puepi, Alain M Chichom
A 70-year-old woman presented with a short history of a spontaneous enterocutaneos fistula in the left inguinal region. A laparotomy revealed a fistulizing Richter's hernia. The fistulizing small bowel segment was resected and the femoral hernia repaired from below. Although rare, a complicating Richter's hernia should be considered in the differential diagnosis of a groin fistula.
2014: Journal of Surgical Case Reports
Renáta Bor, Klaudia Farkas, Anita Bálint, Mónika Szucs, Szabolcs Ábrahám, Gellért Baradnay, Tibor Wittmann, Zoltán Szepes, Ferenc Nagy, Tamás Molnár
BACKGROUND AND AIMS: Recently, anti-TNF-alpha therapy has increasingly been used in the treatment of perianal Crohn's disease (PCD), but there is only limited data regarding its short- and long-term efficacy. MATERIAL AND METHODS: The medical records of 68 patients treated with anti-TNF-alpha for PCD were assessed retrospectively. Rate of complex fistulas was 75%. Every patient received induction therapy, but in 20 cases the treatment was discontinued before week 52 due to funding regulations, an allergic reaction, or compliance problems...
February 2015: Scandinavian Journal of Gastroenterology
Undine A Gerlach, Georgios Vrakas, Srikanth Reddy, Daniel C Baumgart, Daniel C Baumgar, Peter Neuhaus, Peter J Friend, Andreas Pascher, Anil Vaidya
IMPORTANCE: Because of the severity of disease and additional surgery, Crohn disease (CD) may result in intestinal failure (IF) and dependency on home parenteral nutrition (HPN). Defining the indication and timing for intestinal transplantation (ITx) is challenging. OBJECTIVES: To determine the limitations of conventional surgery and to facilitate the decision making for transplantation. DESIGN, SETTING, AND PARTICIPANTS: Data were collected prospectively and obtained by retrospective review of medical records from all patients with CD who were assessed for ITx in Oxford, United Kingdom, and Berlin, Germany, from October 10, 2003, through July 31, 2013...
October 2014: JAMA Surgery
Aurelien Amiot, Vida Setakhr, Philippe Seksik, Mathieu Allez, Xavier Treton, Martine De Vos, David Laharie, Jean-Frederic Colombel, Vered Abitbol, Jean Marie Reimund, Jacques Moreau, Michel Veyrac, Bernard Flourié, Jacques Cosnes, Marc Lemann, Yoram Bouhnik
OBJECTIVES: Although anti-tumor necrosis factor (TNF) therapy is the treatment of choice for perianal fistulizing Crohn's disease (CD), the efficacy and safety of anti-TNF therapy in enterocutaneous fistula (ECF) remains unclear. METHODS: Between January 2008 and December 2009, we retrospectively reviewed the outcomes of all CD patients with ECF (excluding perianal fistula) treated with anti-TNF therapy followed up in Groupe d'Etude Thérapeutique des Affections Inflammatoires du tube Digestif (GETAID) centers...
September 2014: American Journal of Gastroenterology
Bd Stephensen, J Brown, Al Lambrianides
A significant proportion of patients with severe intra-abdominal sepsis are managed by leaving the peritoneal cavity open in an attempt to control the infective process, regardless of aetiology. However, a considerable number of these patients develop enterocutaneous fistulae, which compound the clinical situation and delay closure of the peritoneal cavity. We propose a new method of dealing with such fistulae, by simply fashioning a direct pedicle flap to patch the fistulous opening. This method allows control of the fistula and facilitates early closure of the abdomen...
2012: Journal of Surgical Case Reports
L Flood, Kh Chang, Oj McAnena
The finding of the vermiform appendix in an inguinal hernia has an incidence of approximately 1%. The condition is given the eponymous name Amyand's hernia. However in just 0.08% the condition is complicated by an acute appendicitis. The clinical presentation varies, depending on the extent of inflammation of the appendix and is most often misdiagnosed as an incarcerated inguinal hernia. As such it is rarely recognised prior to surgical exploration. We report a case of Amyand's hernia in an 85 year old woman, which presented as a right groin enterocutaneous fistula...
2010: Journal of Surgical Case Reports
Krisztina Gecse, Reena Khanna, Jaap Stoker, John T Jenkins, Simon Gabe, Dieter Hahnloser, Geert D'Haens
Fistulizing Crohn's disease represents an evolving, yet unresolved, issue for multidisciplinary management. Perianal fistulas are the most frequent findings in fistulizing Crohn's disease. While enterocutaneous fistulas are rare, they are associated with considerable morbidity and mortality. Detailed evaluation of the fistula tract by advanced imaging techniques is required to determine the most suitable management options. The fundamentals of perianal fistula management are to evaluate the complexity of the fistula tract, and exclude proctitis and associated abscess...
June 2013: United European Gastroenterology Journal
G Li, J Ren, G Wang, D Hu, G Gu, S Liu, H Ren, X Wu, J Li
BACKGROUND/OBJECTIVES: Exclusive enteral nutrition (EEN) has been shown to be effective in the management of Crohn's disease (CD). However, few experiences have been reported regarding its role in postoperative intra-abdominal septic complications (IASCs) after bowel resections for enterocutaneous fistulas (ECFs). Our aim was to investigate the influence of preoperative 3-month EEN on the incidence of IASCs and to clarify the risk factors of IASCs in fistulizing CD. SUBJECTS/METHODS: A retrospective study on 123 CD patients suffering from ECFs was conducted from February 2001 to April 2011...
April 2014: European Journal of Clinical Nutrition
P Ravindran, N Ansari, C J Young, M J Solomon
AIM: Enterocutaneous fistula (ECF) presents a complex management problem with significant mortality and morbidity. The aim of this study was to assess the outcome of patients undergoing surgical cure for ECF and to predict factors that might relate to increased postoperative morbidity. METHOD: Medical records of all patients who underwent definitive surgery for cure of an ECF within our colorectal surgery unit between 2000 and 2010 were reviewed. RESULTS: Forty-one patients (18 male) were identified, in whom 44 definitive procedures were performed...
March 2014: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Xiuwen Wu, Jianan Ren, Gefei Wang, Guosheng Gu, Xiaoting Li, Huajian Ren, Zhiwu Hong, Jieshou Li
GOALS: This study was designed to investigate the risk factors affecting glue-assisted closure (GAC) in the enterocutaneous fistula (ECF) patients receiving glue application. BACKGROUND: ECF is a challenging problem in surgical practice, and it is difficult to resolve by spontaneous closure. Currently, GAC is popular when treating fistulas, but data related to risk factors are limited. METHODS: We retrospectively analyzed 82 patients with 93 ECFs, who had autologous glue sealing from 2010 to 2012 in a referral center...
April 2015: Journal of Clinical Gastroenterology
Eyas Alkhalili, Gavin A Falk, Gareth Morris-Stiff, John Cameron
A 71-year-old woman presented to the emergency department with abdominal pain and fever. Her surgical history was significant for gallbladder adenocarcinoma for which she had undergone extensive resection 32 months previously. At that time she underwent cholecystectomy, wedge resection of the liver, pancreatoduodenectomy, right nephrectomy and right hemicolectomy for a locally advanced gallbladder adenocarcinoma. Examination revealed a tender, warm, upper midline abdominal wall mass. A CT scan with oral contrast revealed a fistulous tract extending from the gastrojejunostomy (GJ) into an abscess cavity in the adjacent anterior abdominal wall...
2014: BMJ Case Reports
John K Triantafillidis, Apostolos E Papalois
Total parenteral nutrition (TPN) represents a therapeutic modality that could save the life of a patient with inflammatory bowel disease (IBD) facing severe nutritional problems, by restoring the patient's impaired nutritional status. TPN does not compete with enteral nutrition (EN), the latter being the first choice for all patients having anatomically intact and functionally normal digestive tract. TPN allows bowel rest while supplying adequate calorific intake and essential nutrients, and removes antigenic mucosal stimuli...
January 2014: Scandinavian Journal of Gastroenterology
Dominic Alexander James Slade, Gordon Lawrence Carlson
Key steps in managing patients with enterocutaneous fistulation and an abdominal wall defect include dealing effectively with abdominal sepsis and providing safe and effective nutritional support and skin care, then assessing intestinal and abdominal anatomy, before undertaking reconstructive surgery. The complexity, cost, and morbidity associated with such cases justifies creation of specialized centers in which gastroenterologic, hernia, and plastic surgical expertise, as well as experienced wound and stoma nursing and nutritional and psychological support, can be made available for patients with these challenging problems...
October 2013: Surgical Clinics of North America
Tomohiro Kunishige, Tomoyoshi Takayama, Sohei Matumoto, Kohei Wakatsuki, Koji Enomoto, Tetsuya Tanaka, Kazuhiro Migita, Masamitsu Kuwahara, Hiroshi Iioka, Yoshiyuki Nakajima
INTRODUCTION: In the present paper, we show a rare case of the large abdominal wall defect and enterocutaneous fistulas after the tension free repair using prostheses for incisional hernia. PRESENTATION OF CASE: The patient, a 70-year-old man, had a history of a hemicolectomy for a perforating colon cancer, complicated by a large incisional hernia that was closed primarily but recurred. Three years later, the hernia was repaired at the time of a second colectomy using a Composix Kugel Patch...
2013: International Journal of Surgery Case Reports
Jamie Murphy, Alexander Hotouras, Lena Koers, Chetan Bhan, Michael Glynn, Christopher L Chan
BACKGROUND: The development of enterocutaneous fistula (ECF) is one of the most challenging complications encountered in colorectal surgery. Currently, only two supra-regional centres are nationally designated in the United Kingdom to treat ECF patients. The aim of this study was to assess clinical outcome measures following the implementation of an ECF service at The Royal London Hospital. METHODS: All patients diagnosed with enterocutaneous fistula between December 2005 and November 2011 were recruited to the study...
2013: International Journal of Surgery
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