Management of an enterocutaneous fistula in a patient with a gastrointestinal stromal tumor.

BACKGROUND: Gastrointestinal stromal (GIS) tumors are rare malignancies that affect the esophagus, stomach, gallbladder, liver, small intestine, colon, or rectum. These tumors are often refractory to treatment with radiotherapy and chemotherapy and usually treated with a combination of surgery and imatinib mesylate, a tyrosine kinase inhibitor.

CASE: This case study describes the management of an enterocutaneous fistula in a patient with a rare GIS tumor who ultimately required radical excision of the mesenteric GIS tumor by enteroenterostomy and colocolostomy. He subsequently developed an enterocutaneous fistula within his dehisced surgical wound. This fistula along with the wound required various dressings and pouching modifications to meet treatment goals and enable the patient to be discharged from the hospital.

CONCLUSION: Although rare, WOC nurses may care for a patient with GIS tumors. Fistulas may occur due to the disease or as a result of treatment. The use of a fistula pouching system, combined with individualized and detailed education, may allow patients to maintain a quality of life despite the poor prognosis associated with this malignancy.