Management Approaches for Enterocutaneous Fistulas

Abstract

There are very few clinical studies that highlight a definitive and comprehensive guideline for the management of enterocutaneous fistulas. Most accepted guidelines are found in textbooks and are taken from expert advice and case reports. The goal of this review is to highlight advancements relevant to the management of enterocutaneous fistulas from the recent two to three years. Although strong evidence-based guidelines are lacking, the consensus is that a multidisciplinary team working with a clear treatment plan targeting multiple aspects of management can maximize patient outcomes.

Nutritional Management of Patients With Enterocutaneous Fistulas: Practice and Progression

“…Fistulolysis has proven to be a cost-effective alternative to TPN and can also stimulate the gut mucosa. The use of polymeric feed and elemental feed can provide the effective nutritional support for ECF patients ( 58 ).…”

Use of the Amplatzer cardiac septal occluder to heal a recurrent high‐output chronic enteroatmospheric fistula

“…Enterocutaneous fistulas (ECFs) are a complex surgical issue characterized by abnormal connections between the lumen of hollow viscera and skin 1 . ECFs can be iatrogenic (75–85%) or spontaneous (15–25%) 2 .…”

“…However, if a fistula does not close within 4–6 weeks, surgical repair is recommended in order to excise the bowel loop involved in the fistula. Still, it is advocated to delay surgery up to 6–12 months to achieve a good patient's performance status, to decrease the local inflammatory state and to reduce the risk of bowel injury 1,5,6 …”

Effect Phenytoin Therapy to Fibroblasts and Angiogenesis of Enterocutaneous Fistula in Wistar Rat

“…Enterocutaneous fistula (ECF) is an abnormal communication between the intra-abdominal digestive tract and the skin. 1,2 The ECFoccurs spontaneously on 30% due to malignancy, sepsis, radiation or inflammatory diseases of the intestine, whereas due to postoperative complications of more than 75% . 2,3 ECF patients are faced with conditions of increased morbidity and mortality due to it complications.…”