CLINICAL STUDY OF ENTEROCUTANEOUS FISTULA

Dr.M. R. Kushwaha, Dr. Jigar Patel, Dr. Raj Sharma

Abstract


OBJECTIVE.TO STUDY CAUSE, ANATOMICAL LOCATION, OUTPUT, COMPLICATIONS, OUTCOME OF 22 CONSECUTIVE CASE ENTEROCUTANEOUS FISTULA(ECF) MANAGED FROM 2014 TO 2019.

METHOD. THIS DESCRIPTIVE STUDY WAS CONDUCTED PROSPECTIVELY TO STUDY CAUSE, ANATOMICAL LOCATION, OUTPUT, COMPLICATIONS,OUTCOME OF 22 CASE OF ENTEROCUTANEUOS FISTULA(ECF).PATIENTS WHOM DEVELOP ECF AFTER SURGERY WERE INCLUDED IN THIS STUDY WHILE PATIENTS WITH ESOPHAGEAL,BILIARY,PANCREATIC AND PERIANAL FISTULA WERE EXCLUDED.FISTULA OUTPUT WAS QUANTIFIED BY DIRECT MEASURMENT,IN PRESENCE OF DRAIN OR BY CALCULATING NUMBER OF DRESSING SOAKED PER DAY.

RESULT.A TOTAL OF 22 PATIENTS WERE INCLUDED IN STUDY, OF WHICH 13 MALE AND 9 FEMALE AND MALE TO FEMALE RATIO IS 3:2. MOST OF PATIENTS WITH ECF WERE AGED 35-55 YEAR.OF THE 42 PATIENTS, 16 HAD SMALL BOWEL FISTULA;2 DUODENAL,6 JEJUNAL,8 ILEAL AND REMAINING 6 HAD COLONIC FISTULA.12 PATIENTS HAD LOW OUTPUT FISTULA AND 10 PATIENT HAD HIGH OUTPUT FISTULA.MORTALITY WAS SIGNIFICANTY HIGHER IN PATIENTS WITH AGE > 55 YEAR,MALES,MESENTRIC ISCHEMIA AS UNDERLYING PATHOLOGY,RE-SURGERY,SERUM ALBUMIN <2.5 G/DL.

CONCLUSION.EARLY DIAGNOSIS AND STABILIZATION FORM KEY ASPECTS OF MANAGEMENT OF ECF AS MOST PATIENTS ARE MANAGED  CONSERVATIVELY.PROMPT NUTRITIONAL SUPPLEIMENTS ALTERS OUTCOME OF THIS DISEASE.HIGH OUTPUT FISTULAE REQUIRED MOSTLY SURGICAL MANAGEMENT AND HAD HIGH MORTALITY AND MORBIDITY.


Keywords


Enterocutaneous Fistula (ecf), Abnormal, Stomach, Gastrointestinal Contents

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