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Management of Enterocutaneous Fistula
Published in Jeff Garner, Dominic Slade, Manual of Complex Abdominal Wall Reconstruction, 2020
Jonathan C. Epstein, Mattias Soop
An enterocutaneous fistula is by definition an abnormal communication between the intestinal tract and the skin, and an enteroatmospheric fistula, between exposed bowel and the air. It is not uncommon for enterocutaneous fistulas to co-exist with internal fistulas involving other loops of bowel, a chronic abscess cavity or the urothelial tract, which add to the technical complexity of reconstructive surgery.
Diagnosis of IBD
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Gregor Novak, Geert D’Haens, Najib Haboubi, John B. Schofield
Fistulas are classified according to their location and connection with contiguous organs. Internal fistulas (e.g. enteroenteric, enterovesical, rectovaginal) connect the intestine with various organs or anatomical structures. External fistulas connect the intestine with perianal (perianal fistula) or abdominal skin (enterocutaneous fistula).89 The cumulative risk of at least one fistula at any site one year after the diagnosis of CD is 21%, after 10 years 33% and after 20 years 50%.76
Impact of the Crohn’s disease digestive damage score (Lémann Index) on the perioperative course in patients with Crohn’s disease and ileocolic anastomosis
Published in Scandinavian Journal of Gastroenterology, 2021
Jan P. Arbogast, Sarah Urbanik, Rebecca Schmidt, Rudolf Mennigen, Andreas Pascher, Emile Rijcken
Eighteen patients (17.5%) suffered a postoperative complication higher than Clavien-Dindograde 2: Four patients had to be admitted to intensive care unit (grade 4) for hemodynamic failure (2), respiratory failure (1) and sepsis with renal failure (1), each time after reoperation had become necessary. Further eight patients had to be returned to the operation room (grade 3 b) for bowel leakage (4), intraabdominal abscess (2), volvulus (1) and bleeding (1). Total reoperation rate was 12.6% (13). Five patients suffered a complication grade 3a: emergency endoscopy (4) and CT-guided drainage of an abscess (1). SSI were diagnosed in 33 patients (32%), 17 among these with deep (5) or organ/space (12) infections. Anastomotic leakage was found in 9 patients (8.7%), of which three became apparent as enterocutaneous fistula that occurred after discharge from the hospital.
The Double-Lumen Irrigation-Suction Tube in The Management of Incisional Surgical Site Infection After Enterocutaneous Fistula Excisions: An Observational Study
Published in Journal of Investigative Surgery, 2021
Zheng Yao*, Weiliang Tian*, Xin Xu, Risheng Zhao, Ming Huang, Yunzhao Zhao, Xinhao Chen
This retrospective study was performed in our center, a national treatment center of enterocutaneous fistula and abdominal infection, patients from all over the country are treated at our center. From January 2016 to December 2017, the medical records of patients with ECF excisions were reviewed. All patients had been transferred to our center, following a primary surgery leading to ECF. This study was completed by researchers from the two tertiary hospitals. The study had been approved by the institutional review board (IRB; NO. NJZY-18-0624). All methods were performed in accordance with the relevant guidelines and regulations. Informed consent was obtained from all individuals.
Comparison of a standardized negative pressure wound therapy protocol after midline celiotomy to primary skin closure and traditional open wound vacuum-assisted closure management
Published in Baylor University Medical Center Proceedings, 2018
Justin L. Regner, Matthew J. Forestiere, Yolanda Munoz-Maldonado, Richard Frazee, Travis S. Isbell, Claire L. Isbell, Randall W. Smith, Stephen W. Abernathy
Of the five SSOs in the NPWT protocol group, none required operative re-intervention. Three of the five SSOs were superficial SSIs requiring conversion to open NPWT. One patient had a small fascial dehiscence that was managed nonoperatively. One patient developed an enterocutaneous fistula. Of the 14 SSOs in the standard NPWT group, 9 required a second operative or procedural intervention. One patient developed an enterocutaneous fistula. The remaining SSOs were superficial SSIs requiring drainage and further open NPWT. The six SSOs in the primary skin closure patients were SSIs that were managed with open packing in the outpatient setting.