Enterocutaneous fistulas may result from a wide variety of conditions and circumstances. Care of these patients can be quite challenging, frustrating, and. Management of enterocutaneous fistula has been done with a protocol of delayed surgery ranging from 3 to 6 months postoffending surgery in. Eversion of mucosa in an enterocutaneous fistula, an unfavorable condition for spontaneous closure. Enteroatmospheric fistula (EAF), a special subset of ECF, is defined as a communication between the GI tract and the atmosphere.


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CT scan two weeks later showing residual subcutaneous fluid collection. We continued to treat him conservatively with parenteral nutrition, intravenous antibiotics and regular dressings of the wound.

Faecal fistula responded well to the conservative treatment with complete closure of the fistula in 4 weeks figure 3.

Figure 3 Figure 3: CT scan 6 weeks later showing complete closure of the fistula. Discussion Faecal fistula is defined as an faecal fistula communicating with the intestines.

Management of a faecal fistula in an abdominal wound

Post-appendectomy faecal fistula formation, though a rare complication is associated with significant morbidity 1. Post-appendicectomy faecal fistulas occur mostly when there is severe peri-appendicitis involving the base of the appendix as well as the adjoining caecal wall.

Faecal fistula from the appendiceal stump is incriminated as a major etiological factor in such patients 3.

Injuries to the caecum during appendectomy, although is not frequently reported, are another important etiological factor.

They found that in 21 cases, faecal fistula was severe suppurative, gangrenous or perforated or appendectomy quoted as technically difficult 4.

Management of a faecal fistula in an abdominal wound

This system was changed PRN. Sometimes it would only last 1 day but never more than 3 days due to the changing nature of the output and the application technique. There was also issues in management of the ileostomy faecal fistula sometimes this was active with overflow from the fistula, therefore interrupting the seal of the eakin fistula appliance.

The nursing staff in the ward were trained up to do the application and management of the system in case of leakage.

May October December Over time, the continuous irrigation was ceased and the wall suction was used intermittently to allow her to ambulate and rehabilitate.

Enterocutaneous Fistula Treatment & Management

faecal fistula Some fistulas are created surgically for diagnostic or therapeutic purposes; others occur as result of injury or as congenital abnormalities. Among the many kinds faecal fistula fistulas, the anal type fistula in ano is one of the most common.

It generally develops as a result of a break or fissure in the wall of the anal canal or rectum, or an abscess there.


Converting a lateral duodenal fistula into an end fistula with a tube duodenostomy is a good option but may not be possible in most patients. If anastomosis faecal fistula performed close to a duodenojejunal flexure, then adequate decompression by gastrostomy and feeding faecal fistula are carried out.

The latter is also performed when proximal fistula repair is undertaken eg, lateral duodenal fistula. Myocutaneous or fasciocutaneous flap De Weerd et al described the use of a sandwich-design faecal fistula flap cover to close a high-output ECF.

The fistula was then closed with serratus muscle from a composite free latissimus dorsi—serratus flap.

Fecal fistula | definition of fecal fistula by Medical dictionary

The large abdominal wall defect was closed with the musculocutaneous latissimus dorsi flap taken from the composite flap. The placement of a VAC system between the serratus and the latissimus dorsi helped to fix the serratus to the fistula. Successful direct repair of an ECF using a surrounding fasciocutaneous flap has also been reported.

Postoperative Care In the postoperative phase of surgical therapy for an ECF, good nutritional status is essential because healing of the tissue and anastomosis depends on it. Antibiotic coverage is needed if the operation is performed in the presence of sepsis. Any flare-up of sepsis increases the possibility of breakdown of the anastomosis and of the faecal fistula wall closure leading to dehiscence.