DOI: http://dx.doi.org/10.18203/2349-2902.isj20185034

Rationale in management of entero-cutaneous fistula following routine and emergency surgery: a prospective study in a tertiary care hospital of Odisha

Jagmohan Mishra, Afroza Firodous, Biplab Mishra

Abstract


Background: The enterocutaneous fistula is an abnormal communication between gastrointestinal tract and skin. It is a grave surgical complication following surgery on gastrointestinal tract. Despite in surgical nutrition and critical care, mortality from enterocutaneous fistula remains high. Improvements in outcome are focused on prevention and when fistula occurs, prompt recognition and intervention is essential.

Methods: This is institutional based prospective observational study which was conducted in S.C.B Medical college, Cuttack, Odisha for a period from September 2015 to September 2017 on 30 patients with enterocutaneous fistulae occurring as post-operative complication among patients admitted and operated at our institution for various gastrointestinal conditions and also referred from other centres after complication had set in. Detailed history, physical examination, routine workup, management and its outcome were studied.

Results: The maximum number of fistulae (86.7%) developed after emergency surgery than routine. Incidence of enterocutaneous fistulae was observed in cases operated for intestinal obstruction (40%) followed by operation for enteric perforation (28%). The highest incidence of enterocutaneous fistula occurred on 8th post-operative day (36.7%). 24 cases were treated conservatively while 6 patients underwent operative treatment.

Conclusions: Hence, the enterocutaneous fistula is frequently seen with emergency surgery of gastrointestinal tract, particularly on ileum, usually occurring around 8th post-operative day and most of them end in spontaneous closure with conservative treatment.


Keywords


Enterocutaneous fistula, Emergency laparotomy, Routine G. I. surgery

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