medigraphic.com
ISSN 1561-2945 (Print)

2012, Number 2

<< Back Next >>

Revista Cubana de Cirugía 2012; 51 (2)

High output fistula

Almeida VR, Suárez EO, Pérez GO, Selman HE, Cordovés SC, García RY

Language: Spanish
References: 40
Page:
PDF size: 330.50 Kb.


ABSTRACT

A 37 years-old multi-traumatized male patient went to our emergency service. He had many injures in the thorax and the abdomen, together with symptoms and signs suggestive of multiple costal fractures, with right hemothorax and hemoperitoneum, all of which was confirmed by imaging techniques and by abdominal puncture. Minimal intermediate pleurostomy and exploratory laparoscopy were performed. We found hepatic lesions in the 6th, 5th, 8th and 4th segments, over 3 cm deep; additionally, the loss of serosa from the intestinal ansae and from the colon. Hepatorrhaphy and hepatic packing were also performed. Later on, more complications appeared, so he had to be re-operated more than 60 times. The occurrence of a high output fistula led him to malnutrition and his abdomen remained exposed for 7 months until he was finally discharged from hospital. This paper also presented a literature review on this topic.


REFERENCES

  1. Halversen RC, Hogle HH, Richards RC. Gastric and small bowel fistulas. Am J Surg. 1969;118:968-72.

  2. Nassos TP, Braash JW. External small bowel fistulas. Current treatment and results. Surg Clin North Am. 1971;51:687-92.

  3. Hollender LF, Meyer C, Avet D, Zeyer B. Postoperative fistulas of the small intestine: therapeutic principles. Worid J Surg. 1983;7:474-80.

  4. Martineau P, Schwed JA, Denis R. Is octreotide a new hope for enterocutaneous and external pancreatic fistulas closure? Am J Surg. 1996;172:386-95.

  5. Fuentes Valdés E. Fístulas gastroenterocutáneas: factores que influyen en la mortalidad. Rev Cubana Cir [serie en internet]. 2000 [citado 20 de febrero de 2011];41(2). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-74932002000200004&lng=es&nrm=iso&tlng=es

  6. Edmunds Jr LH, Williams GM, Welch CE. External fistulas arising from the gastrointestinal tract. Ann Surg. 1960;152:445-71.

  7. Berry SM, Fischer JE. Classification and pathophysiologyof enterocutaneous fistulas. Surg Clin North Am. 1996;76:1027-36.

  8. Prickett D, Montgomery R, Cheadie WG. External fistulas arising from the digestive tract. South Med J. 1991;84:736-9.

  9. Fischer JE. The pathophysiology of enterocutaneous fistulas. World J Surg. 1983;7:446-50.

  10. Arenas-Márquez H, Anaya-Prado R, Hurtado H. Consenso mexicano en el manejo integral de las fístulas del aparato digestivo. Cir Gen. 2000;22:287-9.

  11. Kuvshinoff BW, Brodish RJ, McFadden DW, Fischer JE. Serum transferrin as a prognostic indicator of spontaneous closure and mortality in gastrointestinal cutaneous fistulas. Ann Surg. 1993;217(6)5:623.

  12. Lévy E, Frileux P, Cugnenc PH, Honiger J, Ollivier JM, Parc R. High-output external fistulae of the small bowel: management with continuous enteral nutrition. Br J Surg. 1989;76:676-9.

  13. Schein M, Decker GAG. Postoperative external alimentary tract fistulas. Am J Surg. 1991;161:435-8.

  14. Vallés Gamboa M. Fístulas enterocutáneas de intestino delgado. Manejo terapéutico. Gastroenterología Integrada. 2002;3(3):162-6.

  15. Chapman R, Foran R, Dunphy JE. Management of intestinal Fistulas. Am J Surg. 1964;108:157-64.

  16. Zuidema G, Shakelford RT. Fístulas del intestino delgado. 3ra edición. Buenos Aires: Editorial Panamericana; 1997. p. 200-50.

  17. Howard A, Reber CR. Management of External Gastrointestinal Fistulas. Ann Surg. 9 October 1978;188(4):460-83.

  18. Webster NW, Carey LC. Fistulae of intestinal tract. Year Book Medical Publisher. 1976;13(6):20-30.

  19. Morales Díaz I, Pinilla González R. Fístulas externas del tubo digestivo. Actualización de las normas de cirugía [homepage en Internet] La Habana, Cuba [citado 20 de febrero de 2011]. Disponible en: http://www.sld.cu/galerias/pdf/uvs/cirured/38.-_fistulas_intest._ext_2.pdf

  20. MacFayden BV. Management of gastrointestinal fistulas with parenteral hyperalimentation. Ann Surg. 1973;74:100.

  21. Reber HA. Management of external gastrointestinal fistulas. Annals of Surg. 1978;188:460.

  22. Mughal MM, Bancewicz J, Irving HM. "Laparostomy" a technique for the management of intractable abdominal sepsis. Br J Surg. 1996;73:253-9.

  23. Stiges-Serra A, Jaurrieta E, Stiges-Creus A. Management of external postoperative enterocutaneous fistula. Ann Surg. 1979;190:189-202.

  24. Schein M, Decker D. Gastrointestinal fistulas associated with large abdominal wall defects: experience with 43 patients. Br J Surg. 1990;77:97-100.

  25. Stone Patrick A. Trauma. Inf Crit Care. 2004;57:1082-6.

  26. Schirmer CC, Gurski RR, Gugel FL, Lazzaron AR, Brentano L, Kruel CD. Alternative surgical treatment for complex enterocutaneous fistula. Int Surg. 1999;84(1):29-34.

  27. Fazio W, Cooutsoftides T, Eteiger E. Factor influencing the outcome of treatment of small bowell cutaneous fistula. World J Surg. 1983;7(4):481-8.

  28. Peix JL, Barth X, Baulieux J, Boulez J, Donne R, Maillet P. Etude d´une serie de soixante-six fistules postoperatoires de l´intestin grele. Ann Chir. 1982;36:18-24.

  29. Halasz NA. Changing patterns in the management of small bowell fistulas. Am J Surg. 1978;136:61-6.

  30. Soeter PB. Review of 404 patients with gastrointestinal fistulas: impact of parenteral nutrition. Ann Surg. 1979;190:189.

  31. Foster CE, Lefor AT. General treatment of gastrointestinal fistulas. Recognition, stabilization, and correction of fluid and electrolyte imbalances. Surg Clin North Am. 1996;76:1037-52.

  32. Dudrick SJ, Maharaj AR, McKeivey AA. Artificial nutrition support in patients with gastrointestinal fistulas. World J Surg. 1999;23:570-6.

  33. Apostolos K, Tassiopoulos MD, Baum G, Halverson JD. Small bowell fistulas. Surg Clin N Am. 1996;76(5):1175-81.

  34. Buechter KJ, Leonovicz D, Hastings PR, Fonts C. Enterocutaneous fistulas following laparotomy for trauma. Am Surg. 1991;57:354-8.

  35. McIntyre PB, Ritchie JK, Hawley PR, Bartram CI, Lennard-Jones JE. Management of enterocutaneous fistulas: a review of 132 cases. Br J Surg. 1984;71:293-6.

  36. Sheldon GF, Gardiner BN, Way LW, Dunphy JE. Management of gastrointestinal fistulas. Surg Gynecol Obstet. 1971;133:385-9.

  37. Rose D, Yarborough MF, Canizaro PC, Lowry SF. One hundred and fourteen fistulas of the gastrointestinal tract treated with total parenteral nutrition. Surg Gynecol Obstet. 1986;163:345-50.

  38. Buechter KJ, Leonovicz D, Hastings PR, Fonts C. Enterocutaneous fistulas following laparotomy for trauma. Am Surg. 1991;57:354-8.

  39. Hill GL. Operative strategy in the treatment of enterocutaneous fistulas. World J Surg. 1983;7:495-501.

  40. Martínez O. Fístulas enterocutáneas posoperatorias. Gaceta Médica México. 2003;139(2):30-40.




2020     |     www.medigraphic.com