Enterocutaneous Fistula

(Gastrointestinal Fistula; Entero-enternal Fistula)
  • Definition

    An enterocutaneous fistula is an abnormal connection between the intestines and the skin. Intestinal or stomach contents can leak through this connection. The contents may leak into another part of the body or outside of the body.
    Enterocutaneous Fistula
    exh61124
    Copyright © Nucleus Medical Media, Inc.
  • Causes

    Most enterocutaneous fistulas develop as a complication of bowel surgery. Other causes include:
  • Risk Factors

    Factors that may increase your chance of enterocutaneous fistula include:
    • History of radiation
    • Poor nutrition
  • Symptoms

    If you have any of these symptoms, do not assume it is due to a fistula. These symptoms may be caused by other conditions.
    • Leakage of intestinal contents from an abdominal wound onto the skin
    • Diarrhea
    • Abdominal pain
    • Signs of infection, such as fever, chills, and rapid heart rate
    • Dehydration
  • Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may be referred to a colon and rectal surgeon.
    Images may be taken of your bodily structures. This can be done with:
  • Treatment

    A fistula may be able to heal on its own over 2-8 weeks. Talk with your doctor about the best treatment plan for you. Treatment options include the following:
    • Nutritional support may be needed while the fistula is healing:
      • You may need to drink and eat high energy food for a while.
      • Nutrition may need to be delivered through a tube connected to your stomach or intestine.
      • If your bowels needs to rest, nutrition may be given through your vein.
    • Antibiotics may be prescribed to help prevent or control infection.
    • A drain may be attached to your wound to collect leakage from the fistula.
    • If the fistulas do not heal, then part of the intestine may need to be removed.
  • Prevention

    There are no steps you can take to help prevent fistulas.
  • RESOURCES

    American Gastroenterological Association http://www.gastro.org

    Crohn’s and Colitis Foundation of America http://www.ccfa.org

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

    Crohn's and Colitis Foundation of Canada http://www.ccfc.ca

    References

    Cobb A, Knaggs E. The nursing management of enterocutaneous fistulae: a challenge for all. BrJCommunity Nurs . 2003;8;9:S32-8.

    Enterocutaneous fistula. UCSF Medical Center website. Available at: http://www.ucsfhealth.org/conditions/enterocutaneous%5Ffistula/ . Accessed April 2, 2013.

    Pritts TA, Fischer DR, Fischer JE. Postoperative enterocutaneous fistula. Holzheimer RG, Mannick JA, editors. Surgical Treatment: Evidence-Based and Problem-Oriented . Munich: Zuckschwerdt; 2001. Available from: http://www.ncbi.nlm.nih.gov/books/NBK6914/ . Accessed April 2, 2013.

    Revision Information

  • Connect with Steward

    Visit Our Twitter Feed Visit Our Facebook Page Email This Page Print This Page

    Subscribe to our patient e-newsletter

    Copyright © 2014 Steward Health Care
    Connect Healthcare Panacea CMS Solutions