Background: Enterocutaneous fistulas are abnormal communications between the gastro- intestinal tract and the skin. More than 75% of all ECFs arise as a postoperative complication, while about 15-25% of them result from abdominal trauma or occur spontaneously. Fistulas are defined by their sites of origin, communication and flow.
Aim of the work: This paper reviews our experience in the treatment of enterocutaneous fistulas to evaluate current management practice and outcome.
Patients and methods: This retrospective study was conducted on 40 patients with enterocutaneous fistulas treated at El-Demerdash, Ain - Shams University Specialized hospitals in Cairo, Egypt and Alazhar Hospital in Riyadh, KSA during the period from March 2011 to March 2015. Thirty patients (75 %) were males and 10 patients (25%) were females. Their ages ranged between 30 and 50 years.
Results: 95% of fistulas resulted from previous surgery and 5% after trauma. Fifty percent (50%) of the fistulas were high-output, 25% were intermediate-output fistulas and 25% were low-output fistulas. Conservative treatment was successful in 10 patients (25%) and all of them (100%) closed spontaneously while 30 patients (75%) had to be surgically explored and twenty seven patients (90%) were closed after surgery. The overall mortality rate was 10%.
Conclusion: It was concluded from this study, that surgical intervention was indicated in high-output fistulas and fistulas which fail to close with conservative management. Low- output fistulas usually require no surgery and mostly close with conservative treatment