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Clin Colon Rectal Surg 2004; 17(2): 79-88
DOI: 10.1055/s-2004-828654
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Management of Enterocutaneous Fistulas

Manish Kaushal1 , Gordon L. Carlson1
  • 1Intestinal Failure Unit, Department of Surgery, University of Manchester, Hope Hospital, Salford, United Kingdom
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Publication History

Publication Date:
27 May 2004 (online)

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Despite advances in antimicrobial chemotherapy, nutritional support, and perioperative critical care, the development of an enterocutaneous fistula continues to represent a major therapeutic challenge, with appreciable morbidity and mortality. Specific problems that must be addressed for the successful management of patients with enterocutaneous fistulas are the control of sepsis, maintenance of adequate fluid and electrolyte balance, provision of adequate and complication-free nutritional support, and skin-stoma care. In addition, many patients with postoperative intestinal fistulation suffer from significant psychological morbidity, which must be addressed during often prolonged periods of rehabilitation. The complex nature of the care required for successful management of patients with enterocutaneous fistulas mandates a multidisciplinary team approach, with specialist nurses, dieticians, pharmacists, radiologists, physicians, and surgeons all having important roles to play.

KEYWORDS

Sepsis - parenteral nutrition - fistuloclysis - laparostomy

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 Mr.
G L Carlson

Department of Surgery, Hope Hospital

Salford M6 8HD, United Kingdom

Email: gcarlson@fs1.ho.man.ac.uk