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.
This is a potentially serious condition. You will need care from your doctor.
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Most enterocutaneous fistulas develop as a complication of bowel surgery. Other causes include:
Bowel disease, such as
duodenal ulcersTrauma, such as a gunshot or stabbingCancerComplications of cancer treatment, such as radiation therapy
Factors that may increase your chance of enterocutaneous fistula include: History of radiationPoor nutrition
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 skinDiarrheaAbdominal painSigns of infection, such as fever, chills, and rapid heart rateDehydration
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: Barium swallow testBarium enema
if colon is involved
FistulogramCT scan of abdomenUltrasound
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.
There are no steps you can take to help prevent fistulas.
Cobb A, Knaggs E. The nursing management of enterocutaneous fistulae: a challenge for all.
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:
. Accessed April 2, 2013.
Last reviewed March 2013 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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