Management in Entero-Atmospheric Fistula

Authors

  • Tanudchaporn Porntewabuncha Department of Surgery, Faculty of Medicine, Thammasat University
  • Amonpon Kanlerd Trauma and Surgical Critical Care Division, Department of Surgery, Faculty of Medicine, Thammasat University

Keywords:

Entero-atmospheric fistula, Enterocutaneous fistula, Open abdomen, Damage control surgery, Abdominal wall

Abstract

Entero-atmospheric fistula (EAF) is the connecting tract between the intestine and the atmosphere without skin or subcutaneous coverage. This condition mainly occurs after an open abdomen in damage control surgery (DCS). The incidence of EAF following DCS is approximately 5-25%, with a mortality rate of 20-60%. The management phases consist of: The stabilization phase includes fluid resuscitation and electrolytes management, sepsis control, nutritional support, control of fistula drainage, and fistula/wound care. The investigation phase is to evaluate the anatomical and underlying pathology of EAF. The decision phase assesses the likelihood of spontaneous closure of EAF, which usually occurs 4-6 weeks after diagnosis. The definitive operation recommends following restored patient’s conditions within 6-12 months after diagnosis, including abdominal exploration, intraabdominal contamination, resection of perforated bowel and anastomosis, and tension-free abdominal wall reconstruction. Lastly, the rehabilitation phase normalizes the patient’s conditions.   

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Author Biographies

Tanudchaporn Porntewabuncha, Department of Surgery, Faculty of Medicine, Thammasat University

 

 

 

 

Amonpon Kanlerd, Trauma and Surgical Critical Care Division, Department of Surgery, Faculty of Medicine, Thammasat University

 

 

Published

2022-10-21

How to Cite

Porntewabuncha, T., & Kanlerd, A. . (2022). Management in Entero-Atmospheric Fistula. Journal of the Association of General Surgeons of Thailand under the Royal of Patronage of HM the King, 3(7), 111–124. Retrieved from https://he02.tci-thaijo.org/index.php/agstjournal/article/view/259055