From physiology to individualized treatment abstract enterocutaneous fistula is the most common of all intestinal fistulas. The approach to a patient who develops an enterocutaneous fistula requires stringent attention to detail and. The metabolic imbalance that a fistula causes is unknown. Is a condition that requires prolonged hospital stay due to complications such as electrolyte imbalance, malnutrition, metabolic disorders and sepsis. The treatment of enterocutaneous fistulas should aim firstly at stabilizing the patient, correcting any hidroelectrolitic disorders, controlling possible infections and fistula output, and starting nutritional support. Orificio muy grande multiples fistulas sin pared abdominal. Ecfrelated morbidity and mortality can be high due to fluid loss and electrolyte imbalance, sepsis, and malnutrition. Descargue como pdf, txt o lea en linea desde scribd. The full text of this article hosted at is unavailable due to technical difficulties. An enterocutaneous fistula is defined as an abnormal communication between the bowel and skin. Enterocutaneous fistula is the most common of all intestinal fistulas. In this way, an enteric fistula, is defined as an abnormal connection between the.
The enterocutaneous fistula ecf is a devastating complication for both surgeons and patients alike. Fistulas digestivas fisiopatologia, tratamiento general y cuidados locales dr. Management of enterocutaneous fistula is a challenge for surgeons, gastroenterologists, and allied health professionals14 because of the serious complications that can occur, ie, malnutrition, sepsis, and fluid and electrolyte disturbances,5 known as the fistula triad. Fistulas gastrointestinales en abdomen abierto fistulas.
The mortality rate is estimated to be between 5 and 20%. Fistulas enteroatmosfericas posteriores a catastrofe. Classification there are multiple variables that are used to classify and determine the treatment plan for patients with ec fistulas. Nutritional support is an essential part of the management. Montano a montano, abel jalife fistulas enterocutaneas.
Metabolic support of the enterocutaneous fistula patient. Fistulas enterocutaneas nuevos enfoques en su tratamiento. Fistulas digestivas fisiopatologia, tratamiento general y. A fistula, is defined as an abnormal connection formed between two organs, through an epitelized tract. For lowoutput fistulas, enegy needs should be based on resting energy expenditure, and provide 1. In 1964, chapman proposed management for fistulas in which a set of priorities in treatment was emphasized. Gastroenterologia torres e, francis j, sahagun f, stalnikowitz d. Torres e, francis j, sahagun f, stalnikowitz d eds. Enterocutaneous fistula an overview sciencedirect topics. Treatment of upper gastrointestinal fistula and leakage with personal stage nutrition support. The occurrence of a high output fistula led him to malnutrition and his abdomen remained exposed for 7 months until he was finally discharged from hospital. Although data suggest a reduction in the fistula closure time, there is little evidence that this treatment increases the. Gastroenterology 2008 august 28, 14 32 50735077 45. Nutrition and enterocutaneous fistulas request pdf.
A fistula is an abnormal connection between two epithelialized hollow spaces or organs. The mnemonic friends can be used to memorize characteristics which impede the. Fistula enterocutanea cancer care of western new york. Care of these patients can be quite challenging, frustrating, and, ultimately, rewarding. Fistulas enterocutaneas gastroenterologia accessmedicina. Indice definicion historia etiologia clasificacion fisiopatologia tratamiento. Strictly speaking, an enterocutaneous fistula connects the small bowel to the skin. Postoperative enterocutaneous fistula surgical treatment. Fistulas enterocutaneas, octreotida, propiedad antisecretoria, inhibicion hormonal.
A more liberal interpretation of the term, however, also includes enteric fistulas originating from the colon, stomach, and esophagus. Enterocutaneous fistulas tulsyan 2001 nutrition in. The patient with an enterocutaneous fistula presents the surgeon with a plethora of challenges, and a command of related anatomy, physiology, and metabolism is necessary to successfully meet these challenges. The ultimate objective in management of patients with enterocutaneous fistulas is fistula closure. Enterocutaneous fistulas may result from a wide variety of conditions and circumstances. Update on the management of enterocutaneous fistula and enteroatmospheric fistula duran munozcruzado vm, tallon aguilar l, tinoco gonzalez j, sanchez arteaga a, tamayo lopez mj, pareja ciuro f, et al. The widespread use of somatostatin in continuous infusion, or its analogue octeotride, is controversial. Las fistulas son comunicaciones anormales entre 2 superficies epitelizadas. Enterocutaneous fistulas ecfs are a complex topic in terms of classification. An enterocutaneous fistula ecf is an abnormal communication between the small or large bowel and the skin that allows the contents of the stomach or intestines to leak through an opening in the skin. Prior to the advent of sophisticated critical care support and parenteral nutrition, the development of an ecf nearly equated to a death sentence.
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