| Abstrakt: |
There are 105 cases shown, all of them as a consequence of surgical operations or external traumatisms or surgery in the duodenum, jejunum, ileum and colon. These 105 cases were divided into two major groups: 1) simple and 2) multiple. 76 of the first group and 29 of the second group were treated. An equal therapeutic criterion was followed independently of the etiology. In the first stage the surgical cleaning of the wound was made and it was washed and vacuum cleaned with a solution of lactic acid. The surgery is only used in the complicated cases. The nutrition intravenous therapeutic of hidroelectrolitic and blood volume replacement was installed, besides, this system is used for the antibiotheraphy. The success of the parenteral nutrition depends upon the control of the sepsis. In cases where it is possible, the enteral nutrition is started only after 10 days of treatment. Before surgery on the fistula, the medical treatment is maintained, at least, during 4 weeks, which in some cases could be extended up to a maximum of six months. The fistula reappears again when the surgery is performed too soon. When the process is restrained, the nutritive condition is improved and the sepsis is controlled, the surgery takes place to reestablish the intestinal passage. The 47,7% of the cases recovered with only medical treatment. It is evident that late surgery improves the results, since of 22 cases, where surgery was performed, 86,3% cured, and which in turn represents 18% of the total cases. |
