Alternative strategy for the diagnosis of an enterocutaneous fistula in a resource-limited setting
| Autor: | Juan Carlos Puyana, Maria Soledad Ordoñez Velecela, Edison Fernando Peña Perez, Amber Himmler, Juan C Salamea, Raúl Pino Andrade |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Enterocutaneous fistula
medicine.medical_specialty business.industry lcsh:Surgery lcsh:Medical emergencies. Critical care. Intensive care. First aid Postoperative complication Octreotide Challenges in Trauma and Acute Care Surgery lcsh:RD1-811 lcsh:RC86-88.9 Critical Care and Intensive Care Medicine medicine.disease Malignancy Inflammatory bowel disease Surgery Sepsis Parenteral nutrition medicine business Limited resources medicine.drug |
| Zdroj: | Trauma Surgery & Acute Care Open, Vol 5, Iss 1 (2020) Trauma Surgery & Acute Care Open |
| ISSN: | 2397-5776 |
| Popis: | Enterocutaneous fistula (ECF) is a dreaded and challenging postoperative complication often requiring a time-consuming and multidisciplinary approach for treatment. Mortality ranges from 6% to 20%.1 Defined as an abnormal connection between the skin and gastrointestinal tract,2 ECF occur postoperatively in 85%–90% of cases and spontaneously due to inflammatory bowel disease or malignancy in 5%–10% of cases.1 ECF are classified based on various criteria, most commonly anatomic site and quantity of the effluent.3 4 ECF that drain less than 200 mL per day are classified as low output, ECF that drain more than 500 mL per day are classified as high output, and ECF that drain between 200 and 500 mL per day are classified as medium output. Generally, higher output fistulae are less likely to close spontaneously and are associated with higher overall mortality than lower-output fistulae.3 Most ECF are managed non-operatively as up to 90% will spontaneously resolve within 5 weeks.4 Non-operative management aims to decrease the quantity effluent through proper nutritional support, in addition to sepsis control and wound management.3 4 Strategies including the use of total parenteral nutrition, octreotide and negative pressure wound … |
| Databáze: | OpenAIRE |
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