How is enterocutaneous fistula treated?

Conservative Therapy

1. Rehydration.
2. Administration of antibiotics.
3. Correction of anemia.
4. Electrolyte repletion.
5. Drainage of obvious abscess.
6. Nutritional support.
7. Control of fistula drainage.
8. Skin protection.

How long does enterocutaneous fistula last?

Fistulas from the esophagus and duodenum are expected to heal in two to four weeks. Colonic fistulas may heal in 30 to 40 days. Small bowel fistulas may take at least 40 to 60 days.

Can you eat with an enterocutaneous fistula?

According to the patient’s ability to tolerate feeding, the maximum infusion rate can reach 120 ml/h per day. It is also important to avoid constipation and distal intestinal obstruction. Therefore, a balance must be achieved between slowing fistula output and avoiding constipation.

What will prevent spontaneous closure of enterocutaneous fistula?

Distal obstruction – A distal obstruction prevents the spontaneous closure of an ECF, even in the presence of other favorable factors; if present, surgical intervention is needed to relieve the obstruction.

What causes an enterocutaneous fistula?

Most ECFs occur after bowel surgery. Other causes include infection, perforated peptic ulcer and inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis. An ECF may also develop from an abdominal injury or trauma, such as a stabbing or gunshot.

What causes a enterocutaneous fistula?

Can an abdominal fistula heal on its own?

Fistulae that are small and not infected will often close on their own. Fistulae in the colon can take 30–40 days to close while fistulae in the small intestine are likely to take 40–50 days.

How do you feed enterocutaneous fistula?

(1999) recommended a starting point with 20–30 kcal/kg/day of non-protein calories, and 1.5–2.5 g/kg/day of protein. In high output fistula, 1.5–2 times of the usual calories were needed and vitamins and the trace elements recommended must be five to ten times the daily allowance (41).

What is a high output fistula?

A high-output fistula may be defined pragmatically as one with an output of 500 mL/day or more. This may be further refined according to the anatomical site, and the present article focuses on the ECFs.

How can fistula be treated without surgery?

Treatment with fibrin glue is currently the only non-surgical option for anal fistulas. It involves the surgeon injecting a glue into the fistula while you’re under a general anaesthetic. The glue helps seal the fistula and encourages it to heal.

Is the management of enterocutaneous fistula a clinical skill?

Enterocutaneous Fistula: Evidencebased Management. Clin Surg. 2017; 2: 1435. The management of Enterocutaneous fistula (ECF) is a clinical skill that should be in the armamentarium of every general surgeon.

Is there any surgical treatment for EC fistula?

Treatment of EC fistula remains a surgical challenge despite the recent improvement of supportive patient care. Once EC fistula occurs, adequate stabilization of the patient, a thorough investigation of the fistula anatomy, and non-operative management should intially be attempted.

What to do with a high output fistula?

High output fistulas, in particular, often require an intricate network of drains, pouches, and suction to adequately control effluent. Highly specialized wound care teams and enterostomal therapists are invaluable for both wound management and patient comfort [22].

What are the goals of fistula management in nursing?

Goals of nursing care for fistula management include (1) skin protection, (2) containment of effluent, (3) odor control, (3) patient comfort, (4) quantification of effluent output volume, (5) patient mobility, (6) ease of care, and (7) cost containment. Remember that WOCNCB certification measures entry-level knowledge.