Gastro intestinal fistula
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This document summarizes key points about gastrointestinal fistulas: Fistulas are abnormal connections between epithelial surfaces, often between the GI tract and other organs or the skin. GI fistulas can be internal or external. High-output fistulas produce over 500mL/day of output and carry higher risks. Treatment involves recognition, stabilization, investigation to determine the nature and location of the fistula, and definitive treatment such as surgery or medical management.
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The document provides a comprehensive overview of enterocutaneous fistulas, including definitions, types, etiology, diagnosis, complications, and management strategies. Key management principles focus on stabilization, fluid and electrolyte control, nutritional support, and sepsis management. It also discusses the significance of definitive surgery and factors affecting spontaneous closure rates.Entero Cutaneous Fistula by Dr. Onkar
Entero Cutaneous Fistula by Dr. Onkarguesta40423
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This document provides an overview of the management of enterocutaneous fistulas. It discusses the history, classification, etiology, pathophysiology, clinical presentation, investigation, management phases including stabilization, decision making, treatment, and prevention of enterocutaneous fistulas. The management involves correcting fluid and electrolyte imbalances, providing nutritional support, controlling sepsis, making a decision on definitive therapy after 4-6 weeks if not closing spontaneously, and surgical treatment when needed.Discuss the sysytemic disturbances of high intestinal fistula
Discuss the sysytemic disturbances of high intestinal fistulaPromise Echebiri
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The document discusses high intestinal fistulas, highlighting their pathogenesis, systemic disturbances, management strategies, and complications. It defines intestinal fistulas, outlines their systemic effects such as dehydration and malnutrition, and emphasizes the need for a multidisciplinary approach to treatment. The document concludes with principles of management, focusing on hydration, nutritional support, infection control, and the likelihood of spontaneous closure in many cases.Enterocutaneous fistula
Enterocutaneous fistulaSadia Shabbir
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This document discusses enterocutaneous fistulas (ECFs), abnormal connections between the bowel and skin. ECFs can be classified based on their anatomy and complexity. They commonly result from conditions like radiation, inflammatory bowel disease, diverticulitis, and complications of surgery. ECFs can cause issues like malnutrition, infection, and electrolyte imbalances. Treatment involves stabilization, investigation to determine the fistula details, and definitive management depending on the likelihood of closure. Management aims to control drainage and sepsis while optimizing nutrition until closure is achieved.5.Intestinal Fistulas.pptx
5.Intestinal Fistulas.pptxBedrumohammed2
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Intestinal fistulas are abnormal connections between two epithelial surfaces that can be internal or external. The majority of enterocutaneous fistulas are iatrogenic complications resulting from intestinal surgery. Clinical signs include drainage of enteric contents from surgical wounds or drains. Treatment involves stabilization, investigation to define the fistula anatomy, and rehabilitation with nutrition to allow spontaneous closure in many cases. Surgery is needed for fistulas that do not close and involves resection of the fistula tract and affected intestine. Intestinal fistulas can be challenging to treat and are associated with significant morbidity and mortality risks.Gastrojejunocoilic fistula
Gastrojejunocoilic fistulaDavid Edison
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A 43-year-old male presented with dyspepsia, chronic diarrhea, weight loss, and faeculant vomiting. Imaging revealed a gastrojejunocolic fistula. He underwent a surgery involving truncal vagotomy, distal gastrectomy, segmental jejunal resection, involved transverse colon resection, and Roux-en-Y gastrojejunostomy and jejunojejunostomy with double barrel diversion colostomy. Histology found no malignancy. Postoperatively, he recovered well and was discharged on postoperative day 11. Gastrojejunocolic fistula is a rare complication that can develop years after gastrojejunostomy, often due to stomal ulcer from inadequate vagEnterocutaneous fistulas ppt
Enterocutaneous fistulas pptPrabha Om
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1. Enterocutaneous fistulas are abnormal connections between the gastrointestinal tract and skin that allow intestinal contents to drain onto the skin. They most commonly originate from the small intestine.
2. Management of enterocutaneous fistulas involves stabilization of the patient, controlling sepsis, providing adequate nutrition, defining the anatomy of the fistula, and creating a treatment plan.
3. Key steps in management include fluid resuscitation, controlling fistula output, protecting the skin, draining any abscesses, providing nutrition either enterally or parenterally, and using pharmacological agents like octreotide to help reduce output.Enterocutaneous fistulas ppt
Enterocutaneous fistulas pptPrabha Om
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1. Enterocutaneous fistulas are abnormal connections between the gastrointestinal tract and skin that allow intestinal contents to drain onto the skin. They most commonly originate from the small intestine.
2. Management of enterocutaneous fistulas involves stabilization of the patient, controlling sepsis, providing adequate nutrition, defining the anatomy of the fistula, and creating a treatment plan.
3. Key steps in management include fluid resuscitation, drainage of any abscesses, nutritional support either enterally or parenterally, controlling fistula output, and investigating the cause and location of the fistula through tests such as fistulography and CT scan with contrast.Management of enterocutaneous fistula
Management of enterocutaneous fistulabbthapa
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This document discusses the management of enterocutaneous fistulas. Key points include:
- Enterocutaneous fistulas are abnormal connections between the bowel and skin that can have mortality rates up to 21%.
- Management involves stabilization, investigation to determine fistula characteristics, deciding on a treatment plan, and definitive management through surgery or allowing for spontaneous closure.
- Nutritional management is essential, involving enteral or parenteral nutrition depending on fistula output to support healing and potential spontaneous closure. Surgical treatment is considered if the fistula is unlikely to close spontaneously.Entero cutaneous fistulae
Entero cutaneous fistulaeWasula Rathnaweera
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This document discusses the management of small intestinal fistulae. It notes that fistulae can be classified as congenital or acquired, external or internal. Primary fistulae are caused by an underlying gut wall disease while secondary fistulae occur after injury. Outcomes depend on factors like fistula type (simple vs complex), output (high vs low), nutrition status, and presence of sepsis. Management involves resuscitation, nutrition support, delineating anatomy, and either allowing spontaneous closure or surgical closure. Surgical closure is often staged and aims to drain sepsis, resect diseased bowel, and reconstruct the GI tract. Complications can include recurrent fistulae or short bowel syndrome.Ad
Gastro intestinal fistula
- 1. Gastro-Intestinal Fistula Hashmi
- 2. Fistulas are abnormal communications between two epithelial-lined surfaces Gastrointestinal (GI) fistulas represent abnormal ductlike communications between the gut and another epithelial-lined surface organ system skin surface GI tract itself
- 4. The majority of external (cutaneous) fistulas represent a complication of recent abdominal surgery The leading causes of internal fistulas Crohn disease Diverticulitis Malignancy Complication of treatment
- 5. F Foreign Body R Radiation I IBD / Infection E Epithelialized tract N Neoplasm D Distal Obstruction S Segment (>2cm)
- 6. High output fistula are from upper GI tract High-output GI fistula discharge more than 500ml/day High-output pancreatic fistula is one which produces more than 200 ml/day High output fistula more serious metabolic disturbances higher mortality rates
- 7. Spontaneous closure bowel continuity is maintained no abscess adjacent bowel is healthy no distal obstruction fistula tract is not epithelialized not more than 2 cm in length bowel defect is less than 1 cm in diameter Least likely to close with non-operative therapy gastric lateral duodenal ligament of Treitz ileal fistula
- 8. Nutritional Support Minerals, vitamins, electrolytes Caloric intake (35-45 cal/kg/day) Protein (1.5-1.75 gm/kg/day) TPN
- 9. Recognition and Stabilization fluid resuscitation, electrolytes, acid/base balance, control of sepsis, local wound care, nutritional support Investigation and Assessment radiological source, nature of tract, bowel continuity, obstruction, adjacent bowel, abscess Definitive Treatment somatostatin and nutritional support, surgical resection +/- diversion