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Definition

An enterocutaneous fistula is an abnormal connection between the intestines and the skin. Intestinal or stomach contents can leak through this connection. The contents may leak into another part of the body or outside of the body.

This is a potentially serious condition. You will need care from your doctor.

Enterocutaneous Fistula

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Causes

Most enterocutaneous fistulas develop as a complication of bowel surgery. Other causes include:

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Risk Factors

Factors that may increase your chance of enterocutaneous fistula include:

  • History of radiation
  • Poor nutrition

Symptoms

If you have any of these, do not assume they are due to a fistula. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

  • Leakage of intestinal contents from an abdominal wound onto the skin
  • Diarrhea]]>
  • Abdominal pain
  • Signs of infection: Fever, chills, rapid heart rate
  • ]]>Dehydration]]>
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Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may need to see a colon and rectal surgeon.

Tests may include the following:

  • Barium swallow test—This is a series of x-rays of your throat. The barium helps make the throat images more clear.
  • Barium enema]]> if colon is involved—Fluid is inserted into the rectum. The fluid makes your colon show up on an x-ray.
  • Fistulogram—Dye is injected into an opening of the skin. X-rays are taken.
  • ]]>CT scan of abdomen]]>—Several cross-sectional x-ray images are taken to look at the organs inside your body.
  • Ultrasound—This is a test that uses sound waves to examine the abdomen.

Treatment

A fistula may be able to heal on its own over 2-8 weeks. Talk with your doctor about the best plan for you. Treatment options include the following:

  • Nutritional support may be needed while the fistula is healing:
    • You may need to drink and eat high energy food for a while.
    • Nutrition may need to be delivered through a tube connected to your stomach or intestine.
    • If your bowels needs to rest, nutrition may be given through your vein.
  • Antibiotics may be prescribed—to help prevent or control infection
  • A drain may be attached to your wound—to collect leakage from the fistula
  • If the fistulas do not heal—part of the intestine may need to be removed

Prevention

There are no steps you can take to help prevent fistulas.