Definition
An enterocutaneous fistula is an abnormal connection between the intestines and the skin. Intestinal or stomach contents can leak through it. They may also leak into another part of the body or outside of the body.
This is a problem that needs to be treated right away.
| Enterocutaneous Fistula |
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Causes
Most of the time, this problem happens after a bowel surgery. Other causes are:
- Infection
- A perforated duodenal ulcer
- Bowel disease, such as Crohn disease or ulcerative colitis
- Trauma, such as a gunshot or stabbing
- Cancer
- Cancer treatment, such as radiation therapy
Risk Factors
Things that may raise the risk of this problem are:
- Recent bowel surgery
- History of radiation therapy
Symptoms
Problems may be:
- Contents from the intestines that leak from an opening in the skin
- Diarrhea
- Belly pain
Diagnosis
The doctor will ask about your symptoms and health history. A physical exam will be done. You may be referred to a colon and rectal surgeon.
Images may be taken. This can be done with:
- CT scan to view the belly
- Ultrasound to view the belly
- Barium enema to view the colon and rectum using contrast material
- Barium swallow test to view the digestive system using contrast material
- Fistulogram to view the fistula using contrast material
Treatment
This problem may heal on its own over 2 to 8 weeks. Care during this time may be:
- Nutritional support, such as diet changes, IV nutrition, or a feeding tube
- Antibiotics to treat an infection
- A drain to remove leaking fluids
Surgery will be done to close the opening if it does not heal on its own.
RESOURCES
American Gastroenterological Association http://www.gastro.org
Crohn’s & Colitis Foundation http://www.crohnscolitisfoundation.org
CANADIAN RESOURCES
Crohn's & Colitis Canada http://www.crohnsandcolitis.ca
Health Canada http://www.canada.ca
References
Cobb A, Knaggs E. The nursing management of enterocutaneous fistulae: a challenge for all. Br J Community Nurs. 2003;8(9):S32-S38.
Crohn disease in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/crohn-disease-in-adults. Accessed December 31, 2020.
Enterocutaneous fistula. UCSF Medical Center website. Available at: https://www.ucsfhealth.org/conditions/enterocutaneous%5Ffistula. Accessed December 31, 2020.
Kalla R, Ventham NT, et al. Crohn disease. BMJ. 2014 Nov 19;349:g6670.
Revision Information
- Reviewer: EBSCO Medical Review Board Daniel A. Ostrovsky, MD
- Review Date: 12/2020
- Update Date: 12/31/2020