Management and outcome of patients with postoperative anterior abdominal wall fistula

Abstract EN

Objective: Anterior abdominal wall fistulae are an abnormal communication between stomach, small or large bowel, and the cutaneous wall of abdomen allowing the gastrointestinal contents to flow onto the skin.

It is one of the most dreaded postoperative complications.

It is a major cause of morbidity and possible mortality especially in high output fistulae.

The aim of this study is conducted focusing on postoperative gastrointestinal cutaneous fistulae particularly on the clinical presentation, diagnostic, work up, managements, and outcome.

Methods: The study done on 26 consecutive patients collected in one and half year (from 1st January 2016 to 30th June 2017) at Al-Karama Teaching Hospital.

The study included patients with gastrointestinal fistula produced as a postoperative complications, and excluded the patients with fistulas related to urinary tract problems.

All the patients were subjected to history and physical examination according to a data collection sheet.

Results: There were 16 males and 10 females in this study, mean age 40.96 years, and the mean hospital stay was 14-45 days.

There were eleven patients out of twenty-six (42.3%) due to malignancy, eight patients out of twenty-six (30.7%) following laparotomy for trauma.

One of the cases (3.8%) was due to surgery for inflammatory bowel disease (total colectomy), and six patients (23.2%) were due to miscellaneous causes.

Conclusions: Trauma and malignancy are the major two causes of postoperative gastrointestinal fistulae in this study.

The higher output fistula, the more incidence of complications, such as sepsis, electrolyte disturbances, skin excoriation and weight loss.