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Original Research

RMJ. 2010; 35(1): 72-74


Planned re-operation-a better choice management for ileal entero-cutaneous fistula

Shaukat Ali Sheikh, Nauman Mustafa, Yasir Mehmood, Mohammad Iqbal, Muhammad Iftikhar.

Abstract
Objective
To determine the successs of early surgical intervention in management of ileal enterocutaneous fistula.
Patients and Methods
It is a prospective non-randomized study of 28 patients who developed entero-cutaneous fistula
(ECF) after surgery on small and large intestine. Only Ileal fistulae developed after surgery for typhoid,
tuberculous, traumatic perforations and intestinal obstruction were included. Out of these, 21 were
categorized as high output and seven as low output fistula. In most patients’ fistula occurred on 6th and
7th post-operative day. All patients were managed initially for 24 to 72 hours with application of
fistulae collection device, correction of fluid and electrolyte deficit, antibiotics and occasional blood
transfusion, and then re-operated on 3rd or 4th day after the development of fistulae. The data was
analysed using SPSS software.
Results
Overall six patients were expired and in remaining 22 patients, the post operative complications were
seen in 17 % and with mean hospital stay was 6.5 days.
Conclusion
An appropriately timed, planned early surgical intervention is life saving, cost effective and has
reduced morbidity and mortality. (Rawal Med J 2010;35: )

Key words: Entero-Cutaneous Fistula, ileal fistula, planned Early Re-Operation.



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