Accession Number : ADA615480


Title :   Enterocutaneous Fistulas in the Setting of Trauma and Critical Illness


Descriptive Note : Journal article


Corporate Author : ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX


Personal Author(s) : Dubose, Joseph J ; Lundy, Jonathan B


Full Text : http://www.dtic.mil/get-tr-doc/pdf?AD=ADA615480


Report Date : Jan 2010


Pagination or Media Count : 9


Abstract : One of the most devastating complications to develop in the general surgical patient is an enterocutaneous fistula (ECF). Critically ill patients suffering trauma, thermal injury, infected necrotizing pancreatitis, and other acute intraabdominal pathology are at unique risk for this complication as well. By using decompressive laparotomy for abdominal compartment syndrome and leaving the abdomen open temporarily for other acute processes, survival in some instances may be improved. However, the exposed viscera are at risk for fistulization in the presence of an open abdomen, a newly defined entity termed the enteroatmospheric fistula (EAF). The purpose of this article is to describe the epidemiology of ECF in the setting of trauma and critical illness, nutrition in injured/ critically ill patients with ECF, pharmacologic adjuncts to decrease fistula effluent, wound care, surgical management of the EAF/ECF, and techniques for prevention of these dreaded complications in patients with an open abdomen.


Descriptors :   *FISTULAS , *TRAUMA , ABDOMEN , EPIDEMIOLOGY , PREVENTION , RISK


Subject Categories : Medicine and Medical Research


Distribution Statement : APPROVED FOR PUBLIC RELEASE