enterocutaneous fistula

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pertaining to or communicating with the intestine and the skin, or surface of the body.
enterocutaneous fistula one in which there is communication between the intestinal tract and the skin. Some fistulas are created surgically, with gastrostomy, esophagostomy, or colostomy. Others may result from surgical trauma, breakdown of an intestinal anastomosis, or erosions around a surgical drain or tube. Fistulas frequently occur at a suture line, may be complete or incomplete, and are most likely to develop in malnourished patients and in those with impaired blood supply to intestine, an obstruction distal to an anastomosis, carcinoma of the intestine, or an infected wound.
Patient Care. Care of the site of a fistula is similar to that of a surgically created stoma. Collection of the drainage can be accomplished by using a collection device designed for an ostomy patient. Care must be taken that the drainage is collected before it comes into contact with the skin. A skin barrier such as Stomahesive is used to prevent excoriation.

Patient care also must include monitoring of the patient for signs of fluid and electrolyte imbalance. The amount of drainage and its characteristics should be noted and reported.


 [fis´tu-lah] (pl. fistulas, fis´tulae) (L.)
any abnormal tubelike passage within body tissue, usually between two internal organs or leading from an internal organ to the body surface. Some fistulas are created surgically for diagnostic or therapeutic purposes; others occur as result of injury or as congenital abnormalities. Among the many kinds of fistulas, the anal type (fistula in ano) is one of the most common. It generally develops as a result of a break or fissure in the wall of the anal canal or rectum, or an abscess there. Treatment is by surgery.

In women, difficult labor in childbirth may result in formation of a vesicovaginal fistula between the bladder and the vagina with resulting leakage of urine into the vagina. In a vesicointestinal fistula, there is leakage of urine from the bladder into the intestine. In a rectovaginal fistula, feces escape through the wall of the anal canal or rectum into the vagina. This condition, formerly a serious hazard of childbirth, is now rare; like other kinds of fistula, it can be corrected by surgery.

With the types of fistulas described here, typical symptoms are pain in the affected region and an abnormal discharge through the skin near the anus or through the vagina. Fistulas at different places of the body may be caused by tuberculosis, actinomycosis (a fungus infection), the presence of diverticula, or certain other serious diseases, and the fistula itself may be a site of infection and discomfort.
abdominal fistula one between a hollow abdominal organ and the surface of the abdomen.
anal fistula (fistula in a´no) one opening on the cutaneous surface near the anus, which may or may not communicate with the rectum.
arteriovenous fistula one between an artery and a vein, either pathologic (such as a varicose aneurysm) or surgically created to ensure an access site for hemodialysis. The site must be allowed 6 to 8 weeks to mature before it can be cannulated. Such a fistula may be the anastomosis of a natural artery and vein, a bovine graft, or a synthetic polytetrafluoroethylene (PTFE) graft. The bovine graft is taken from the bovine carotid artery and anastomosed to the vein and artery of the patient. In a PTFE graft, fibers are woven into a mesh called Gore-Tex and made into a sleeve and flange; this is available in a variety of sizes.

Precautions necessary to insure patient safety when caring for an individual with an arteriovenous fistula include frequent assessments for adequate circulation in the fistula and the distal extremity. A bruit or thrill can be heard over the access site. Blood pressure measurements, withdrawal of blood, injections, and administration of intravenous fluids should not be done on the extremity with such a fistula.
Internal arteriovenous fistulas.
blind fistula one open at one end only, opening on the skin (external blind fistula) or on an internal surface (internal blind fistula).
branchial fistula a persistent pharyngeal groove (branchial cleft).
Brescia-Cimino fistula an arteriovenous fistula for hemodialysis access, connecting the cephalic vein and radial artery.
bronchopleural fistula one between a bronchus and the pleural cavity, causing an air leak into the pleural cavity; sometimes seen as a complication of empyema, fibrosis, or pneumonia.
cerebrospinal fluid fistula one between the subarachnoid space and a body cavity, such as from head trauma or bone erosion, with leakage of cerebrospinal fluid, usually in the form of rhinorrhea or otorrhea.
complete fistula one extending from the skin to an internal body cavity.
craniosinus fistula one between the cerebral space and a paranasal sinus, permitting escape of cerebrospinal fluid into the nose.
Eck's fistula an artificial communication made between the portal vein and the vena cava.
enterocutaneous fistula see enterocutaneous fistula.
enterovesical fistula one connecting some part of the intestine with the urinary bladder; called also vesicoenteric f.
fecal fistula one between the colon and the external surface of the body, discharging feces.
gastric fistula
1. one communicating between the stomach and some other body part.
2. a passage created artificially through the abdominal wall into the stomach.
horseshoe fistula one near the anus, having a semicircular tract with both openings on the skin.
incomplete fistula blind fistula.
perilymph fistula rupture of the round window with leakage of perilymph into the inner ear, so that changes in middle ear pressure directly affect the inner ear, causing sensorineural deafness as well as dizziness, vertigo, nausea, and vomiting. Head trauma and dramatic changes in atmospheric pressure are the most common causes. The usual treatment is restriction in activity (sometimes with complete bed rest), so that the fistula can heal. Surgical repair may be necessary, consisting of placement of a graft over the defect.
pilonidal fistula pilonidal sinus.
pulmonary arteriovenous fistula a congenital fistula between the pulmonary arterial and venous systems, allowing unoxygenated blood to enter the systemic circulation.
rectovaginal fistula one between the rectum and vagina.
rectovesical fistula one between the rectum and urinary bladder.
salivary fistula one between a salivary duct or gland and the cutaneous surface, or into the mouth through an abnormal pathway.
thoracic fistula one communicating with the thoracic cavity.
umbilical fistula one communicating with the intestine or urachus at the umbilicus.
urinary fistula any fistula communicating between the urinary tract and another organ or the surface of the body.
vesicoenteric fistula (vesicointestinal fistula) enterovesical fistula.
vesicovaginal fistula one from the bladder to the vagina.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

en·ter·o·cu·ta·ne·ous fis·tu·la

a fistulous passage connecting the intestine and skin of the abdomen.
Farlex Partner Medical Dictionary © Farlex 2012
References in periodicals archive ?
In the management of enterocutaneous fistula, there is patient stabilization, treatment of sepsis when present, skin protection and adequate nutrition (6).
Enterocutaneous fistula complicating prosthetic parietoplasty by the Lichtenstein procedure is rare.
Enterocutaneous fistulas are associated with high morbidity and mortality.
-- Treatment of enterocutaneous fistulas continues to rely primarily on surgery, augmented in some cases by octreotide or vacuum-assisted closure, according to a review of 106 patients.
Randomized trial of fibrin tissue glue for low output enterocutaneous fistula. British Journal of Surgery, 83(1), 112.
The exudate from the distal laparotomy wound appeared fecal in origin and an enterocutaneous fistula was suspected.
[1,7,9] The other major complications were respiratory tract infection, burst abdomen and enterocutaneous fistula. Wound infection was more commonly seen in cases where adhesiolysis was done, than in cases where resection was done for adhesions.
To date, only one other study describes a case of SCC involving a Crohn's enterocutaneous fistula [5].
Scrotal enterocutaneous fistula: A rare initial presentation of inguinal hernia.
(2,3) We recently experienced the case of delayed detected sigmoid colon perforation and enterocutaneous fistula due to TVT tape operation after 7 years.
Roman-Ramos, "Factors predictive of recurrence and mortality after surgical repair of enterocutaneous fistula," Journal of Gastrointestinal Surgery, vol.