An enterocutaneous fistula (ECF) is an abnormal communication between the

small Small means of insignificant size Size in general is the Magnitude (mathematics), magnitude or dimensions of a thing. More specifically, ''geometrical size'' (or ''spatial size'') can refer to three geometrical measures: length, area, or ...

large bowel The large intestine, also known as the large bowel, is the last part of the gastrointestinal tract and of the digestive system in tetrapods. Water is absorbed here and the remaining waste material is stored in the rectum as feces before being rem ...

and the skin that allows the contents of the

stomach The stomach is a muscular, hollow organ in the upper gastrointestinal tract of Human, humans and many other animals, including several invertebrates. The Ancient Greek name for the stomach is ''gaster'' which is used as ''gastric'' in medical t ...

or intestines to leak through an opening in the skin.

Causes

The

mnemonic A mnemonic device ( ), memory trick or memory device is any learning technique that aids information retention or retrieval in the human memory, often by associating the information with something that is easier to remember. It makes use of e ...

HIS FRIENDS can be used to memorize characteristics which impede the closure of ECF. H: high output I: IBD S:short tract * F

Foreign body A foreign body (FB) is any object originating outside the body of an organism. In machinery, it can mean any unwanted intruding object. Most references to foreign bodies involve propulsion through natural orifices into hollow organs. Foreign b ...

* R

Radiation In physics, radiation is the emission or transmission of energy in the form of waves or particles through space or a material medium. This includes: * ''electromagnetic radiation'' consisting of photons, such as radio waves, microwaves, infr ...

* I

Infection An infection is the invasion of tissue (biology), tissues by pathogens, their multiplication, and the reaction of host (biology), host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmis ...

Inflammatory bowel disease Inflammatory bowel disease (IBD) is a group of inflammatory conditions of the colon and small intestine, with Crohn's disease and ulcerative colitis (UC) being the principal types. Crohn's disease affects the small intestine and large intestine ...

* E

Epithelialization Wound healing refers to a living organism's replacement of destroyed or damaged tissue by newly produced tissue. In undamaged skin, the epidermis (surface, epithelial layer) and dermis (deeper, connective layer) form a protective barrier again ...

* N

Neoplasm A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...

* D Distal obstruction * S Short tract (<2 cm)

Diagnosis

Classification

Congenital types: tracheoesophageal, vitellointestinal duct, patent urachus, rectovaginal Acquired: trauma (postoperative), radiation, malignancy, infection

Two categories

Low-output fistula: < 500 mL/day High-output fistula: > 500 mL/day

Three categories

Low-output fistula: < 200 mL/day Moderate-output fistula: 200–500 mL/day High-output fistula: > 500 mL/day

Treatment

The majority will close spontaneously within approximately 6 weeks. If it has not closed by 12 weeks, it is unlikely to do so and definitive surgery should be planned. The median time to definitive repair from

fistula In anatomy, a fistula (: fistulas or fistulae ; from Latin ''fistula'', "tube, pipe") is an abnormal connection (i.e. tube) joining two hollow spaces (technically, two epithelialized surfaces), such as blood vessels, intestines, or other h ...

onset was 6 months (range 1 day to 28 months). The 6-month time course is commonly utilized by groups with significant experience treating fistulas, owing to the trend in encountering a less hostile abdomen than in the early phases. Some evidence also suggests that

somatostatin Somatostatin, also known as growth hormone-inhibiting hormone (GHIH) or by #Nomenclature, several other names, is a peptide hormone that regulates the endocrine system and affects neurotransmission and cell proliferation via interaction with G ...

can be an effective treatment with respect to reducing closure time and improving the spontaneous closure rate of enterocutaneous fistulas.

References

* {{cite journal , author = Metcalf C , year = 1999 , title = Enterocutaneous fistulae , journal = Journal of Wound Care , volume = 8 , issue = 3, pages = 141–142 , doi=10.12968/jowc.1999.8.3.25854 Digestive diseases Fistulas Medical mnemonics