Abstract
The outcome among 39 patients with enterocutaneous fistulae complicating Crohn's disease has been reviewed. The patients were considered in two groups: (1) no disease - all were early postoperative fistulae (n = 9); (2) active disease (i) without abscess formation (n = 16), (ii) with abscess formation (n = 14). Postoperative fistulae with no evidence of active Crohn's disease healed spontaneously. Fistulae in the presence of active disease did not heal even with prolonged medical management. The only effective treatment was excision of the diseased segment from which the fistulae arose and any distal obstruction. None of the fistulae closed surgically has recurred.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Blackett R. L., Hill G. L. Postoperative external small bowel fistulas: a study of a consecutive series of patients treated with intravenous hyperalimentation. Br J Surg. 1978 Nov;65(11):775–778. doi: 10.1002/bjs.1800651105. [DOI] [PubMed] [Google Scholar]
- Coutsoftides T., Fazio V. W. Small intestine cutaneous fistulas. Surg Gynecol Obstet. 1979 Sep;149(3):333–336. [PubMed] [Google Scholar]
- Driscoll R. H., Jr, Rosenberg I. H. Total parenteral nutrition in inflammatory bowel disease. Med Clin North Am. 1978 Jan;62(1):185–201. doi: 10.1016/s0025-7125(16)31831-4. [DOI] [PubMed] [Google Scholar]
- Eisenberg H. W., Turnbull R. B., Jr, Weakley F. L. Hyperalimentation as preparation for surgery in transmural colitis (Crohn's disease). Dis Colon Rectum. 1974 Jul-Aug;17(4):469–475. doi: 10.1007/BF02587022. [DOI] [PubMed] [Google Scholar]
- Elson C. O., Layden T. J., Nemchausky B. A., Rosenberg J. L., Rosenberg I. H. An evaluation of total parenteral nutrition in the management of inflammatory bowel disease. Dig Dis Sci. 1980 Jan;25(1):42–48. doi: 10.1007/BF01312731. [DOI] [PubMed] [Google Scholar]
- Enker W. E., Block G. E. The operative treatment of Crohn's disease complicated by fistulae. A personal consecutive series. Arch Surg. 1969 Apr;98(4):493–499. [PubMed] [Google Scholar]
- Irving M. Local and surgical management of enterocutaneous fistulas. Br J Surg. 1977 Oct;64(10):690–694. doi: 10.1002/bjs.1800641003. [DOI] [PubMed] [Google Scholar]
- MacFadyen B. V., Jr, Dudrick S. J., Ruberg R. L. Management of gastrointestinal fistulas with parenteral hyperalimentation. Surgery. 1973 Jul;74(1):100–105. [PubMed] [Google Scholar]
- Monod-Broca P. Treatment of intestinal fistulas. Br J Surg. 1977 Oct;64(10):685–689. doi: 10.1002/bjs.1800641002. [DOI] [PubMed] [Google Scholar]
- Mullen J. L., Hargrove W. C., Dudrick S. J., Fitts W. T., Jr, Rosato E. F. Ten years experience with intravenous hyperalimentation and inflammatory bowel disease. Ann Surg. 1978 May;187(5):523–529. doi: 10.1097/00000658-197805000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pennington L., Hamilton S. R., Bayless T. M., Cameron J. L. Surgical management of Crohn's disease. Influence of disease at margin of resection. Ann Surg. 1980 Sep;192(3):311–318. doi: 10.1097/00000658-198009000-00006. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Reber H. A., Roberts C., Way L. W., Dunphy J. E. Management of external gastrointestinal fistulas. Ann Surg. 1978 Oct;188(4):460–467. doi: 10.1097/00000658-197810000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Reilly J., Ryan J. A., Strole W., Fischer J. E. Hyperalimentation in inflammatory bowel disease. Am J Surg. 1976 Feb;131(2):192–200. doi: 10.1016/0002-9610(76)90096-9. [DOI] [PubMed] [Google Scholar]
- Roback S. A., Nicoloff D. M. High output enterocutaneous fistulas of the small bowel. An analysis of fity-five cases. Am J Surg. 1972 Mar;123(3):317–322. doi: 10.1016/0002-9610(72)90293-0. [DOI] [PubMed] [Google Scholar]
- Rosenberg I. H. Nutritional support in inflammatory bowel disease. Gastroenterology. 1979 Aug;77(2):393–396. [PubMed] [Google Scholar]
- Sheldon G. F., Gardiner B. N., Way L. W., Dunphy J. E. Management of gastrointestinal fistulas. Surg Gynecol Obstet. 1971 Sep;133(3):385–389. [PubMed] [Google Scholar]
- Soeters P. B., Ebeid A. M., Fischer J. E. Review of 404 patients with gastrointestinal fistulas. Impact of parenteral nutrition. Ann Surg. 1979 Aug;190(2):189–202. doi: 10.1097/00000658-197908000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Steinberg D. M., Cooke W. T., Alexander-Williams J. Abscess and fistulae in Crohn's disease. Gut. 1973 Nov;14(11):865–869. doi: 10.1136/gut.14.11.865. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sternquist J. C., Bubrick M. P., Hitchcock C. R. Enterocutaneous fistula. Dis Colon Rectum. 1978 Nov-Dec;21(8):578–581. doi: 10.1007/BF02586400. [DOI] [PubMed] [Google Scholar]