Background Entero-cutaneous fistula are a major catastrophe to the patients and surgeons and it still has high incidence of morbidity a& mortality and their management remain a big challenge. Aim Recent experience with paraentral nutrition for treatment of entero-cutaneous fistula in gastroenterology and hepatology teaching hospital is reviewed to study the main causes of the fistula and to determine the factors related to successful treatment . Methods A total of 50 consecutive patients with entero-cutaneous fistula were studied prospectively during a period of two years. Thirty seven patients received total parenteral nutrition and 18 patients underwent surgical operation attempting for fistula closure. Results in 48 patients the fistula developed postoperatively, the most common primary cause was missile injury ( 46%) , whereas only two patients fistula occurred spontaneously. In 22 patients the fistula closed by conservative treatment, the mean duration of spontaneous closure was 16.5 days . In 9 patients the fistula was closed by surgical interference and 18 patients died., In one patient the fistula was neither closed by conservative nor by surgical treatment .The mean duration for hospitalization was 25.2 days Conclusion In spite of improvement of spontaneous closure rate of patients with entero-cutaneous fistula who received total parentral nutrition .There is still high unacceptable mortality rate of this catastrophic disease , which requires additional care and improvement in intensive monitoring.
Background Entero-cutaneous fistula are a major catastrophe to the patients and surgeons and it still has high incidence of morbidity a& mortality and their management remain a big challenge. Aim Recent experience with paraentral nutrition for treatment of entero-cutaneous fistula in gastroenterology and hepatology teaching hospital is reviewed to study the main causes of the fistula and to determine the factors related to successful treatment . Methods A total of 50 consecutive patients with entero-cutaneous fistula were studied prospectively during a period of two years. Thirty seven patients received total parenteral nutrition and 18 patients underwent surgical operation attempting for fistula closure. Results in 48 patients the fistula developed postoperatively, the most common primary cause was missile injury ( 46%) , whereas only two patients fistula occurred spontaneously. In 22 patients the fistula closed by conservative treatment, the mean duration of spontaneous closure was 16.5 days . In 9 patients the fistula was closed by surgical interference and 18 patients died., In one patient the fistula was neither closed by conservative nor by surgical treatment .The mean duration for hospitalization was 25.2 days Conclusion In spite of improvement of spontaneous closure rate of patients with entero-cutaneous fistula who received total parentral nutrition .There is still high unacceptable mortality rate of this catastrophic disease , which requires additional care and improvement in intensive monitoring.