E.F. Ehtuish, M.M. Sharma
Surgical Department, Central Hospital, Tripoli, Libya .
Garyounis Medical Journal Vol. 9, No.2. January 1986: 39-43
Gastrointestinal cutaneous fistula can be a threat to life unless carefully handled, Of the 5 cases of G.I. C.F. treated at the Surgical Department of the Central Hospital, Tripoli, Libya, three occurred post-operatively, one after trauma and one after inflammatory duodenal disease (perforated duodenal ulcer). Two were high output, three low output. In two cases abscess drainage was performed and all the cases were managed by gastric suction, blood transfusion, fluid and electrolyte replacement, antibiotics, hyperalimentation, suction offistula discharge, skin ointment.
A very important role was played by total parenteral nutrition (T.P.N.). Two cases healed after two weeks. The same treatment was given to the other three cases for a period of four weeks, during which time preparation for surgical intervention was made. Resection and anastomosis of terminal ilium was performed in Case II and resection with ilio transverse colostomy was performed in Case IV. In Case I transfer of BI to BII was performed but there was persistent leakage. The patient was re-explored and later developed septic shock and died. Four of the cases were treated successfully but one died.
Keywords: Management of Gastrointestinal-Cutaneous Fistula