Enterocutaneous Fistula

Enterocutaneous Fistula

(Gastrointestinal Fistula; Entero-enternal Fistula)

Definition

An enterocutaneous fistula is an abnormal connection between the intestines and the skin. Intestinal or stomach contents can leak through it. They may also leak into another part of the body or outside of the body.

This is a problem that needs to be treated right away.

Enterocutaneous Fistula

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Causes

Most of the time, this problem happens after a bowel surgery. Other causes are:

Risk Factors

Things that may raise the risk of this problem are:

  • Recent bowel surgery
  • History of radiation therapy

Symptoms

Problems may be:

  • Contents from the intestines that leak from an opening in the skin
  • Diarrhea
  • Belly pain

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. You may be referred to a colon and rectal surgeon.

Images may be taken. This can be done with:

  • CT scan to view the belly
  • Ultrasound to view the belly
  • Barium enema to view the colon and rectum using contrast material
  • Barium swallow test to view the digestive system using contrast material
  • Fistulogram to view the fistula using contrast material

Treatment

This problem may heal on its own over 2 to 8 weeks. Care during this time may be:

  • Nutritional support, such as diet changes, IV nutrition, or a feeding tube
  • Antibiotics to treat an infection
  • A drain to remove leaking fluids

Surgery will be done to close the opening if it does not heal on its own.

Prevention

There are no known guidelines to prevent this health problem.

RESOURCES:

American Gastroenterological Association
http://www.gastro.org
Crohn’s & Colitis Foundation
http://www.crohnscolitisfoundation.org

CANADIAN RESOURCES:

Crohn's & Colitis Canada
http://www.crohnsandcolitis.ca

References:

Cobb A, Knaggs E. The nursing management of enterocutaneous fistulae: a challenge for all. Br J Community Nurs. 2003;8(9):S32-S38.
Crohn disease in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/crohn-disease-in-adults. Accessed December 31, 2020.
Enterocutaneous fistula. UCSF Medical Center website. Available at: https://www.ucsfhealth.org/conditions/enterocutaneous_fistula. Accessed December 31, 2020.
Kalla R, Ventham NT, et al. Crohn disease. BMJ. 2014 Nov 19;349:g6670.
Last reviewed December 2020 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD
Last Updated: 12/31/2020

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