Year: 2026 | Month: August | Volume: 13 | Issue: 8 | Pages: 454-457
DOI: https://doi.org/10.52403/ijrr.20260846
Enterocutaneous Fistula Management and Outcome
Monali1, Ramesh Tambat2, Resin3, Aadiraj4
1,2,3,4Department of General Surgery, Sapthagiri Institute of Medical College, Bengaluru, India.
Corresponding Author: Monali
ABSTRACT
Background: Enterocutaneous fistula (ECF) is a serious postoperative complication characterized by an abnormal communication between the gastrointestinal tract and skin, leading to significant morbidity due to fluid loss, sepsis, and malnutrition. Effective management requires a multidisciplinary and staged approach.
Case Presentation: A 45-year-old male presented with feculent discharge from a postoperative abdominal wound for 7 days, along with fever, abdominal pain, and generalized weakness. He had undergone exploratory laparotomy with bowel resection and anastomosis 20 days prior. On examination, he was dehydrated with tachycardia (104/min), hypotension (100/60 mmHg), and fever (38.2°C). Local examination revealed feculent discharge of approximately 400 ml/day from the surgical wound. Laboratory investigations showed anemia (Hb 9.2 g/dL), leukocytosis (14,500/mm³), electrolyte imbalance, and hypoalbuminemia (2.5 g/dL). Imaging studies confirmed an ileal enterocutaneous fistula with intra-abdominal collection.
Management and Outcome: The patient was managed initially with conservative measures including fluid resuscitation, electrolyte correction, broad-spectrum antibiotics, and nutritional support with total parenteral nutrition. Ultrasound-guided drainage of intra-abdominal collection was performed. After six weeks of stabilization and improvement in nutritional status, definitive surgical management with resection of the fistulous segment and anastomosis was undertaken. The postoperative period was uneventful, with complete resolution of the fistula.
Conclusion: Early diagnosis, effective sepsis control, and adequate nutritional support followed by timely surgical intervention are key to successful management of enterocutaneous fistula. A structured, multidisciplinary approach significantly improves patient outcomes.
Keywords: Enterocutaneous Fistula; Postoperative Complication; Nutritional Support; Sepsis Control; Surgical Management
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