Postoperative Enterocutaneous Fistula: A Severe and Desperate Complication in a Disadvantaged Surgical Setting

Soumaoro Labile Togba; Fofana Houssein; Fofana Naby; Kondano Saa Yawo; Thea Kokolype; Toure Aboubacar; Diallo Aissatou Taran

doi:doi:10.11648/j.js.20221001.12

Postoperative Enterocutaneous Fistula: A Severe and Desperate Complication in a Disadvantaged Surgical Setting

Soumaoro Labile Togba, Fofana Houssein, Fofana Naby, Kondano Saa Yawo, Thea Kokolype, Toure Aboubacar, Diallo Aissatou Taran

Published in Journal of Surgery (Volume 10, Issue 1)

Received: 15 November 2021 Accepted: 1 December 2021 Published: 12 January 2022

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Abstract

Purpose: Digestive or gastrointestinal fistula is one of the most feared postoperative complication along with dehiscence and infection. The aim of this study was to determine the etiological, clinical and therapeutic aspects of enterocutaneous fistulas in a disadvantaged surgical setting. Methods: This was a retrospective study covering a period of three years (January 2018 to December 2020) including records of patients managed for postoperative enterocutaneous fistula in the general surgery department of the Ignace DEEN national hospital in Conakry (Guinea). Results: During the three years of study, we compiled 69 records of patients with postoperative enterocutaneous fistulas, representing 14.68% of all postoperative abdominal complications registered in the department (n=468). The mean age of the patients was 29.61±17.32 years. In this series, 53 patients (76.81%) were initially operated in private health facilities and then referred to our department after the occurrence of the fistula. The most frequent indications for initial surgery were typhoid ileal perforation (37.68%) followed by appendicitis (26.09%) and sigmoid colon volvulus (15.94%). Spontaneous closure of the fistula was obtained in 41 patients (59.42%) with a mean time of 23 days. We noted 18 deaths (26.09%). Conclusion: Postoperative enterocutaneous fistula is a severe complication whose management in our environment is difficult and desperate for both patient and surgeon.

Published in	Journal of Surgery (Volume 10, Issue 1)
DOI	10.11648/j.js.20221001.12
Page(s)	4-7
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Enterocutaneous Fistula, Management, Disadvantaged Environment

References

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[2]	Cisse M, Toure AO, Seck M et al Prise en charge des fistules entéro-cutanées post-opératoires au service de chirurgie générale du CHU A Le Dantec. Rev Afr Chir 2013; 7 (3): 5-9.
[3]	Eni UE, Gali BM Aetiology, management and outcome of enterocutaneous fistulas in Maiduguri, Nigeria. Nigeria Journal of Clinical Practice 2007; 10 (1): 47-51.
[4]	Kumar P, Maroju NK, Kate V Enterocutaneous fistulae: Etiology, treatment, and outcome - A study from South India. Saudi J Gastroenterol 2011; 17: 391-5.
[5]	Kathryn L, Galie MD, and Charles B, Whitlow MD Postoperative enterocutaneous fistula: when to reoperate and how to succeed Clinics in Colon and Rectal Surgery 2006; 19 (4): 237-246.
[6]	Mohanty SK, Mohanty R Evaluation and management of post-operative enterocutaneous fistula. Ann. Int. Med. Den. Res. 2017; 3 (4): sg01-sg04.
[7]	Haffejee AA Surgical management of high output enter- ocutaneous ﬁstulae: a 24-year experience. Curr Opin Clin Nutr Metab Care 2004; 7: 309–316.
[8]	Alvarez C, Mcfadden DW, Reber HA Complicated enterocutaneous ﬁstulas: failure of octreotide to improve healing. World J Surg 2000; 24: 533–538.
[9]	Makhdoom ZA, Komar MJ, Still CD Nutrition and enterocutaneous ﬁstulas. J Clin Gastroenterol 2000; 31: 195– 204.
[10]	Memon AS, Siddiqui FG Causes and management of postoperative enterocutaneous ﬁstulas. J Coll Physicians Surg Pak 2004; 14: 25–28.
[11]	Hollington P, Mawdsley J, Lim W, Gabe SM, Forbes A, Windsor AJ An 11-year experience of enterocuaneous fistula. Br J Surg 2004; 91 (12): 1646-51.
[12]	Sulea EA, Nzegwub MA, Okoloc JC, Onyemekheiad RU Postoperative enterocutaneous ﬁstula - principles in non-operative approach Annals of Medicine and Surgery 2017; 24: 77–81.
[13]	Evenson AR, Fischer JE Current management of enterocutaneous fistula. J Gastrointest Surg 2006; 10: 455-464.
[14]	Lloyd DAJ, Gabe SM and Windsor ACJ Nutrition and management of enterocutaneous ﬁstula British Journal of Surgery 2006; 93: 1045–105.
[15]	Martinez JL, Luque-de-Leon E, Mier J et al Systematic management of postoperative enterocutaneous fistulas: factors related to outcomes. World J Surg 2008; 32: 436–443.
[16]	Noori IF Postoperative enterocutaneous fistulas: Management outcomes in 23 consecutive patients. Annals of Medicine and Surgery 2021; 66 (5): 102413; doi: 10.1016/jamsu.2021.102413.
[17]	Wainstein DE, Tungler V, Ravazzola C, Chara O Management of external small bowell fistulae: challenges and controversies confronting the general surgeon. Int J Surg 2011; 9: 198-203.
[18]	Schein M What’s new in postoperative enterocutaneous fistulas? World J Surg 2008; 32 (3): 336-338.
[19]	Schecter WP, Hirshberg A, Chang DS et al Enteric fistulas: principles of management. J Am Coll Surg 2009; 209 (4): 484-491.
[20]	Connolly PT, Teubner A, Lees NP, Anderson ID, Scott NA, Carlson GL Outcome of reconstructive surgery for intestinal fistula in open abdomen. Ann Surg 2008; 247 (3): 440-444.
[21]	Lauro A, Cirochi R, Cautero N et al. Surgery for post-operative entero-cutaneous fistulas: is bowel resection plus primary anastomosis without stoma a safe option to avoid early recurrence? Report on 20 cases by a single center and systematic review of the literature. G Chir 2017; 38 (4): 185-198.

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Soumaoro Labile Togba, Fofana Houssein, Fofana Naby, Kondano Saa Yawo, Thea Kokolype, et al. (2022). Postoperative Enterocutaneous Fistula: A Severe and Desperate Complication in a Disadvantaged Surgical Setting. Journal of Surgery, 10(1), 4-7. https://doi.org/10.11648/j.js.20221001.12

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ACS Style

Soumaoro Labile Togba; Fofana Houssein; Fofana Naby; Kondano Saa Yawo; Thea Kokolype, et al. Postoperative Enterocutaneous Fistula: A Severe and Desperate Complication in a Disadvantaged Surgical Setting. J. Surg. 2022, 10(1), 4-7. doi: 10.11648/j.js.20221001.12

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AMA Style

Soumaoro Labile Togba, Fofana Houssein, Fofana Naby, Kondano Saa Yawo, Thea Kokolype, et al. Postoperative Enterocutaneous Fistula: A Severe and Desperate Complication in a Disadvantaged Surgical Setting. J Surg. 2022;10(1):4-7. doi: 10.11648/j.js.20221001.12

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@article{10.11648/j.js.20221001.12,
  author = {Soumaoro Labile Togba and Fofana Houssein and Fofana Naby and Kondano Saa Yawo and Thea Kokolype and Toure Aboubacar and Diallo Aissatou Taran},
  title = {Postoperative Enterocutaneous Fistula: A Severe and Desperate Complication in a Disadvantaged Surgical Setting},
  journal = {Journal of Surgery},
  volume = {10},
  number = {1},
  pages = {4-7},
  doi = {10.11648/j.js.20221001.12},
  url = {https://doi.org/10.11648/j.js.20221001.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20221001.12},
  abstract = {Purpose: Digestive or gastrointestinal fistula is one of the most feared postoperative complication along with dehiscence and infection. The aim of this study was to determine the etiological, clinical and therapeutic aspects of enterocutaneous fistulas in a disadvantaged surgical setting. Methods: This was a retrospective study covering a period of three years (January 2018 to December 2020) including records of patients managed for postoperative enterocutaneous fistula in the general surgery department of the Ignace DEEN national hospital in Conakry (Guinea). Results: During the three years of study, we compiled 69 records of patients with postoperative enterocutaneous fistulas, representing 14.68% of all postoperative abdominal complications registered in the department (n=468). The mean age of the patients was 29.61±17.32 years. In this series, 53 patients (76.81%) were initially operated in private health facilities and then referred to our department after the occurrence of the fistula. The most frequent indications for initial surgery were typhoid ileal perforation (37.68%) followed by appendicitis (26.09%) and sigmoid colon volvulus (15.94%). Spontaneous closure of the fistula was obtained in 41 patients (59.42%) with a mean time of 23 days. We noted 18 deaths (26.09%). Conclusion: Postoperative enterocutaneous fistula is a severe complication whose management in our environment is difficult and desperate for both patient and surgeon.},
 year = {2022}
}

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TY  - JOUR
T1  - Postoperative Enterocutaneous Fistula: A Severe and Desperate Complication in a Disadvantaged Surgical Setting
AU  - Soumaoro Labile Togba
AU  - Fofana Houssein
AU  - Fofana Naby
AU  - Kondano Saa Yawo
AU  - Thea Kokolype
AU  - Toure Aboubacar
AU  - Diallo Aissatou Taran
Y1  - 2022/01/12
PY  - 2022
N1  - https://doi.org/10.11648/j.js.20221001.12
DO  - 10.11648/j.js.20221001.12
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 4
EP  - 7
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20221001.12
AB  - Purpose: Digestive or gastrointestinal fistula is one of the most feared postoperative complication along with dehiscence and infection. The aim of this study was to determine the etiological, clinical and therapeutic aspects of enterocutaneous fistulas in a disadvantaged surgical setting. Methods: This was a retrospective study covering a period of three years (January 2018 to December 2020) including records of patients managed for postoperative enterocutaneous fistula in the general surgery department of the Ignace DEEN national hospital in Conakry (Guinea). Results: During the three years of study, we compiled 69 records of patients with postoperative enterocutaneous fistulas, representing 14.68% of all postoperative abdominal complications registered in the department (n=468). The mean age of the patients was 29.61±17.32 years. In this series, 53 patients (76.81%) were initially operated in private health facilities and then referred to our department after the occurrence of the fistula. The most frequent indications for initial surgery were typhoid ileal perforation (37.68%) followed by appendicitis (26.09%) and sigmoid colon volvulus (15.94%). Spontaneous closure of the fistula was obtained in 41 patients (59.42%) with a mean time of 23 days. We noted 18 deaths (26.09%). Conclusion: Postoperative enterocutaneous fistula is a severe complication whose management in our environment is difficult and desperate for both patient and surgeon.
VL  - 10
IS  - 1
ER  -

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Author Information

Soumaoro Labile Togba

Department of General Surgery, Ignace Deen National Hospital, Conakry, Guinea
Fofana Houssein

Department of General Surgery, Ignace Deen National Hospital, Conakry, Guinea
Fofana Naby

Department of General Surgery, Ignace Deen National Hospital, Conakry, Guinea
Kondano Saa Yawo

Department of General Surgery, Ignace Deen National Hospital, Conakry, Guinea
Thea Kokolype

Department of General Surgery, Regional Hospital of N’Zerekore, N’Zerekore, Guinea
Toure Aboubacar

Department of General Surgery, Ignace Deen National Hospital, Conakry, Guinea
Diallo Aissatou Taran

Department of General Surgery, Ignace Deen National Hospital, Conakry, Guinea

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APA Style

Soumaoro Labile Togba, Fofana Houssein, Fofana Naby, Kondano Saa Yawo, Thea Kokolype, et al. (2022). Postoperative Enterocutaneous Fistula: A Severe and Desperate Complication in a Disadvantaged Surgical Setting. Journal of Surgery, 10(1), 4-7. https://doi.org/10.11648/j.js.20221001.12

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ACS Style

Soumaoro Labile Togba; Fofana Houssein; Fofana Naby; Kondano Saa Yawo; Thea Kokolype, et al. Postoperative Enterocutaneous Fistula: A Severe and Desperate Complication in a Disadvantaged Surgical Setting. J. Surg. 2022, 10(1), 4-7. doi: 10.11648/j.js.20221001.12

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AMA Style

Soumaoro Labile Togba, Fofana Houssein, Fofana Naby, Kondano Saa Yawo, Thea Kokolype, et al. Postoperative Enterocutaneous Fistula: A Severe and Desperate Complication in a Disadvantaged Surgical Setting. J Surg. 2022;10(1):4-7. doi: 10.11648/j.js.20221001.12

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@article{10.11648/j.js.20221001.12,
  author = {Soumaoro Labile Togba and Fofana Houssein and Fofana Naby and Kondano Saa Yawo and Thea Kokolype and Toure Aboubacar and Diallo Aissatou Taran},
  title = {Postoperative Enterocutaneous Fistula: A Severe and Desperate Complication in a Disadvantaged Surgical Setting},
  journal = {Journal of Surgery},
  volume = {10},
  number = {1},
  pages = {4-7},
  doi = {10.11648/j.js.20221001.12},
  url = {https://doi.org/10.11648/j.js.20221001.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20221001.12},
  abstract = {Purpose: Digestive or gastrointestinal fistula is one of the most feared postoperative complication along with dehiscence and infection. The aim of this study was to determine the etiological, clinical and therapeutic aspects of enterocutaneous fistulas in a disadvantaged surgical setting. Methods: This was a retrospective study covering a period of three years (January 2018 to December 2020) including records of patients managed for postoperative enterocutaneous fistula in the general surgery department of the Ignace DEEN national hospital in Conakry (Guinea). Results: During the three years of study, we compiled 69 records of patients with postoperative enterocutaneous fistulas, representing 14.68% of all postoperative abdominal complications registered in the department (n=468). The mean age of the patients was 29.61±17.32 years. In this series, 53 patients (76.81%) were initially operated in private health facilities and then referred to our department after the occurrence of the fistula. The most frequent indications for initial surgery were typhoid ileal perforation (37.68%) followed by appendicitis (26.09%) and sigmoid colon volvulus (15.94%). Spontaneous closure of the fistula was obtained in 41 patients (59.42%) with a mean time of 23 days. We noted 18 deaths (26.09%). Conclusion: Postoperative enterocutaneous fistula is a severe complication whose management in our environment is difficult and desperate for both patient and surgeon.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Postoperative Enterocutaneous Fistula: A Severe and Desperate Complication in a Disadvantaged Surgical Setting
AU  - Soumaoro Labile Togba
AU  - Fofana Houssein
AU  - Fofana Naby
AU  - Kondano Saa Yawo
AU  - Thea Kokolype
AU  - Toure Aboubacar
AU  - Diallo Aissatou Taran
Y1  - 2022/01/12
PY  - 2022
N1  - https://doi.org/10.11648/j.js.20221001.12
DO  - 10.11648/j.js.20221001.12
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 4
EP  - 7
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20221001.12
AB  - Purpose: Digestive or gastrointestinal fistula is one of the most feared postoperative complication along with dehiscence and infection. The aim of this study was to determine the etiological, clinical and therapeutic aspects of enterocutaneous fistulas in a disadvantaged surgical setting. Methods: This was a retrospective study covering a period of three years (January 2018 to December 2020) including records of patients managed for postoperative enterocutaneous fistula in the general surgery department of the Ignace DEEN national hospital in Conakry (Guinea). Results: During the three years of study, we compiled 69 records of patients with postoperative enterocutaneous fistulas, representing 14.68% of all postoperative abdominal complications registered in the department (n=468). The mean age of the patients was 29.61±17.32 years. In this series, 53 patients (76.81%) were initially operated in private health facilities and then referred to our department after the occurrence of the fistula. The most frequent indications for initial surgery were typhoid ileal perforation (37.68%) followed by appendicitis (26.09%) and sigmoid colon volvulus (15.94%). Spontaneous closure of the fistula was obtained in 41 patients (59.42%) with a mean time of 23 days. We noted 18 deaths (26.09%). Conclusion: Postoperative enterocutaneous fistula is a severe complication whose management in our environment is difficult and desperate for both patient and surgeon.
VL  - 10
IS  - 1
ER  -

Copy | Download