Table 125 Enterocutaneous fistulas

Cause of Enterocutaneous Fistula Rate

Postoperative complication 82%

Inflammatory bowel disease 6.3%

Cancer 3.8%

Infectous 2.5%

Iatrogen ic 2.5%

drainage of abdominal abscesses. Spontaneous fistula formation due to disease process occurs usually into an internal organ. Thus colovesical fistula or colovaginal fistula may complicate colonic diverticulitis, carcinoma or Crohn's disease (Table 12.5).

Factors involved in the development of fistulas include are excess tension or ischemia at bowel anastomosis. Abscesses, distal bowel obstruction and acute necro-tizing pancreatitis may also contribute to fistulization. Patient comorbidities predispose to fistula are catabolic illness, severe malnutrition (with serum-albumin <2 g/dL), marked diabetes mellitus, morbid obesity, prolonged steroid therapy.

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