Nonoperative treatment of enteric fistulas: results in 53 patients.
Fifty-three patients with enterocutaneous fistulas were treated nonoperatively. While most of the fistulas resulted as a complication of surgery, other causes included inflammatory disease, trauma, and malignancy. Fistulas originated from the esophagus (n = 4), stomach (n = 4), duodenum (n = 5), small bowel (n = 27), colonic-small bowel anastomosis (n = 2), colon (n = 10), and Hartmann pouch (n = 1), and included both high-output (n = 29) and low-output (n = 24) types. Nonoperative management resulted in spontaneous fistula closure in 57%. Most of the spontaneous closures (83%) occurred within 2 months of treatment. Spontaneous closure rates were similar for low-output and for high-output fistulas (52% vs 63%), but the treatment duration was longer for high-output than for low-output fistulas (mean treatment duration, 17 days vs 41 days). Colonic fistulas were particularly difficult to manage and closed spontaneously in only 10% of patients (one of 10).
LaBerge
J M
JM
Department of Radiology, University of California, San Francisco 94143-0628.
Kerlan
R K
RK
Gordon
R L
RL
Ring
E J
EJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage / Q000379:methods; D005260:Female; D005402:Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D005767:Gastrointestinal Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012189:Retrospective Studies