Contaminated fistula following J-pouch ileoanal reservoir. Treatment with a collagen sponge containing gentamicin and metronidazole. Case report.
In a 55-year-old woman, a 1 x 5 cm fistula developed in the ileoanal anastomosis after restorative proctocolectomy with J-pouch ileoanal reservoir and temporary ileostomy for intractable ulcerative colitis. The fistula extended between the pouch and the sacral bone. Lasting closure was achieved by intrafistular placement of a collagen sponge containing gentamicin and soaked in metronidazole solution and pouch drainage through a transanal Foley catheter.
Nielsen
R
R
Department of Surgical Gastroenterology, Hvidovre University Hospital, Copenhagen, Denmark.
Bülow
S
S
Moesgaard
F
F
D001003:Anal Canal / Q000601:surgery; D000714:Anastomosis, Surgical / Q000379:methods; D001424:Bacterial Infections / Q000150:complications / Q000188:drug therapy*; D001847:Bone Diseases / Q000150:complications / Q000188:drug therapy / Q000382:microbiology; D003094:Collagen; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007082:Ileum / Q000601:surgery; D007412:Intestinal Fistula / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D008795:Metronidazole / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy* / Q000382:microbiology; D012447:Sacrum; D013997:Time Factors
D005839:Gentamicins; D008795:Metronidazole; D003094:Collagen