Faecal fistulae in children.
Faecal fistula has been a challenging problem for every surgeon. It develops spontaneously, postoperatively or post-traumatically. Spontaneous faecal fistula develops following peritonitis. Tuberculous peritonitis is an important cause in developing countries. Postoperative faecal fistula develops after enteric perforation or appendicular diseases. Abdominal trauma-blunt, penetrating or perforating, isolated or part of multiple injuries--can lead to faecal fistula. Faecal fistula is more common after emergency surgery, especially in malnourished children. Faecal fistula leads to unnatural losses of fluid and electrolytes and malnutrition. Infection is generally a causative factor or the malnourished child with faecal fistula develops infection very fast. Assessment of the general condition of the child and the level of the fistula is very important in treating the child. Correction of fluid and electrolyte balance, control of infection and supplementation of nutrition is the basis of treatment. Improved parasurgical care and parenteral hyperalimentation has improved the survival rate and the spontaneous healing, reducing the need for surgical intervention.
D000005:Abdomen; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007412:Intestinal Fistula / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D012871:Skin Diseases / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*