Development of a colocutaneous fistula in a patient with a large surface area burn.
A 61 year old female sustained a large surface area burn, complicated by inhalation injury. One month before the incident, she had undergone a left hemicolectomy with colorectal anastomosis for diverticular disease. Due to the severity of her burns, multiple surgical debridement and skin grafting procedures were required, including a large fascial debridement of her flank and back. Her hospital course was complicated by recurrent episodes of pulmonary and systemic infection, as well as pre-existing malnutrition. Prior to her discharge to a rehabilitation center, stool began to drain from her left posterior flank. This complication represented a colonic fistula arising from the recent colon anastomosis. The fistula was managed nonoperatively and gradually closed. To our knowledge, this is the first report of a colocutaneous fistula spontaneously draining from the abdomen via the retroperitoneum in a burn victim, not related to direct thermal injury to the peritoneal cavity.
Matthews
M R
MR
Department of Surgery, Maricopa Medical Center, Phoenix, AZ 85008, USA.
Caruso
D M
DM
Al-Kasspooles
M F
MF
Phillips
B J
BJ
Schiller
W R
WR
D000714:Anastomosis, Surgical; D002056:Burns / Q000150:complications*; D003106:Colon / Q000601:surgery; D003108:Colonic Diseases / Q000209:etiology*; D017577:Cutaneous Fistula / Q000209:etiology*; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology*; D008875:Middle Aged; D011183:Postoperative Complications; D012007:Rectum / Q000601:surgery