Nutrition and enterocutaneous fistulas.
Enterocutaneous fistulas (ECFs) are a complex topic in terms of classification. ECF-related morbidity and mortality can be high due to fluid loss and electrolyte imbalance, sepsis, and malnutrition. Most prognostic factors influencing the outcome of ECF are now well-known. ECF treatment is complex; and, based on various situations, it can be surgical or conservative/ medical. Depending on fistula site and nutritional status, clinicians have to decide whether total parenteral or enteral nutrition should be established. In cases where total parenteral nutrition alone for 7 days has failed to influence the high output fistulas, overall data support the use of adjuvant drug, somatostatin, or its synthetic analogue, octreotide. Somatostatin 250 microg/d and octreotide 300-600 microg/d have been tried along with total parenteral nutrition to decrease the healing time of ECFs and to reduce the number of complications.
Makhdoom
Z A
ZA
Section of Gastroenterology/Nutrition, Penn State Geisinger Medical Center, Danville, Pennsylvania 17822, USA. Zmakhdoom@psghs.edu
Komar
M J
MJ
Still
C D
CD
D017577:Cutaneous Fistula / Q000628:therapy*; D004750:Enteral Nutrition; D005765:Gastrointestinal Agents / Q000009:adverse effects / Q000627:therapeutic use; D006728:Hormones / Q000627:therapeutic use; D006801:Humans; D007412:Intestinal Fistula / Q000628:therapy*; D009752:Nutritional Status; D015282:Octreotide / Q000009:adverse effects / Q000627:therapeutic use; D010289:Parenteral Nutrition, Total; D013004:Somatostatin / Q000627:therapeutic use
D005765:Gastrointestinal Agents; D006728:Hormones; D013004:Somatostatin; D015282:Octreotide