[Enterocutaneous fistulas in patients older than 70 years].
BACKGROUND
Enterocutaneous fistula remains a major complication after abdominal surgery.


METHODS
We reviewed the charts of patients over 70 years of age with enterocutaneous fistula who were seen in a general surgery department. Special interest was given to mortality-related factors.


RESULTS
A total of 19 patients were seen. The median age was 76 years. All fistulas were postoperative. All patients were managed based on the phases of Chapman and Sheldon. The most common site of presentation was colon, followed by jejunum and duodenal fistulas. More than half of the patients were malnourished at time of presentation. Spontaneous closure presented in eight patients (47%), seven other patients required surgical treatment for closure of their fistulas. Closure of the fistulas was obtained in 15 patients (79%). Four patients died resulting in a mortality rate of 21%. The factors against spontaneous closure were high output (p < 0.03), jejunal fistulas (p < 0.05), hydroelectrolytic imbalance (p < 0.01) and multiple fistulas (p < 0.02). The factors related to mortality were high output (p < 0.04), hydroelectrolytic imbalance (p < 0.02), jejunal fistulas (p < 0.04) and sepsis (p < 0.01).


CONCLUSIONS
Patients > 70 years of age with enterocutaneous fistulas have the same mortality reported in the overall population. Sepsis remains the most important cause of death in patients with enterocutaneous fistulas.
Martínez-Ordaz
José Luis
JL
Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Col. Doctores, México DF. jlmo1968@hotmail.com
Suárez-Moreno
Roberto Manuel
RM
Luque-de León
Enrique
E
Blanco-Benavides
Roberto
R
D000368:Aged; D000369:Aged, 80 and over; D017577:Cutaneous Fistula / Q000628:therapy*; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000628:therapy*; D008297:Male