[Acquierd entero-cutaneous fistulas--diagnostic and therapeutic approach].
The acquired entero-cutaneous fistulas are a current problem in the field of abdominal surgery. Most of them are postoperative--after an intestinal resection and/or anastomosis. Crohn's disease and coplicated colonic diverticulosis rank second as causal factors. The risk factors for the development of an entero-cutaneous fistula and for the poor prognosis at the same time are the next: (1) Most of the patients suffer of severe main and co-exhisting diseases; (2) The presence of previous laparotomies, radion and chemotherapy, significant disturbances in the base-acid and water-electrolyte balance; (3) The fistula itself worsens these disturbances and may doom to fail the substitutional and nutritional therapy. The diagnostics of a fistula, including its location is comparatively easy. The surgical treatment plays an important role in the therapeutic scheme, especially in cases of high-output fistulas of the small intestin. At the same time the adequate total parenteral nutrition and correction of the base-acid and water-electrolyte disbalance is also very important. Recently there are some new diagnostic methods and alternatives of the basic surgical procedures, some of them quite contraversial.
Draganov
K
K
Dimitrova
V
V
Ionkov
A
A
Rusenov
D
D
Tosheva
E
E
Dimitrov
K
K
Tonev
S
S
D000714:Anastomosis, Surgical / Q000009:adverse effects*; D017577:Cutaneous Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D016154:Digestive System Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D006801:Humans