Acute management of stoma-related colocutaneous fistula by temporary placement of a self-expanding plastic stent.
Colocutaneous fistulas are frequently the result of complications related to previous operative procedures and are a major cause of morbidity. Most are initially treated conservatively, with a large percentage eventually requiring further surgery for definitive treatment. The use of a temporary colonic stent for the management of colostomy-related colocutaneous fistula has not been previously described. Two patients with colocutaneous fistula related to end colostomies and opening into midline laparotomy wounds were treated by temporary plastic stenting. A removable Polyflex silicone stent was inserted into the stoma. Stent redeployment was needed on several occasions following partial stent expulsion. Midline wound healing was achieved in both cases by 6 weeks post-stent insertion, and complete fistula closure occurred in 1 case. Temporary stent placement in certain cases may aid in the management of a colocutaneous fistula associated with a colostomy to allow fecal diversion from wounds and aid fistula closure.
Nikfarjam
Mehrdad
M
Department of Surgery, University Hospitals, Cleveland, Ohio 44106, USA.
Champagne
Brad
B
Reynolds
Harry L
HL
Poulose
Benjamin K
BK
Ponsky
Jeffrey L
JL
Marks
Jeffrey M
JM
D000368:Aged; D003125:Colostomy / Q000009:adverse effects*; D017577:Cutaneous Fistula / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology / Q000628:therapy*; D008297:Male; D011474:Prosthesis Design; D015607:Stents