title: Management of fistula of ileal conduit in open abdomen by intra-condoit negative pressure system.
abstract: BACKGROUND
  We aimed to present the management of a patient with fistula of ileal conduit in open abdomen by intra-condoid negative pressure in conjunction with VAC Therapy and dynamic wound closure system (ABRA).
  
  
  METHODS
  65-Year old man with bladder cancer underwent radical cystectomy and ileal conduit operation. Fistula from uretero-ileostomy anastomosis and ileus occurred. The APACHE II score was 23, Mannheim peritoneal index score was 38 and Björck score was 3. The patient was referred to our clinic with ileus, open abdomen and fistula of ileal conduit. Patient was treated with intra-conduid negative pressure, abdominal VAC therapy and ABRA.
  
  
  CONCLUSIONS
  Management of urine fistula like EAF in the OA may be extremely challenging. Especially three different treatment modalities of EAF are established in recent literature. They are isolation of the enteric effluent from OA, sealing of EAF with fibrin glue or skin flep and resection of intestine including EAF and re-anastomosis. None of these systems were convenient to our case, since urinary fistula was deeply situated in this patient with generalized peritonitis and ileus.
  
  
  CONCLUSIONS
  Application of intra-conduid negative pressure in conjunction with VAC therapy and ABRA is life saving strategies to manage open abdomen with fistula of ileal conduit.
authors.affiliation: Atatürk Research and Training Hospital, General Surgery Department, Ankara, Turkey. Electronic address: drfahriyetisir@hotmail.com.
authors.forename: Fahri
authors.initials: F
authors.lastname: Yetişir
authors.affiliation: Atatürk Research and Training Hospital, Anesthesiology and Reanimation Department, Ankara, Turkey.
authors.forename: A Ebru
authors.initials: AE
authors.lastname: Salman
authors.affiliation: Atatürk Research and Training Hospital, General Surgery Department, Ankara, Turkey.
authors.forename: Muhittin
authors.initials: M
authors.lastname: Aygar
authors.affiliation: Kutahya Dumlupınar University, General Surgery Department, Kutahya, Turkey.
authors.forename: Faik
authors.initials: F
authors.lastname: Yaylak
authors.affiliation: Atatürk Research and Training Hospital, Anesthesiology and Reanimation Department, Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Aksoy
authors.affiliation: Atatürk Research and Training Hospital, General Surgery Department, Ankara, Turkey.
authors.forename: Abdussamet
authors.initials: A
authors.lastname: Yalçin
keywords: Dynamic closure; Entero atmospheric fistula; Ileal conduit; Negative pressure; Open abdomen