title: Efficacy of fibrin glue therapy for abscess-associated enteric fistulas.
abstract: BACKGROUND
  Abdominal abscess that result from bowel injury may require treatment with percutaneous drainage. In some cases, an abscess-associated fistula develops between the injured bowel and the drainage catheter. Fistulas that fail to resolve may require surgery; however, fibrin glue therapy (FGT) may be a suitable alternative.
  
  
  METHODS
  We retrospectively identified patients undergoing FGT for an abscess-associated enteric fistula between 2004 and 2015. Success was defined as closure of the fistula tract without need for additional intervention. A multivariable logistic regression analysis was utilized to identify factors associated with success.
  
  
  RESULTS
  We identified 34 patients with a median age of 54 (23-87) years and 24 (71 %) males. FGT was successful in 23 (67 %) patients. On multivariate analysis, a tract width less than 5 mm (OR 19.2, 95 % CI 1.7-214.5) and removal of the drain (OR 13.8, 95 % CI 1.2-157.6) predicted FGT success. The time from initial FGT to resolution was significantly decreased for the patients who were successfully treated compared to those who failed 24 (14-38) days vs. 99 (71-175) days, respectively (p < 0.001).
  
  
  CONCLUSIONS
  Fibrin glue therapy for abscess-associated enteric fistula results in successful and accelerated healing in the majority of cases. Factors associated with successful fibrin glue therapy were identified.
authors: Department of Surgery, University of Colorado School of Medicine, 12631 E. 17th Ave. C313, Aurora, CO, 80045, USA. brandon.chapman@ucdenver.edu.
authors: B C
authors: BC
authors: Chapman
authors: Department of Surgery, University of Colorado School of Medicine, 12631 E. 17th Ave. C313, Aurora, CO, 80045, USA.
authors: J
authors: J
authors: Merkow
authors: Department of Surgery, University of Colorado School of Medicine, 12631 E. 17th Ave. C313, Aurora, CO, 80045, USA.
authors: A
authors: A
authors: Paniccia
authors: Department of Surgery, University of Colorado School of Medicine, 12631 E. 17th Ave. C313, Aurora, CO, 80045, USA.
authors: D M
authors: DM
authors: Overbey
authors: Department of Surgery, University of Colorado School of Medicine, 12631 E. 17th Ave. C313, Aurora, CO, 80045, USA.
authors: M
authors: M
authors: Gipson
authors: Department of Surgery, University of Colorado School of Medicine, 12631 E. 17th Ave. C313, Aurora, CO, 80045, USA.
authors: G
authors: G
authors: Stiegmann
authors: Department of Surgery, University of Colorado School of Medicine, 12631 E. 17th Ave. C313, Aurora, CO, 80045, USA.
authors: J D
authors: JD
authors: Vogel
mesh_terms: D000038:Abscess / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D007412:Intestinal Fistula / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D012189:Retrospective Studies; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects
chemical_list: D003287:Contrast Media; D015718:Fibrin Tissue Adhesive
keywords: Abdominal abscess; Fibrin glue; Fistula