Enterocutaneous fistulas. Effects of total parenteral nutrition and surgery

Diseases of the Colon and Rectum
R T ZeraC R Hitchcock

Abstract

Fifty patients with 68 enterocutaneous fistulas were retrospectively reviewed at Hennepin County Medical Center from 1967 to June 1981. Eleven of 28 patients, treated with total parenteral nutrition (TPN) as the initial therapy for their fistulas, had spontaneous closure of 22 of 44 fistulas (three gastroduodenal, 17 small-bowel, two colonic fistulas). There were 35 operative procedures resulting in the closure of 26 fistulas, ten of which had failed to close with TPN (two gastroduodenal, ten small-bowel, and fourteen colonic fistulas). Overall mortality was 22 per cent, with five postoperative deaths and four deaths of patients treated with TPN. Aggressive use of TPN has not obviated the need for surgical closure in the authors' experience, particularly low in the gastrointestinal tract. Management should include TPN for up to four weeks and surgery if there has been no improvement with conservative therapy.

References

Nov 1, 1978·Diseases of the Colon and Rectum·J C SternquistC R Hitchcock
Oct 1, 1978·Annals of Surgery·H A ReberJ E Dunphy
Sep 1, 1960·Annals of Surgery·L H EDMUNDSC E WELCH
Aug 1, 1964·American Journal of Surgery·R CHAPMANJ E DUNPHY

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Citations

Jul 1, 1992·Diseases of the Colon and Rectum·D I BorisonT J Pritchard
Aug 1, 1984·Diseases of the Colon and Rectum·T O Nwabunike
May 1, 2004·Clinics in Colon and Rectal Surgery·Naila Arebi, Alastair Forbes
Nov 28, 2012·The Surgical Clinics of North America·Kurt G Davis, Eric K Johnson
Aug 2, 2008·Alimentary Pharmacology & Therapeutics·J E MawdsleyS M Gabe
Jun 29, 2006·The British Journal of Surgery·D A J LloydA C J Windsor
Oct 1, 1985·Current Problems in Surgery·J J Reilly, A L Gerhardt
Oct 1, 1996·The Surgical Clinics of North America·A K TassiopoulosJ D Halverson
Mar 13, 2018·Inflammatory Bowel Diseases·Robert P HirtenJean-Frederic Colombel
Jul 1, 1987·Drug Intelligence & Clinical Pharmacy·J M Mirtallo, T Oh
Oct 29, 2013·The American Surgeon·Hossein MasoomiMichael J Stamos

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