MANAGEMENT OF SMALL INTESTINAL FISTULAE

Abstract

This study discusses the small intestinal fistulae as regard their causes, complication, pathophysiology, outcome, investigations and treatment .

The study shows that the causes of intestinal fistula may be classified as postoperative, traumatic or spontaneous such as those associated with inflammatory bowel disease, cancer or radiation enteritis.

Among these causes, postoperative is the commonest cause, and the most common inflammatory cause is Crohn's disease.

When a gastrointestinal fistula is diagnosed, the patients are liable to many complications. These complications are responsible for high rate of morbidity and lengthy hospitalization. These complication include, malnutrition, fluid and electrolytes imbalance, sepsis and multiple- organ failure. Skin excoriation is also Q major problem in external fistula.

These complications are responsible for high rate of mortality up to 34% to 37%, the variability in the mortality rates is due to the very heterogeneous nature of patients and their fistulas. Whereas some patients are well nourished

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