Presentation
The presenting signs and symptoms of fistulae associated with ovarian tumours vary. Rare cases present with giant cystic air-filled masses 8, 9 ; others, with bowel obstruction necessitating emergency surgical intervention 10. [current-oncology.com]
OBJECTIVE: To present a case of ureterocolonic fistula secondary to acute sigmoid diverticulitis in a nonfunctioning ureter due to a previous nephrectomy. [ncbi.nlm.nih.gov]
They made this recommendation because unacceptable levels of NDMA, a probable carcinogen (or cancer-causing chemical), were present in some ranitidine products. [medicalnewstoday.com]
Entire Body System
- Wound Infection
Treatment focuses on keeping you well-nourished and preventing wound infection. [healthline.com]
Gastrointestinal
- Rectal Bleeding
They’re accompanied by other symptoms, including: abdominal pain painful bowel obstruction fever elevated white blood cell count People who have internal fistulas may experience: diarrhea rectal bleeding a bloodstream infection or sepsis poor absorption [healthline.com]
- Abdominal Distension
Discontinuation of enteral nutrition prior to operation may decrease abdominal distension and aid in abdominal closure. Entering the abdomen through a new incision is preferred if possible. [ncbi.nlm.nih.gov]
Cardiovascular
- Hypotension
Intestinal anastomoses are susceptible to partial or complete dehiscence in the presence of impaired blood supply to the area, systemic hypotension, anastomotic suture line tension, perianastomotic infection, and diseased bowel segment anastomosis. [emedicine.medscape.com]
Psychiatrical
- Suggestibility
Imaging by ct performed after the 3rd cycle suggested a decrease in the size of the splenic, retroperitoneal, lung, and abdominal masses. [current-oncology.com]
The 6-month time course is commonly utilized by groups with significant experience treating fistulas, owing to the trend in encountering a less hostile abdomen than in the early phases. [4] Some evidence also suggests that somatostatin can be an effective [en.wikipedia.org]
The appearance of feculent material at the umbilicus suggests the diagnosis, and surgical resection of the patent duct is performed. Congenital patent omphalomesenteric duct resulting in an enterocutaneous fistula. [emedicine.medscape.com]
If your doctor doesn’t already suggest it, tell them if you’re at risk for a gastrointestinal fistula. If you have a history of inflammatory bowel problems, or you’ve recently had surgery, you’re at a higher risk. [healthline.com]
Definition of the anatomic course of a fistula is necessary as it may suggest the etiology of the fistula and aid in estimating likelihood of spontaneous closure. [ncbi.nlm.nih.gov]
Workup
X-Ray
- Gastric Fistula
[…] external surface of the body, discharging feces. gastric fistula 1. one communicating between the stomach and some other body part. 2. a passage created artificially through the abdominal wall into the stomach. horseshoe fistula one near the anus, having [medical-dictionary.thefreedictionary.com]
Enterocutaneous fistula after bowel injury from an incisional hernia repair, 6 weeks postinjury. Gastric fistulas Gastric fistulas are iatrogenic in most cases (85%). [emedicine.medscape.com]
Treatment
It is emphasized that these less commonly used approaches should be regarded as complimentary tools in the arsenal of those treatments whose role is already established in the treatment of enterocutaneous fistulas. [ncbi.nlm.nih.gov]
Treatment focuses on keeping you well-nourished and preventing wound infection. [healthline.com]
Treatment Treatment for a gastrointestinal fistula depends on its severity and location. Fistulae that are small and not infected will often close on their own. [medicalnewstoday.com]
Other causes include: Blockage in the intestine Infection (such as diverticulitis) Crohn disease Radiation to the abdomen (most often given as part of cancer treatment) Injury, such as deep wounds from stabbing or gunshot Swallowing caustic substances [mountsinai.org]
Prognosis
Outlook (Prognosis) The outlook depends on the person's overall health and how bad the fistula is. People who are otherwise healthy have a very good chance of recovery. [mountsinai.org]
Prognosis The prognosis is based on the etiology of the fistula, as well as the comorbidities of the patient. [emedicine.medscape.com]
Etiology
(See Etiology and Prognosis.) Fistulas were formerly associated with considerable mortality rates. [emedicine.medscape.com]
Fistulas may be classified based on anatomic, physiologic, or etiologic criteria ( table I ). [ncbi.nlm.nih.gov]
Epidemiology
[…] to the suture line, resulting in the midportion of the graft eroding into adjacent bowel; conversely, primary aortoenteric fistulas almost always result from erosion of the aneurysmal or infected aorta into surrounding areas, most commonly the bowel Epidemiology [emedicine.medscape.com]
Pathophysiology
Thus, in essence, the pathophysiology underlying the development of metabolic acidosis from a duodenal fistula is the same as that of a pancreatic fistula- it is basically the same secretions being lost. Not so for the jejunum. [derangedphysiology.com]
Pathophysiology and therapy of chronic radiation-induced injury to the colon. Dig Dis. 1998 Jul-Aug. 16 (4):253-61. [QxMD MEDLINE Link]. Li Y, Ren JA, Wang GF, et al. [emedicine.medscape.com]
Prevention
However, you can take steps to prevent GIF before surgery. [healthline.com]
The presence of food in the gut triggers the additional secretion of gastric juices, preventing a person with a fistula from getting enough nutrients. A lack of nutrition will make it difficult for a person's body to heal. [medicalnewstoday.com]
Malnutrition is easier to prevent than correct. Once established, malnutrition may be difficult to correct, especially with concomitant sepsis, but malnutrition and sepsis remain principal causes of death in patients with fistulas. [ncbi.nlm.nih.gov]