• Abdul Razaque Sheikh
  • Arshad M Malik
  • Gulshan Ara Sheikh


Objectives: To study the out come and benefits of an early surgical intervention in postoperativeentero-cutaneous fistulae. Methods: It’s a retrospective descriptive study conducted at department ofsurgery LUMHS from Jan 2001 to November 2008. Two hundred and thirteen (213) post-operativefistulae are included as study subjects while those due to inflammatory bowel diseases, road trafficaccidents or following blunt, stab or gunshot abdominal trauma are excluded. An aggressivetreatment to build up nutritional status, correction of anaemia and control of sepsis was followed bysurgical intervention as soon as the patient’s condition permitted. Variables such as type of fistula,out put per 24 hours, duration since development , complications due to fistula, nutritional status,operative procedure, operative time, post-operative complications, total post-operative stay, followup schedule, outcome. The results were statistically analysed on SPSS-12. Results: A total 213patients comprising 184 males (85.6%) and 29 (13.5%) females with a mean age of 36.08 years anda range of 64 (78–14) years presenting with post-operative enter-cutaneous fistula are included in thestudy. Maximum number of patients (171, 79.5%) developed fistula between 4th–6th postoperativeday and a vast majority of fistula occurred in the ileum (207, 97.18%) either as a result ofanastomotic failure (103), leak from primary closure (99) or from un-noticed missed perforations (5).Of the total number, 24 patients eventually died making a mortality of 11.2%. Early surgicalintervention proved life saving (p<0.001). A strong relation was found pre-operative albumin levelsand surgical closure of the fistula (p<0.001) and associated mortality (p<0.001). Conclusion: Highout put fistula is unlikely to close spontaneously on conservative measures. Early surgicalintervention can be life saving.Keywords: Entero-cutaneous fistula, early surgical intervention, morbidity, mortality


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