Enterocutaneous Fistula : Aetiology and Management Outcome in a Tertiary Center in Nigeria

Abstract

Background: Enterocutaneous fistula is a major surgical challenge worldwide. It has a potential for serious morbidity and mortality, especially the high output type.
Objective: To review the cases of Enterocutaneous fistula that presented to Federal Medical Center, Owerri, over a 6 year period with the aim of determining the causes and management outcomes.
Method: A six year retrospective study from July, 2005 to June, 2011. Data were retrieved from emergency room, theatre and ward records.
Results: There were 20 patients; 11 females and 9 males. The mean age was 33years while the age range was 14 to 80 years. Post-surgical complication accounted for 17(85%) of the cases. ECF from post appendectomy was 6 (30%) making it the most common aetiological factor. Spontaneous closure of ECF after conservative (nonoperative) treatment was recorded in 2(10%) patients. Intestinal resection and anastomosis was the most common procedure done. Five (25%) of the patients died during the course of management. Four (20%) of them had types 1 and 4 ECF.
Conclusion: The incidence of ECF in Federal Medical Center Owerri is low (4 cases per year). Appendicectomy is the most common cause of ECF in the study. Mortality is unacceptably high for patients with types 1 and 4 ECF. Operative treatment was offered to most of the patients.

Keywords: Enterocutaneous fistula, aetiology, management outcome.