Enterocutaneous Fistula in University of Port Harcourt Teaching Hospital

Abstract

INTRODUCTION: Enterocutaneous fistula (ECF) is a distressful problem to the surgeon, patients and relatives. In spite of the medical advances over the years, mortality still remains between 10 and 20%. The objective of this study was to evaluate the management of ECF and its outcome as seen in University of Port Harcourt Teaching Hospital (UPTH).
PATIENTS AND METHODS: This is a retrospective study of all cases of ECF seen and managed in UPTH over an 8 year period. Relevant data were retrieved and analyzed.
RESULTS: Thirty six folders were retrieved and analyzed within the study period. There were 24 females and 12 males. Their ages ranged from 13 to 68 years with the peak age incidence at 51  60 years. The commonest cause was post operative (91.7%) and appendicectomy was the commonest surgical procedure (36.4%). Twenty patients were managed conservatively and 15(75%) had spontaneous closure of their fistulae. Conservative management was satisfactory in most of our patients either alone (93.8%) or conservative followed by surgery (100%) with 1(6.2%) mortality while surgical management had 6 (37.5%) mortalities and 4 (25%) recurrences that were subsequently and successfully managed conservatively. Mortality rate was 19.4%.
CONCLUSION: The commonest cause of ECF is post operative. The  modality of treatment should be conservative while surgery be reserved for selected cases.

KEY WORDS: Enterocutaneous fistula, management outcome Port Harcourt.