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  • Title: [Postoperative intestinal fistulae].
    Author: Georgescu I, Nemeş R, Ghelase F, Vâlcea V, Surlin V, Martin L.
    Journal: Chirurgia (Bucur); 2000; 95(3):267-71. PubMed ID: 14768332.
    Abstract:
    58 (6.25%) intestinal fistulae raised after 928 operations performed for varied surgical small bowel diseases were studied. The primary operation was performed for bowel obstruction, acute peritonitis, small bowel tumours, postoperative eviscerations and for entro-mesenteric infarction. We also noticed that the surgery was performed for the small bowel diseases in 47 (81%) acses and for the diseases belonging to other abdominal viscera in the rest, having an emergency character in 81% of cases. The small bowel fistulae were single (51 cases) or multiple having the following topographic distribution: jejunal fistulae in 25 (43.4%) cases and ileal fistulae in 33 cases (56.6). The coming out of the fistulae was directly in 41 (70%) cases and trough an intermediate route in 17 (30%) cases. The onset of the fistulae was certainly pointed by the coming out moment, early only in 39.6% of cases. This underlining the importance of an active exploration of the operative wound, imposed by the general and/or local premonitory symptoms. The treatment was complex, using conservative and/or surgical procedures; 23 (39.6%) patients were operated on. The mortality rate was of 29.4%. The parenteral nutrition and the therapeutical option for the conservative methods were the main therapeutical acquisitions, which improved the results and the prognosis of the intestinal fistulae.
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