Definition

An enterocutaneous fistula is an abnormal connection between the intestines and the skin. Intestinal or stomach contents can leak through this connection. The contents may leak into another part of the body or outside of the body.

Causes

Most enterocutaneous fistulas develop as a complication of bowel surgery. Other causes include:

• Bowel disease, such as Crohn’s disease or ulcerative colitis
• Perforated duodenal ulcers
• Trauma, such as a gunshot or stabbing
• Cancer
• Complications of cancer treatment, such as radiation therapy

Risk Factors

Factors that may increase your chance of enterocutaneous fistula include:

• History of radiation
• Poor nutrition

Symptoms

Symptoms may include:

• Leakage of intestinal contents from an abdominal wound onto the skin
• Diarrhea
• Abdominal pain
• Signs of infection, such as fever, chills, and rapid heart rate
• Dehydration

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. You may be referred to a colon and rectal surgeon.

Images may be taken of your bodily structures. This can be done with:

• Barium swallow test
• Barium enema if colon is involved
• Fistulogram
• CT scan of abdomen
• Ultrasound

Treatment

A fistula may be able to heal on its own over 2-8 weeks. Talk with your doctor about the best treatment plan for you. Treatment options include the following:

• Nutritional support may be needed while the fistula is healing:
  • You may need to drink and eat high energy food for a while.
  • Nutrition may need to be delivered through a tube connected to your stomach or intestine.
  • If your bowels need to rest, nutrition may be given through your vein.
• Antibiotics may be prescribed to help prevent or control infection.
• A drain may be attached to your wound to collect leakage from the fistula.
• If the fistulas do not heal, then part of the intestine may need to be removed.

Prevention

There are no steps you can take to help prevent fistulas.

Crohn’s and Colitis Foundation of America http://www.ccfa.org

Health Canada http://www.hc-sc.gc.ca

Enterocutaneous fistula. UCSF Medical Center website. Available at:
http://www.ucsfhealth.org/conditions/enterocutaneous_fistula
Accessed April 2, 2013.

Pritts TA, Fischer DR, Fischer JE. Postoperative enterocutaneous fistula. Holzheimer RG, Mannick JA, editors. Surgical Treatment: Evidence-Based and Problem-Oriented. Munich: Zuckschwerdt; 2001. Available from:
http://www.ncbi.nlm.nih.gov/books/NBK6914
Accessed September 23, 2014.