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Results for “INTESTINAL FISTULA”

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At least 55 records · Page 3Linked to original sources
PubMed2006

[Management of tertiary peritonitis in the patients complicated with intestinal fistula].

OBJECTIVE: To investigate the etiology and management of tertiary peritonitis in the patients with intestinal fistula. METHODS: One hundred and fifty-three cases of intestinal fistula complicated with tertiary peritonitis were reviewed. The microbiological characteristics, treatment Methods and outcomes were analyzed. RESULTS: There were 114 males and 39 females with a mean age of (42+/- 19) years. The main causes of intestinal fistula included gastrointestinal surgery (40.5%), trauma (31.4%) and severe pancreatitis (14.4%), etc. The most common cultured bacteria of 157 specimens from 79 patients with tertiary peritonitis were Escherichia coli (24.2%), Pseudomonas aeruginosa (12.1%), Staphylococcus aureus (10.8%), Enterobacter cloacae (10.2%), Klebsiella pneumoniae (8.3%). Debridement of the necrotic tissues, drainage of the abscess, continuous rinsing plus negative pressure drainage and antibiotics treatment were performed in 52 cases. Nineteen patients only changed from simple tube drainage to continuous rinsing plus negative pressure drainage. Twenty- eight patients changed to continuous rinsing plus negative pressure drainage and received antibiotics as well. Thirty- six patients received antibiotics and ecoimmune nutrition, while 18 patients only received ecoimmun nutrition. CONCLUSIONS: Intestinal fistula complicated with tertiary peritonitis was mainly caused by residual infectious focus and inappropriate drainage. The rational treatments include reoperation for debridement of the necrotic and infectious tissues, changing drainage to continuous rinsing plus negative pressure drainage, appropriate usage of antibiotics, and ecoimmune nutrition.

Abdominal Cavity↗
PubMed2002

[Improvement strategies in the treatment of high small intestinal fistula].

The experience of treatment of 54 patients with external small intestinal fistula was summarized. The method of surgical treatment was choosen basing on estimation of the fistula localization, its occlusion possibility and in accordance with state of homeostasis. Early performance of operative intervention according to vital indications is necessary in presence of unformed fistula with massive and uncontrolled loss of intestinal contents. Application of rational surgical tactics and complex treatment of patients with high external small intestinal fistula have allowed to lower lethality from 30 to 19%.

Adolescent↗
PubMed1997

[Treatment of undeveloped external intestinal fistulas].

135 patients with undeveloped intestinal fistulas (116-85.9%-males, and 19-14.1%-females) were followed up by the authors. The patients underwent surgery for acute appendicitis-17 (12.6%), traumatic injuries of abdominal organs-78 (57.8%), acute intestinal obstruction-33 (24.4%), inflammatory processes of the uterus and adnexites-7 (5.2%). Small bowel fistulas were observed in 88 (65.2%) of patients, large bowel fistulas-in 47 (34.8%). The optimal mode of treatment for the fistula seems the obturation of fistula duct by means of catheter of Petzer of Foley. It is guite necessary to perform a simultaneous broad exploration of abscesses of anterior abdominal wall and their sanatation by the method of flowing-aspiration therapy by N.N. Kanshin. For elimination of endotoxicosis the ultraviolet irradiation of autologous blood was used as well as intravenous laser irradiation of blood, hemosorption, plasmapheresis, infusions of plasma and plasma substitutional solutions. The patients were given 2-3 antibiotics of a broad spectrum of action, one of which being obligatory introduced intravenously. From 135 patients 104 (77.0%) underwent surgery. The method of choice in small bowel fistulas the authors suggest intraabdominal resection of the bowel, and in large bowel fistulas-resection of 3/4 by the method of A.V. Melnikov. 17 patients (17.3%) died after the surgery.

Adult↗
PubMed1994

[Ultrasonographic diagnosis of intestinal fistulae associated with Crohn disease].

In two patients with Crohn's disease, abdominal mass and fever, abdominal ultrasound disclosed enteroenteric fistula in one, and intestinal fistula associated to subcutaneous abscess in the second. We emphasize the role of ultrasound in the diagnosis of active Crohn's disease, especially as a complementary method for the detection of intraabdominal complications.

Adult↗
PubMed1990

[Treatment of external intestinal fistulas].

The paper based on own extensive clinical material of 29 cases stresses the value of conservative treatment of external intestinal fistulae as illustrated by a case of small intestine fistula associated with large bowel fistula treated previously many times surgically without success. Besides that the importance is emphasized of radiological treatment in the diagnosis and treatment of external intestinal fistulae.

Abdomen, Acute↗
PubMed1992

[The treatment of unformed intestinal fistulae].

Experience in the treatment of 33 patients with unformed intestinal fistulas is discussed. The choice of the method for surgical management was determined by the localization of the fistulas, the possibility of their occlusion, and the severity of the patient's condition. Complex therapy included selective administration of antibacterial agents and extracorporeal detoxification by means of biohemosorption. Rational surgical tactics and complex treatment including extracorporeal detoxification in patients with unformed external intestinal fistulas made it possible to reduce the mortality rate from 33.4% to 21.2% (7 patients died).

Anastomosis, Surgical↗
PubMed1981

[Surgical procedure in external postoperative intestinal fistulae in children].

Results of the surgical treatment of 39 children with postoperative external intestinal fistulas are presented. The surgical treatment of patients with high small-intestine fistulas was performed in early terms and was divided into two steps. The first step included recovery of the intestinal passability. The second step fulfilled in later terms was to eliminate the fistula. In low small-intestine and large intestine fistulas and in tubular fistulas the continuous conservative treatment was used. On the formation of the lip-shaped fistulas, its one-step closure was performed.

Acid-Base Equilibrium↗
PubMed1977

[Urological aspect of vesico-intestinal fistulas. Apropos of 14 cases].

This series of 14 cases of vesico-intestinal fistulae, together with a review of the literature, led to a certain number of remarks: From an aetiological standpoint, in addition to classical concepts with the predominance of diverticulosis of the colon accounting for 46% of cases, followed by carcinoma of the colon (14%) and Crohn's disease, we feel it to be of interest to stress the possible urinary origin of vesico intestinal fistulae (4 of our cases, and 4.5% of the total number collectedin the literature). From a diagnostic standpoint, we would emphasise that these fistulae present almost solely with urinary symptoms and signs and stress the clinical importance of what is now known, since J. Cibert, as "pre-fistulous cystitis" preceding the development of pathognomic signs--faecaluria and pneumatria. Radiological opacification of the colon and rectum is essential in patients with a syndrome of chronic urinary infection unexplained by a urological cause. From a therapeutic standpoint, the surgical treatment of vesico-intestinal fistulae is associated with a high operative mortality (2 deaths amongst our 14 patients) and which, independently of the aetiological factor (predominance of carcinomas) is explained above all by the septic nature of the lesions.

Adult↗
PubMed1978

[Differential therapy of vesico-intestinal fistulas].

40 patients with vesico-intestinal fistulas (50% inflammatory, 30% traumatic, 20% neoplastic) were treated within 10 years. Closure was achieved in 97% of 31 patients operated on with curative intention. The remaining 9 patients had palliative surgery, i.e. colostomy or cystostomy. The decision single- or multiple-stage procedure depends upon the etiology, localization and extent of the fistula.

Colostomy↗
PubMed1991

[Tactics in the treatment of postoperative intestinal fistula].

The experience with treatment of 331 patient with external intestinal fistulas is summarized. It is necessary to remove the high non-shaped "emaciating" fistulas at day 1-2 after their development. A rational method for the treatment of other non-shaped intestinal fistulas is their open management with active aspiration, or flowing drainage. Conservative therapy of the shaped tubular fistulas is effective only within first 4 mos, and later, the operative treatment is indicated to the patients.

Drainage↗