Enterocutaneous fistula associated with malignancy and prior radiation therapy.

Enterocutaneous fistula (ECF) associated with cancer or radiation injury increases the complexity of normal management. Factors such as timing of additional adjuvant therapy or palliative care, technical considerations for operating on irradiated bowel, poor wound healing, increased risk of additional ECF, and decreased likelihood of spontaneous ECF closure all need to be considered in this scenario. Here the authors focus specifically on the management of ECF associated with cancer and/or radiation-induced injury to the bowel.