Saigusa Susumu, Yamamura Takeshi, Tanaka Koji, Ohi Masaki, Kawamoto Aya, Kobayashi Minako, Inoue Yasuhiro, Kusunoki Masato
Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Japan.
BMJ Case Rep. 2011 Mar 15;2011:bcr0920103342. doi: 10.1136/bcr.09.2010.3342.
Enterocutaneous fistulae (ECF) are challenging problem commonly encountered by surgeons and cause significant complications. They not only prolong hospital stay, but also restrict a patient's activities of daily living. The authors report a case of successful treatment of multiple intractable ECF in a patient with decreased coagulation factor XIII (FXIII) activity using intravenous FXIII treatment. A 74-year-old man with multiple ECF was referred. Although no factors involved in impaired wound were initially identified, he developed ECF after multiple surgical interventions with repeated wound dehiscence. FXIII activity was below the normal value. A definitive operation was performed and FXIII was administrated for 5 days postoperatively. There was no fistula recurrence and no other complications. Preoperative assessment of factors related to wound repair, such as FXIII activity, may be important for patients with wound dehiscence and subsequent fistula development and should be considered in patients who are resistant to standard treatments.
肠皮肤瘘（ECF）是外科医生常遇到的具有挑战性的问题，并会引发严重并发症。它们不仅延长住院时间，还会限制患者的日常生活活动。作者报告了1例使用静脉注射凝血因子 XIII（FXIII）治疗成功治愈1例凝血因子 XIII（FXIII）活性降低患者的多发顽固性ECF的病例。 一名患有多发ECF的74岁男性前来就诊。虽然最初未发现伤口愈合受损的相关因素，但他在多次手术干预且伤口反复裂开后出现了ECF。FXIII活性低于正常值。进行了确定性手术，并在术后给予FXIII治疗5天。未出现瘘复发及其他并发症。术前评估与伤口修复相关的因素，如FXIII活性，对于有伤口裂开及随后发生瘘的患者可能很重要，对于对标准治疗耐药的患者也应予以考虑。
