Chaudhry Rajan
Senior Advisor (Surgery & Gastrointestinal Surgery), Command Hospital (Northern Command), C/o 56 APO.
Med J Armed Forces India. 2004 Jul;60(3):235-8. doi: 10.1016/S0377-1237(04)80053-4. Epub 2011 Jul 21.
During a period of six years, 17 cases of enterocutaneous fistulae arising from the small intestine were managed. Majority of the fistulae, (76%) resulted from surgical complications. There were 6 females and 11 male patients. The mean age of the patients was 40 years. In 9/17 patients (52%) the fistulae arose from the proximal small gut (duodenum and jejunum) and in the remaining 48% from the ileum. Octreotide was used in 11/17 patients (64%). Enteral nutrition was used in 9/17 patients (52%) while re-feed from the proximal gut fistulae was used in 4/9 patients (44%) to maintain the nutrition of the patients. Only one fistula (6%) closed spontaneously. There were 2 deaths (12%) in this study. 14/17 patients (82%) required surgical intervention at some stage for successful closure of intestinal fistula. Aggressive surgical treatment with judicious use of octreotide, nutritional support, stoma care and control of sepsis significantly improves the outcome of small intestinal fistulae.
在六年的时间里，共处理了17例源于小肠的肠皮肤瘘病例。大多数瘘（76%）是由手术并发症引起的。患者中有6名女性和11名男性。患者的平均年龄为40岁。在17例患者中有9例（52%）瘘源于近端小肠（十二指肠和空肠），其余48%源于回肠。17例患者中有11例（64%）使用了奥曲肽。17例患者中有9例（52%）采用了肠内营养，而9例患者中有4例（44%）通过近端肠瘘进行再喂养以维持患者营养。仅1例瘘（6%）自行闭合。本研究中有2例死亡（12%）。17例患者中有14例（82%）在某个阶段需要手术干预以成功闭合肠瘘。积极的手术治疗并合理使用奥曲肽、营养支持、造口护理和控制感染显著改善了小肠瘘的治疗效果。
