Treatment of Colocutaneous Fistula in the Left Thigh.

There are few publications on the surgical management of a colocutaneous fistula in the thigh. Here, we describe a patient who presented with a 2-year history of fecal fistula in the left thigh, following a history of drainage of a psoas abscess. This is followed by a discussion of appropriate treatment modalities for this type of fistula.  To determine the appropriate treatment for our patient with chronic fistula, we thoroughly reviewed the relevant literature in an Internet-based search and selected a staged operative approach for our patient.  Using a staged surgical procedure, we were able to resolve the colocutaneous fistula without the occurrence of comorbidities.  Substantial morbidity is associated with the presence of colocutaneous fistulas. The best possible approach is prevention of its occurrence, but this is not always feasible. Measures for management of an acute fistula differ from those in patients with chronic fistula. Medical management can be more effective in acute cases, while chronic cases require surgical management. We used a staged surgical method with a few risks for our patient and he is in good health 1 year after treatment.