Alharbi Ahlam Hamed, Alotaibi Abdularahman M
Department of Surgery, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Surgery, Dr. Soliman Fakeeh Hospital, Faculty of Medicine in Jeddah, Jeddah University, Jeddah, Saudi Arabia.
J Surg Case Rep. 2021 May 5;2021(5):rjab165. doi: 10.1093/jscr/rjab165. eCollection 2021 May.
Enterocutaneous fistula (ECF) is a distressing complication. Commonly, it follows abdominal operations that require extensive adhesiolysis. Its management is challenging, burdening health systems. Complete healing can take several weeks. Several modalities have been described, with varying success rates. A 48-year-old male underwent a trauma laparotomy, with resection of a segment of the proximal bowel and anastomosis. He experienced an anastomosis leak, wound infection and ECF and was managed conservatively for 5 weeks with parenteral nutrition and bowel rest. He was then referred to us and treated with approximation sutures and cyanoacrylate adhesive. His wound was closed with a subcutaneous drain. He experienced complete healing of the fistula and wound after undergoing a minimally invasive approach using sutures and a cyanoacrylate sealant. Cyanoacrylate glue is a safe initial non-invasive treatment of low-output ECF. It can be selected over approximation sutures to ensure sealing of the tract before surgery.
肠皮肤瘘(ECF)是一种令人痛苦的并发症。通常,它发生在需要广泛粘连松解的腹部手术后。其治疗具有挑战性,给卫生系统带来负担。完全愈合可能需要数周时间。已经描述了几种治疗方式,成功率各不相同。一名48岁男性接受了创伤性剖腹手术,切除了一段近端肠管并进行了吻合。他出现了吻合口漏、伤口感染和肠皮肤瘘,并通过肠外营养和肠道休息进行了5周的保守治疗。然后他被转诊至我们这里,接受了接近缝合和氰基丙烯酸酯粘合剂治疗。他的伤口用皮下引流管闭合。在采用缝合和氰基丙烯酸酯密封剂的微创方法治疗后,他的瘘管和伤口完全愈合。氰基丙烯酸酯胶水是低输出量肠皮肤瘘安全的初始非侵入性治疗方法。与接近缝合相比,它可以被选用,以确保在手术前封闭瘘管通道。