Solis-Pazmino Paola, da Silva Leonardo Oliveira, Huiracocha Juan Quezada, Saldanha Luis Henrique, Avila Augusta, Ribeiro Guilherme, Pinto Rodrigo Pozza
Surgery Department, Hospital Dom João Becker, Santa Casa de Misericórdia in Porto Alegre (SCMPA), Porto Alegre, Brazil.
J Surg Case Rep. 2023 Mar 31;2023(3):rjad161. doi: 10.1093/jscr/rjad161. eCollection 2023 Mar.
An enterocutaneous fistula (ECF) is a complex medical issue that occurs when abnormal communication between the small intestine and the skin occurs. This can lead to the leakage of digestive contents, such as feces and food, onto the skin's surface. The case of an 86-year-old woman is presented, who developed high-output ECF after undergoing Hartmann surgery, intestinal transit reconstruction for perforated diverticulitis and incisional hernia treatment involving hernioplasty and polypropylene mesh. The patient had suffered from a serous-purulent discharge from a low-volume surgical wound for several years. Despite optimizing the patient's nutritional status, a laparotomy and small bowel resection were performed successfully. However, using vacuum dressing as a cover for the fistula in the lower gastrointestinal tract remains a subject of debate and limited research. No officially recognized international guidelines recommend its use for small bowel ECF.
肠皮肤瘘（ECF）是一种复杂的医学问题，当小肠与皮肤之间出现异常连通时就会发生。这可能导致消化内容物，如粪便和食物，泄漏到皮肤表面。本文介绍了一位86岁女性的病例，她在接受哈特曼手术、因穿孔性憩室炎进行肠道转运重建以及包括疝修补术和聚丙烯网片的切口疝治疗后出现了高流量ECF。该患者多年来一直有少量手术伤口的浆液脓性分泌物。尽管优化了患者的营养状况，但还是成功进行了剖腹手术和小肠切除术。然而，使用负压敷料覆盖下消化道瘘仍然是一个存在争议且研究有限的课题。没有官方认可的国际指南推荐将其用于小肠ECF。
