Nur Nuradin M, Salad Najib M, Ahmed Abdullahi A
General Surgery Department.
Thoracic Surgery Department, Mogadishu Somali Turkey, Recep Tayyip Erdogan Training and Research Hospital, Somalia.
Ann Med Surg (Lond). 2023 Jun 5;85(8):4050-4052. doi: 10.1097/MS9.0000000000000886. eCollection 2023 Aug.
Enterocutaneous fistula (ECF) is a common complication of abdominal surgery. Postoperatively, it may be the result of a small intestinal injury or an anastomosis leak, and it typically manifests days or weeks following surgery.
A 56-year-old man with a history of a gunshot wound injury in the abdomen with colon injury managed for colocolic anastomosis 17 years earlier presented to our hospital's general surgery clinic with the complaint of drainage at the scar area. It was discovered that he had an ECF. The patient underwent a laparotomy. Fistula tract excision and segmental colon resection with colocolic anastomosis were done.
ECF formation after an extraordinarily long latency due to an anastomotic leak, which has not been previously documented in the literature, is a distinctive aspect of the case. As a result, surgeons should consider ECF in their differentials for patients with a history of abdominal operations.
Surgical management is the definitive treatment of ECF after proper resuscitation and stabilization of the patient's condition. Preoperative imaging is crucial for determining the anatomy of the fistula and any associated intra-abdominal pathology.
肠皮肤瘘（ECF）是腹部手术的常见并发症。术后，它可能是小肠损伤或吻合口漏的结果，通常在手术后数天或数周出现。
一名56岁男性，17年前因腹部枪伤致结肠损伤行结肠结肠吻合术，现因瘢痕区有引流物而到我院普通外科门诊就诊。发现他患有肠皮肤瘘。患者接受了剖腹手术。进行了瘘管切除和结肠节段切除并结肠结肠吻合术。
由于吻合口漏导致异常长时间潜伏期后形成肠皮肤瘘，这在以前的文献中尚未有记载，是该病例的一个独特之处。因此，外科医生在对有腹部手术史的患者进行鉴别诊断时应考虑肠皮肤瘘。
在对患者进行适当的复苏和病情稳定后，手术治疗是肠皮肤瘘的确定性治疗方法。术前影像学检查对于确定瘘管的解剖结构和任何相关的腹腔内病变至关重要。
