[Therapeutic aspects of dehiscence of a laparotomy wound after a digestive fistula or following intervention for acute pancreatitis].

Fourteen cases of digestive fistulas, complicated by a dehiscence of the laparotomy wound, are described. Ten patients have a single fistula and 4 have multiple digestive fistulas. There were eleven survivors. This represents a mortality of 21.4%. In 9 cases, the spontaneous recovery of the fistulated zone is followed by a losing of the laparotomy wound. In 2 cases, surgical intervention was necessary to permit the recovery of the fistula and of the dehiscence of the laparotomy. The treatment of such patients requires a mean hospitalization in an intensive care ward of about 48 days +/- 25.8 (SD). The authors report the different therapeutic aspects : the nutritional support, the control of the infection and of the locoregional and systemic complications.