Alhan E, Calik A, Kucuktulu U
Department of Surgery, Faculty of Medicine, Karadeniz Technical University, Trabzon-Turkey.
Z Gastroenterol. 1993 Nov;31(11):657-60.
During a period of nine years, all patients with enterocutaneous fistula who received parenteral nutrition as part of therapy were evaluated retrospectively. Twenty-three patients were studied. Peptic ulcer was the most common primary disease, with the fistula arising in 78 percent of the cases from the breakdown of an anastomosis and in the remainder from a direct trauma to the bowel. The most common site of the fistulas was the ileum followed by the duodenum. All the patients were treated conservatively with total bowel rest and parenteral nutrition, and in 56.5 percent of the cases spontaneous closure occurred within an average of 29.6 days. In five patients, the fistula failed to close, and surgery was performed. The mean surgical closure time overall 36.4 days, but this varied from 20.8 days for the duodenum to 39 days for the jejunum and ileum, and 19.7 days for the large intestine. Five patients (22.7%) died, four from sepsis, the fifth from systemic malignancy. Mortality was related to the location and output of the fistula, with jejuno-ileal high-output fistulas in particular figuring prominently in the mortality.
在九年的时间里，对所有接受肠外营养作为治疗一部分的肠皮肤瘘患者进行了回顾性评估。共研究了23例患者。消化性溃疡是最常见的原发性疾病，78%的病例瘘管源于吻合口破裂，其余病例源于肠道直接创伤。瘘管最常见的部位是回肠，其次是十二指肠。所有患者均采用全肠休息和肠外营养进行保守治疗，56.5%的病例平均在29.6天内实现自发闭合。5例患者的瘘管未能闭合，因此进行了手术。总体手术闭合时间平均为36.4天，但十二指肠为20.8天，空肠和回肠为39天，大肠为19.7天。5例患者（22.7%）死亡，4例死于败血症，第5例死于全身恶性肿瘤。死亡率与瘘管的位置和排出量有关，空肠-回肠高排出量瘘管在死亡率中尤为突出。
