Intestinal Fistula Notes, Study Guides, Projects, Research of Medical Sciences

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Intestinal Fistulae * Definition : It is abnormal communication between intestinal epithelium and the epithelium of a surrounding structure . * Aetiology : 1) 90% of external fistulae are postoperative due to unrecognized intestinal injury , failure of intestinal anastomosis (due to poor vascularity , suture under tension , distal obstruction , sepsis ,poor surgical technique , presence of specific pathology or poor health of patient e.g. hypoproteinaemia ). 2)Other causes : e Congenital : as patent vitello-intestinal duct . e Abdominal trauma . ¢ Inflammatory condition as Crohn’s disease or diverticulitis of colon e Malignant tumours . * Pathology : e The fistula is usually lined by granulation tissue or less commonly lined by epithelium . e Classification : 1)Internal fistula connect the intestine with a hollow viscera e.g. other part of gut , urinary bladder or vagina . 2) External fistula connect the intestine with the skin .It is further classified into one of the followings : a-Low-—output fistula :discharge less than 500 ml/day . b-High—output fistula :discharge more than 500 ml/day leading to marked metabolic effect. e The discharge of the fistula may be one of the followings : a) Bile stained discharge in duodenal or jejunal fistula .