Challenges and Triumphs in Enterocutaneous Fistula Management: A Case Report of Complex Surgical Intervention and Multidisciplinary Care.

Enterocutaneous fistulas (ECF) present complex challenges following abdominal surgery, involving abnormal communication between the gastrointestinal system and skin. We report an intriguing case of a 50-year-old female with a history of appendiceal perforation, primarily managed by right hemicolectomy with ileotransverse anastomosis, which led to an anastomotic leak and eventually an ECF. Failed conservative management, prompting re-exploratory laparotomy revealing extensive adhesions and iatrogenic enterotomies secondary to attempted adhesiolysis, led to multiple fistulae, further complicated by failed abdominal closure leading to a large abdominal wound to be managed along with the numerous enteroatmospheric fistulae.