Enteroatmospheric fistula (EAF) is a relatively rare complication of patients undergoing open abdomen (OA) for damage control surgery. Mortality rates are high due to the increased risk of peritonitis, intraabdominal abscess, sepsis, and new perforations. There are a wide range of EAF management therapies in the literature, however, there are limited options on cases involving fistula-vaccum assisted closure (VAC) therapy. This case describes the treatment course of a 57-year-old, male admitted for blunt abdominal trauma secondary to a motor vehicle accident. Upon admission the patient underwent damage control surgery. The surgeons elected to have the patient's abdomen open, applying a mesh to promote healing. After several weeks of hospitalization an EAF was discovered in the abdominal wound subsequently managed by utilizing a fistula-VAC technique. Based on the successful outcome of this patient, fistula-VAC was shown as an effective way to promote wound healing while reducing the chances of complications.
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http://dx.doi.org/10.7759/cureus.37668 | DOI Listing |
Cureus
November 2024
General Surgery, Centro Hospitalar Barreiro Montijo, Barreiro, PRT.
An enteroatmospheric fistula (EAF) is one of the most feared complications of damage control laparotomy. Its management is highly challenging, often requiring multiple surgeries and prolonged hospitalization. It is a serious condition, and despite significant improvements in mortality rates due to advancements in intensive care, the rate remains substantial.
View Article and Find Full Text PDFJ Surg Case Rep
December 2024
Department of Surgery, Arrowhead Regional Medical Center, 400 N Pepper Ave, Colton, CA 92324, United States.
Managing patients with severe fixation of intra-abdominal contents, known as frozen abdomen, often creates a vicious cycle of tissue injury that further prolongs open abdomen resolution. We share the management course of a 28-year-old male status post motor vehicle accident with traumatic pancreatitis and complex liver injury. Following multiple laparotomies for abdominal wash out, he developed a frozen abdomen and an entero-atmospheric fistula (EAF) through granulated bowel.
View Article and Find Full Text PDFWounds
September 2024
Casa Di Cura Villa Dei Fiori, Naples, Italy.
Cureus
August 2024
General Surgery, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, IND.
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.
View Article and Find Full Text PDFWorld J Surg
October 2024
Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, USA.
Introduction: Open abdomen (OA) therapy is used in the management of patients who require surgery for severe abdominal conditions. This meta-analysis aims to evaluate the VAWCM technique regarding short and long-term outcomes.
Methods: PubMed, Embase, and Cochrane Central were systematically searched for studies that analyzed VAWCM therapy in OA.
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