Gastro Intestinal Fistula
Definition
A fistula is tract connecting two epithelial surfaces one of which is a hollow organ.
Internal Fistula:-
A fistula connecting any two digestive organs.
External Fistula:-
A fistula connecting a digestive organ and skin.
Uncontrolled fistula:-
A fistula which contaminates the general peritoneal cavity is called uncontrolled fistula.
Controlled fistula
If the effluent of a fistula is drained out using a Foley’s catheter, without contaminating the general peritoneal cavity, it is called controlled fistula.
Based on the out put fistulae can be
Low output Fistula :– If the output is less than 200 ml/24 Hours
Moderate output Fistula:– If the output is between 200-500ml/24 Hours
High output Fistula:– If the output is more than 500ml/24 Hours
Causes of Gastro Intestinal Fistula
- Congenital
- Traumatic
- Inflammatory-Cohn’s Disease
- Neoplastic-Carcinoma colon
- Post operative-Post appendicectomy /Intestinal Anastomosis.
Complications of GI Fistula
- Sepsis
- Fluid and Electrolyte Imbalance
- Malnutrition
- Effluent Dermatitis-resulting in skin excoriations, ulcerations and infections.
- Correction of Fluid and Electrolyte Imbalance.
- Nil Per Oral and Bowel rest.
- Total Parenteral Nutrition.
- Conversion of an uncontrolled fistula into a controlled fistula.
Prevention of Effluent Dermatitis:-
By painting the skin with Zinc oxide paste.
MCQ
The commonest electrolyte abnormality associated with a GI Fistula is Hypokalemia.
