Intestinal fistula

Description:

Intestinal fistula — the opening in a gut wall connecting her cavity to a body surface (outside intestinal fistula) or to hollow body (internal intestinal fistula).

Symptoms of Intestinal fistula:

Intestinal fistulas happen multiple, their openings can be various size, localization and a form. Allocation outside of intestinal contents and gases is characteristic of outside intestinal fistulas.
At high fistulas of a small bowel the discharge contains the low-digested food with considerable impurity of bile; around fistula the expressed changes of skin — dermatitis are usually observed. To protect skin,  it is covered with a thick layer of 2% of zinc oxide ointment, Lassar's paste, clay mix with a tannin  , etc. Under a bandage dermatitis proceeds much heavier therefore patients have to lie with open fistula under a framework. The condition of such patients is burdened by considerable loss with intestinal separated nutrients and liquid; quickly there comes exhaustion, dehydration, intoxication. To avoid it, it is necessary to enter intravenously or subcutaneously from two to three liters of normal saline solution, 5% of solution of glucose, vitamins. Hemotransfusion and proteinaceous blood substitutes is of great importance.

Reasons of Intestinal fistula:

Intestinal fistulas can be inborn or be formed as a result of damage of a gut at the closed injury, and also the getting stomach wound cutting, pricking, by firearms; at damage  of a wall of a gut from within foreign bodys; at a perforation of intestinal ulcers. Intestinal fistula can result also from a necrosis of an intestinal wall owing to local vascular frustration.
Artificial outside intestinal fistulas quite often impose with the medical purpose for the patient's food (for example, at burns or tumors of a stomach) or for temporary unloading of intestines at intestinal impassability, peritonitis.
Intestinal fistulas  divide on labelloid (full and incomplete) at which the mucous membrane of a gut grows together with edge of skin, and tubular when defect in a gut does not adjoin to skin, and is reported with it by means of the channel.

Treatment of Intestinal fistula:

Use various obturators which mechanically stop receipt of intestinal contents outside to temporary closure of enteric fistulas. Labelloid fistulas spontaneously are not closed and existence them serves as the indication to operation. Tubular fistulas as a result of scarring of the channel are, as a rule, closed independently.
At intestinal fistulas of lower parts of a small bowel and especially large intestine of allocation irritate skin less and care of it of special work does not represent. Food of patients is not limited. Patients with fistulas of a large intestine can be treated on an outpatient basis. If intestinal fistula  of a large intestine is not closed within 6 — 7 months, operational treatment is shown. An exception are the artificial intestinal fistulas imposed with the medical purpose. Terms of their closing are defined by special indications.