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Enterocutaneous Fistula

Authors:
  • Cynthia M. Johnson, MA
Publication Type:

Condition

Enterocutaneous Fistula

(Gastrointestinal Fistula; Entero-enternal Fistula)

Definition

An enterocutaneous fistula is an abnormal connection between the intestines and the skin. Intestinal or stomach contents can leak through it. They may also leak into another part of the body or outside of the body.

This problem needs to be treated right away.

Enterocutaneous Fistula. enterocutaneous fistulas

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Causes

Most of the time, an enterocutaneous fistula happens after bowel surgery. Other causes are:

Risk Factors

Things that may raise the risk of an enterocutaneous fistula are:

  • Recent bowel surgery
  • History of radiation therapy

Symptoms

Problems may be:

  • Contents from the intestines that leak from an opening in the skin
  • Loose stools (poop)
  • Belly pain

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. The person may be referred to a colon and rectal surgeon.

Images may be taken with:

  • CT scan to view the belly
  • Ultrasound to view the belly
  • Barium enema to view the colon and rectum using contrast material
  • Barium swallow test to view the digestive system using contrast material
  • Fistulogram to view the fistula using contrast material

Treatment

The goal is to help the enterocutaneous fistula heal. It is also to prevent or treat complications. An uncomplicated fistula may heal on its own over 2 to 8 weeks. Care during this time may be:

  • Nutritional support, such as diet changes, IV nutrition, or a feeding tube
  • Medicines to:
    • Prevent or treat an infection
    • Ease pain
    • Reduce stomach acid and leaking fluids
  • A drain to remove leaking fluids

Surgery will be done to close the opening—if it does not heal on its own.

Underlying causes, such as bowel disease, will also need to be managed.

Prevention

There are no known guidelines to prevent an enterocutaneous fistula.

RESOURCES:

CANADIAN RESOURCES:

CANADIAN RESOURCES:

References

  • Bhama AR. Evaluation and management of enterocutaneous fistula. Dis Colon Rectum. 2019;62(8):906-910.
  • Crohn disease in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/crohn-disease-in-adults.
  • Cushing K, Higgins PDR. Management of Crohn disease: a review. JAMA. 2021;325(1):69-80.
  • Enterocutaneous fistula. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/enterocutaneous-fistula-ecf.
  • Enterocutaneous fistula. UCSF Medical Center website. Available at: https://www.ucsfhealth.org/conditions/enterocutaneous-fistula.

Contributors

  • Daniel A. Ostrovsky, MD
Last Updated:
2022-09-01

(C) Copyright 2022 EBSCO Information Services

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.