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Enterocutaneous fistula: A reconstructive dilemma


Surgical repair of enterocutaneous fistulae in Crohn’s disease may result in large skin defects of the anterior abdominal wall. We present a case in which a large defect was managed with reconstruction using a pedicled rectus abdominis mycocutaneous flap in a single procedure. The case highlights the technical challenge of such a case and the value of a joint surgical approach between plastic and colorectal services.

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  1. 1.

    Hehir, D. J., Gorey, T. F. Intravenous nutritional support and the surgeon: where next? Ir. J. Med. Sci. 1992; 161: 401–3.

  2. 2.

    Michaelassi, F., Stella, M., Balestracci, T., Giuliane, F., Marogna, P., Block, G. E. Incidence, diagnosis, and treatment of enteric and colorectal fistulae in patients with Crohn’s disease. Ann. Surg. 1993; 218: 660–6.

  3. 3.

    Taylor, G. I., Corlett, R. J., Boyd, J. B. The versatile deep inferior epigastric (inferior rectus abdominus) flap. Br. J. Plast. Surg. 1984; 37: 330–50.

  4. 4.

    Bostwick, J., Hill, L., Nahi, F. Repairs in the lower abdomen, groin, or perineum with mycocutaneous or omental flaps. Plast. Reconstruct. Surg. 1979; 63: 186–94.

  5. 5.

    Pezim, M. E., Wolff, B. G., Woods, J. E., Beart, R. W. Jr., Ilstrup, D. M. Closure of the post-proctectomy perineal sinus with gracilis muscle flaps. Can. J. Surg. 1987; 30: 212–214.

  6. 6.

    Terasshi, H., Hasimoto, H., Shibuya, H., Ishii, Y., Sato, H., Takayasu, S. Use of groin flap and anterolateral thigh adipofascial flap of tensor fascia lata for reconstruction of a wide lower abdominal wall defect. Ann. Plast. Surg. 1995; 35: 320–21.

  7. 7.

    Milloy, F. J., Anson, B. J., McAfee, D. K. The rectus abdominus muscles and epigastric arteries. Surg. Gynaecol. Obstet. 1960; 110: 293–302.

  8. 8.

    Taylor, G. I., Corlett, R., Boyd, J. B. The extended deep inferior epigastric flap: a clinical technique. Plast. Reconstruct. Surg. 1984; 72: 751–764.

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Correspondence to C. O. Duncan or M. J. Earley or P. R. O’Connell.

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Duncan, C.O., Earley, M.J. & O’Connell, P.R. Enterocutaneous fistula: A reconstructive dilemma. I.J.M.S. 167, 9–10 (1998). https://doi.org/10.1007/BF02937543

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  • Myocutaneous Flap
  • Enterocutaneous Fistula
  • Skin Paddle
  • Mater Misericordiae Hospital
  • Deep Inferior Epigastric Artery