Enterocutaneous Fistula



Enterocutaneous fistula (ECF) is defined as an abnormal communication between the small intestinal lumen and skin. Most ECFs develop after an operation for inflammatory bowel disease, malignancy, small bowel obstruction, severe adhesions, or radiation enteritis. Appropriate metabolic and nutritional support is vital to achieve spontaneous fistula closure. If closure does not occur within 4–6 months, then the fistula and diseased segment of bowel must be resected; anastomosis is the preferred technique. In all cases, multispecialty care is necessary to ensure closure with low morbidity and mortality.


Short Bowel Syndrome Abscess Cavity Enterocutaneous Fistula Radiation Enteritis Definitive Repair 


  1. 1.
    Evenson AR, Fischer JE. Current management of enterocutaneous fistula. J Gastrointest Surg. 2006;10:455–64.PubMedCrossRefGoogle Scholar
  2. 2.
    Campos AC, Andrade DF, Campos GM, Matias JE, Coelho JC. A multivariate model to determine prognostic factors in gastrointestinal fistulas. J Am Coll Surg. 1999;188:483–90.PubMedCrossRefGoogle Scholar
  3. 3.
    Remzi FH, Fazio VW. Enterocutaneous fistula. In: Bland KI, Sarr MG, Buchler MW, Csendes A, Garden OJ, Wong J, editors. General surgery: principles and international practice. 2nd ed. London: Springer; 2009. p. 649–59.Google Scholar
  4. 4.
    Fazio VW. Intestinal fistulas. In: Keighley MRB, Pemberton JH, Fazio VW, et al., editors. Atlas of colorectal surgery. New York: Churchill Livingstone; 1996. p. 363–77.Google Scholar
  5. 5.
    Lloyd DA, Gabe SM, Windsor AC. Nutrition and management of enterocutaneous fistula. Br J Surg. 2006;93:1045–55.PubMedCrossRefGoogle Scholar
  6. 6.
    Becker HP, Willms A, Schwab R. Small bowel fistulas and the open abdomen. Scand J Surg. 2007;96:263–71.PubMedGoogle Scholar
  7. 7.
    Lynch CA, Delaney CP, Senagore AJ, Connor JT, Remzi FH, Fazio VW. Clinical outcome and factors predictive of recurrence after enterocutaneous fistula surgery. Ann Surg. 2004;240:825–31.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Colorectal Surgery, Digestive Disease InstituteCleveland Clinic FoundationClevelandUSA

Personalised recommendations