Treatment of Pancreatic Fistulas in Outpatients
External pancreatic fistulas can occur after blunt or penetrating abdominal trauma and as a complication of abdominal surgery or pancreatic inflammatory disease. Although most of these fistulas will eventually heal, drainage often persists for many weeks to many months. During this period, serious complications can develop such as sepsis, hemorrhage, erosion into adjacent organs, fluid and electrolyte imbalance, malnutrition, and local skin breakdown. Primary management of external pancreatic fistulas is fairly well standardized. The pancreas and gastrointestinal tracts are rested by eliminating oral intake and by applying nasogastic suction when needed. Dehydration is prevented and electrolyte abnormalities are corrected by intravenous fluid administration. Nutritional support is given often in the form of intravenous hyperalimentation. Skin protection averts breakdown and wound problems. Most importantly, adequate drainage is provided to prevent or control sepsis. As these are accomplished, therapeutic efforts are ultimately directed at closing the fistula.
KeywordsDepression Albumin Europe Creatinine Adenocarcinoma
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