SUCCESSFUL MANAGEMENT OF EXTERNAL DUODENAL FISTULA IN A SPECIALIZED UNIT

BACKGROUND: High-output external duodenal fistula remains a challengin g condition to treat. Despite advances in metabolic and nutritional ca re, mortality rates remain high. METHOD: Retrospective casenote review of patients managed on a specialised unit. RESULTS: Thirteen of 388 a dmissions (3.4%, 11 males, median age 51 years) had an external duoden al fistula. Management was by eradication of abdominal and systemic se psis and maintenance of nutritional status by the administration of to tal parenteral nutrition. The majority of fistulas followed surgery fo r peptic ulcer disease. Eight of 13 fistulas closed spontaneously, and of those requiring operative closure, surgery was successful in 4 of 5 cases. There were 2 mortalities. CONCLUSION: High-Output external du odenal fistula may be successfully managed in a specialised unit. (C) 1997 by Excerpta Medica, Inc.