Development of a colocutaneous fistula in a patient with a large surface area burn

A 61 year old female sustained a large surface area burn, complicated by in halation injury. One month before the incident, she had undergone a left he micolectomy with colorectal anastomosis for diverticular disease. Due to th e severity of her burns, multiple surgical debridement and skin grafting pr ocedures were required, including a large fascial debridement of her flank and back. Her hospital course was complicated by recurrent episodes of pulm onary and systemic infection, as well as pre-existing: malnutrition. Prior to her discharge to a rehabilitation center, stool began to drain from her left posterior flank. This complication represented a colonic fistula arisi ng from the recent colon anastomosis. The fistula was managed nonoperativel y and gradually closed. To our knowledge, this is the first report of a col ocutaneous fistula spontaneously draining from the abdomen via the retroper itoneum in a burn victim, not related to direct thermal injury to the perit oneal cavity. (C) 1999 Elsevier Science Ltd and ISBI. All rights reserved.