EXTRA-ABDOMINAL CLOSURE OF ENTEROCUTANEOUS FISTULA

Enterocutaneous fistula is a dread complication of gastrointestinal di sease and gastrointestinal operation. These patients typically have un dergone numerous abdominal operations, often with peritoneal contamina tion, carcinoma, and/or a history of radiation, making operation for r epair daunting, if not impossible. We describe a method for closure of enterocutaneous fistula, which we have used successfully in four such patients. After failure of nonsurgical management, each patient's fis tula was closed with a combination of skin, muscle, and fascial flaps after intubation of the fistula with a Malecot catheter. No intra-abdo minal dissection was necessary. All fistulas healed completely. We rec ommend this closure in any patient who has failed surgical or nonsurgi cal therapy or in whom celiotomy is contraindicated or is to be avoide d.