postheadericon Enteroenteric Fistulas – Colon And Rectal Surgery

Enteroenteric fistulas are the most common type of internal fistula not arising in people with Crohn’s disease, and they were reported to occur in 33% of patients while external fistulas affecting 15% of fistulas people.170 isolated enteroenteric usually cause few symptoms unless obstructive or septic complications dominate the clinical picture. However, nearly 40% of patients with internal fistulas initially managed by non-operative will require surgery within a year, mainly due to the disease intractability.171 The principles of surgical management include resection of the source of the fistula, a refresh of the abnormality in the adjacent loop of bowel by wedge excision, and transverse closure of the defect. Primary intestinal anastomosis can usually be done safely after resection of the diseased segment is completed. However, certain clinical situations may arise difficulties.172 If a phlegmonous reaction involving the rectosigmoid region is part of a fistula ileosigmoid, suture closure of the defect sigmoid may be vulnerable to degradation. Instead, limited sigmoid resection with primary anastomosis should be performed because the risk of anastomotic dehiscence negligible.173 In these cases, the sigmoid colon is sick in nearly 40% of patients and the recurrence rate is significantly increased when reoperation preoperative endoscopy is omitted 0174

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