Presentation
The presenting signs and symptoms of fistulae associated with ovarian tumours vary. Rare cases present with giant cystic air-filled masses 8, 9 ; others, with bowel obstruction necessitating emergency surgical intervention 10. [current-oncology.com]
OBJECTIVE: To present a case of ureterocolonic fistula secondary to acute sigmoid diverticulitis in a nonfunctioning ureter due to a previous nephrectomy. [ncbi.nlm.nih.gov]
They made this recommendation because unacceptable levels of NDMA, a probable carcinogen (or cancer-causing chemical), were present in some ranitidine products. [medicalnewstoday.com]
Entire Body System
- Malnutrition
Symptoms can include: abdominal pain dehydration diarrhea fever malnutrition raised heart rate vomiting A person with a gastrointestinal fistula can become very ill and may develop a condition known as sepsis. [medicalnewstoday.com]
Possible Complications Fistulas may result in malnutrition and dehydration, depending on their location in the intestine. They may also cause skin problems and infection. [mountsinai.org]
Malnutrition is easier to prevent than correct. Once established, malnutrition may be difficult to correct, especially with concomitant sepsis, but malnutrition and sepsis remain principal causes of death in patients with fistulas. [ncbi.nlm.nih.gov]
You’re more likely to develop a fistula if you have: cancer radiation treatment to your abdomen a bowel obstruction surgical suture problems incision site problems an abscess an infection a hematoma, or blood clot under your skin a tumor malnutrition [healthline.com]
- Anemia
Anemia, which is often present, should be corrected by transfusion. If the patient is hypoalbuminemic (less than 3 g/dl), consideration should be given to albumin administration, as this may improve bowel function. [ncbi.nlm.nih.gov]
- Weight Loss
Contact your doctor if you experience any of these symptoms: a significant change in your bowel habits unusual or severe weight loss fever severe diarrhea fluid leakage from an opening in your abdomen or near your anus unusual abdominal pain There may [healthline.com]
Respiratoric
- Pneumonia
(external blind fistula) or on an internal surface (internal blind fistula). bronchopleural fistula one between a bronchus and the pleural cavity, causing an air leak into the pleural cavity; sometimes seen as a complication of empyema, fibrosis, or pneumonia [medical-dictionary.thefreedictionary.com]
Cardiovascular
- Hypotension
Intestinal anastomoses are susceptible to partial or complete dehiscence in the presence of impaired blood supply to the area, systemic hypotension, anastomotic suture line tension, perianastomotic infection, and diseased bowel segment anastomosis. [emedicine.medscape.com]
Treatment
It is emphasized that these less commonly used approaches should be regarded as complimentary tools in the arsenal of those treatments whose role is already established in the treatment of enterocutaneous fistulas. [ncbi.nlm.nih.gov]
Treatment focuses on keeping you well-nourished and preventing wound infection. [healthline.com]
Treatment Treatment for a gastrointestinal fistula depends on its severity and location. Fistulae that are small and not infected will often close on their own. [medicalnewstoday.com]
Other causes include: Blockage in the intestine Infection (such as diverticulitis) Crohn disease Radiation to the abdomen (most often given as part of cancer treatment) Injury, such as deep wounds from stabbing or gunshot Swallowing caustic substances [mountsinai.org]
Prognosis
Outlook (Prognosis) The outlook depends on the person's overall health and how bad the fistula is. People who are otherwise healthy have a very good chance of recovery. [mountsinai.org]
Prognosis The prognosis is based on the etiology of the fistula, as well as the comorbidities of the patient. [emedicine.medscape.com]
Etiology
(See Etiology and Prognosis.) Fistulas were formerly associated with considerable mortality rates. [emedicine.medscape.com]
Fistulas may be classified based on anatomic, physiologic, or etiologic criteria ( table I ). [ncbi.nlm.nih.gov]
Epidemiology
[…] to the suture line, resulting in the midportion of the graft eroding into adjacent bowel; conversely, primary aortoenteric fistulas almost always result from erosion of the aneurysmal or infected aorta into surrounding areas, most commonly the bowel Epidemiology [emedicine.medscape.com]
Pathophysiology
Thus, in essence, the pathophysiology underlying the development of metabolic acidosis from a duodenal fistula is the same as that of a pancreatic fistula- it is basically the same secretions being lost. Not so for the jejunum. [derangedphysiology.com]
Pathophysiology and therapy of chronic radiation-induced injury to the colon. Dig Dis. 1998 Jul-Aug. 16 (4):253-61. [QxMD MEDLINE Link]. Li Y, Ren JA, Wang GF, et al. [emedicine.medscape.com]
Prevention
However, you can take steps to prevent GIF before surgery. [healthline.com]
The presence of food in the gut triggers the additional secretion of gastric juices, preventing a person with a fistula from getting enough nutrients. A lack of nutrition will make it difficult for a person's body to heal. [medicalnewstoday.com]
Malnutrition is easier to prevent than correct. Once established, malnutrition may be difficult to correct, especially with concomitant sepsis, but malnutrition and sepsis remain principal causes of death in patients with fistulas. [ncbi.nlm.nih.gov]