This paper is an overview of all problems linked to gastrointestinal fistulas (GIFs). Various classifications have been used to define GIFs: anatomical (external, internal, and complex), physiological (fistula output), and etiological (congenital or acquired postoperatively, due to irradiation, inflammation, ischemia, or malignancy), and each of these carries specific implications regarding outcome and treatment. Prognostic factors are related both to patient characteristics such as age, malnutrition, diagnosis, sepsis, diabetes, and previous surgery, and to fistula characteristics such as fistula output, organ of origin, and cause and duration of fistula. GIFs are associated with a high rate of complications and mortality related to sepsis, bleeding, fluid and electrolyte disturbances, and malnutrition. Therapy is often complex and includes medical therapy (fluid and electrolyte restoration, antimicrobial therapy, somatostatin or octreotide, proton pump inhibitors, and artificial nutrition), skin care management, percutaneous drainage, and operative endoscopy, while surgery is indicated only in selected cases. The role of artificial nutrition in preventing malnutrition, improving the nutritional status, and providing gastrointestinal tract rest is analyzed.
|Number of pages||22|
|Journal||Nutritional Therapy and Metabolism|
|Publication status||Published - Jul 2007|
- Gastrointestinal fistulas
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine
- Nutrition and Dietetics