A fistula is an anomalous communication between two surfaces. Fistulae are named according to the organs or surfaces connected. An intestinal fistula is a fistula that begins from the intestine. Through fistula formation, it can connect to multiple organs or surfaces. It is not a condition on its own, rather a complication of certain conditions.
Intestinal fistula is commonly formed as a complication of an injury or surgery. Their common causes are:
Surgical procedures are responsible for 50 percent of the intestinal fistulae formation.
This happens because of the erosion of the diverticular wall and factors causing inflammation.
Non-surgical injuries and the presence of foreign bodies: These involve injuries acquired in abdominal trauma of some kind tend to increase the chances of fistula formation.
Depending on the organs impacted and involved in fistula formation numerous symptoms come into interplay, such as:
When other adjacent organs get involved in fistula formation, the following symptoms are added to the list:
In cases where the skin gets involved in fistula formation:
An intestinal fistula is a result of complications. The appropriate diagnosis of a fistula involves the following parameters:
Having met with these metrics and the presented symptoms, the doctor may consider either of the imaging techniques for evaluation:
In some cases, only the organs involved in fistula formation get confirmed. Here, a contrast enema or small-bowel follow-through gives better details of the fistula.
Further, an MRI is sorted only when the formed fistulae are complex, like the ones formed in the case of Crohn's disease.
This technique generally is to identify the underlying cause of fistula formation, like intestinal cancer or Crohn's disease.
Non-surgical Treatment
Treatment by conservative measures is considered in high-risk patients where fibrin glue or occlusive methods are used.
Other conservative treatment modalities include management and alleviation of symptoms presented because of the fistula formation.
Surgical Treatment
Operative procedures are carried out when the diagnosis of the fistula is generally accurate. This procedure involves excising the fistula and reinstating the linings of the respective organs involved in fistula formation.
Removal of all the unhealthy tissue involved in fistula formation and healing of the healthy, viable tissue sutured together at their ends is necessary for the healing of the fistula.
The operating surgeon confirms the expected length of the surgery and the number of days of hospitalization depending on the surgery and healing period post-surgery.
Depending on the type, the complications of an untreated intestinal fistula may lead to obstruction of the bowels and incontinence, dehydration, low blood pressure, and reoccurrence of the fistula at some other location.
As the severity increases, it may lead to sepsis (the most common), damage the other organs involved, and ultimately cause death if left untreated.
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