BACKGROUND Enteroatmospheric fistula(EAF)is a catastrophic complication that can occur after open abdomen.EAFs cause severe body fluid loss,hypercatabolism,and wound complications,leading to adverse clinical outcomes....BACKGROUND Enteroatmospheric fistula(EAF)is a catastrophic complication that can occur after open abdomen.EAFs cause severe body fluid loss,hypercatabolism,and wound complications,leading to adverse clinical outcomes.CASE SUMMARY A 72-year-old female patient underwent ventral hernia repair.Five days after the surgery,she exhibited severe abdominal pain with septic shock.Exploratory laparotomy revealed extensive intestinal adhesions and severe intraperitoneal contamination.Since the patient was hemodynamically unstable,a salvage operation rather than definite surgery was needed,and three surgical open drains were inserted into the peritoneal cavity.Postoperative EAFs developed,and it was almost impossible to isolate and reduce the fistula output despite the use of vacuum-assisted closure dressings and endoscopic stent insertion.Finally,we anastomosed two vascular grafts to the openings of each EAF to restore enteric continuity.The inserted vascular grafts showed acceptable patency,and the patient could receive optimal nutritional support with elemental enteral feeding.She underwent EAF resection 76 d after graft implantation.CONCLUSION Control of the enteric effluent are key elements in achieving favorable clinical conditions which should precede definite surgery for EAFs.展开更多
The use of open abdomen(OA) as a technique in the treatment of exsanguinating trauma patients was first described in the mid-19 th century. Since the 1980 s, OA has become a relatively new and increasingly common stra...The use of open abdomen(OA) as a technique in the treatment of exsanguinating trauma patients was first described in the mid-19 th century. Since the 1980 s, OA has become a relatively new and increasingly common strategy to manage massive trauma and abdominal catastrophes. OA has been proven to help reduce the mortality of trauma. Nevertheless, the OA method may be associated with terrible and devastating complications such as enteroatmospheric fistula(EAF). As a result, OA should not be overused, and attention should be given to critical care as well as special management. The temporary abdominal closure(TAC) technique after abbreviated laparotomy was used to improve wound healing and facilitate final fascial closure of OA. Negative pressure therapy(NPT) is the most commonly used TAC method.展开更多
文摘BACKGROUND Enteroatmospheric fistula(EAF)is a catastrophic complication that can occur after open abdomen.EAFs cause severe body fluid loss,hypercatabolism,and wound complications,leading to adverse clinical outcomes.CASE SUMMARY A 72-year-old female patient underwent ventral hernia repair.Five days after the surgery,she exhibited severe abdominal pain with septic shock.Exploratory laparotomy revealed extensive intestinal adhesions and severe intraperitoneal contamination.Since the patient was hemodynamically unstable,a salvage operation rather than definite surgery was needed,and three surgical open drains were inserted into the peritoneal cavity.Postoperative EAFs developed,and it was almost impossible to isolate and reduce the fistula output despite the use of vacuum-assisted closure dressings and endoscopic stent insertion.Finally,we anastomosed two vascular grafts to the openings of each EAF to restore enteric continuity.The inserted vascular grafts showed acceptable patency,and the patient could receive optimal nutritional support with elemental enteral feeding.She underwent EAF resection 76 d after graft implantation.CONCLUSION Control of the enteric effluent are key elements in achieving favorable clinical conditions which should precede definite surgery for EAFs.
文摘The use of open abdomen(OA) as a technique in the treatment of exsanguinating trauma patients was first described in the mid-19 th century. Since the 1980 s, OA has become a relatively new and increasingly common strategy to manage massive trauma and abdominal catastrophes. OA has been proven to help reduce the mortality of trauma. Nevertheless, the OA method may be associated with terrible and devastating complications such as enteroatmospheric fistula(EAF). As a result, OA should not be overused, and attention should be given to critical care as well as special management. The temporary abdominal closure(TAC) technique after abbreviated laparotomy was used to improve wound healing and facilitate final fascial closure of OA. Negative pressure therapy(NPT) is the most commonly used TAC method.
