Abdominal fistulas are abnormal openings that allow the contents of the stomach or bowels to leak. Leakage into other organs is called an entero-enteral fistula. If the contents leak through to the skin, it is known as an enterocutaneous fistula. Learning about abdominal fistulas can help those affected recognize the signs and symptoms so that early diagnosis and treatment can be made.
Causes
According to the National Institutes of Health, most of these fistulas are the result of surgery. Gunshot wounds and knife wounds that penetrate the muscles that protect the abdominal organs can also cause fistulas. Another cause of abdominal fistulas is inflammatory processes such as inflammation and infection. Crohn's disease and ulcerative colitis are examples of inflammatory diseases that can cause fistulas to form.
Signs and Symptoms
Signs and symptoms of abdominal fistula vary in severity based on which type of fistula is present. If the stomach or intestinal contents leak into other organs, there may be no symptoms. If leakage through to the skin occurs, the affected person will notice this leakage. Fistulas can also cause dehydration, malabsorption and diarrhea.
Diagnosis
This condition can be diagnosed with imaging studies that examine the digestive tract. Abdominal fistulas can be detected on an abdominal CT scan or barium swallow. If the colon is affected by a fistula, a barium enema may be required for diagnosis. Fistulogram may also be done to determine the severity of a fistula. During this procedure, contrast dye is injected into the opening of an enterocutaneous fistula so that x-rays can be taken.
Treatments
Abdominal fistulas may heal on their own, so doctors may take a wait-and-see approach. While a fistula heals, a patient with this condition may be unable to eat normally. Nutrition can be delivered intravenously so that malnutrition and dehydration do not occur. If a fistula does not heal on its own, the affected part of the intestine may be removed.
Complications
The most common complications of abdominal fistulas are dehydration and malnutrition. Once a fistula has been diagnosed, a patient must be carefully monitored to ensure that fluid and nutrient levels remain steady. Enterocutaneous fistulas may also cause infections and skin problems. Antibiotics may be administered to prevent or treat such infections. Medical attention should be sought if severe diarrhea occurs or there is leakage of fluid from an opening in the abdomen.
