Pioderma gangrenoso y fístulas enterocutáneas tras anastomosis ileoanal con reservorioGangrenous pyoderma and enterocutaneous fistulas after ileal. Introducción: la baja prevalencia de las fístulas enterocutáneas (FEC) en los pacientes con enfermedad de Crohn (EC) justifica la escasez de. Necesidad de formar unidades funcionales especializadas en el manejo médico- quirúrgico de pacientes con fístulas enterocutáneas y fracaso intestinal.
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Risk factors for recurrence after repair of enterocutaneous fistula. During this period 6 patients died 5. Management of external small bowel fistulae: Later, with the arrival of these drugs, 24 of the 26 patients in our study started treatment with anti-TNF agents due to the poor response to previous treatments. Fortunately, surgeons rarely must afford such difficult problem. Fistulas are a very common and significant complication in Crohn’s disease CD.
Because of this, a large portion of our patients were diagnosed long before the era fietulas biological drugs. All patients were recruited in the following tertiary hospital centers: Based on location, they can be divided into: The appearance of postoperative enterocutaneous fistula makes a deep trouble for the patient, a high concern to the surgeon and major economic costs for the institutions.
Nine of them, with abdominal collections, were fisyulas by percutaneous drainage, 2 of which were completed by directed laparotomy. Rev Esp Enferm Dig ; After reaching stability, 32 patients continued treatment at home.
First, it should be pointed out that fistula closure has been achieved in some cases, after this time period, with the assistance of innovative treatments, such as sub-atmospheric pressure  – . After the first, second and third dose, patients described symptomatic improvement and had no output from the fistula after the eighth dose. A total of 24 patients were treated with anti-TNF.
Int J Colorectal Dis ; They are themselves defined as a clinical pattern of the disease. However, it is possible that many other factors should significantly impact fistulized patient outcomes.
In recent years, enthusiasm has waned because it could be seen that, while it is effective to reduce enteric output, and even to accelerate some fistulas closure time, it has not been possible to demonstrate a rise in percentage of spontaneous closure or a fall in mortality rate.
World J Surg ; 32 3: They were treated with antibiotics, immunosuppressants and even surgery. The aim of this research is to present the results of a systematized management of this complication, to asses the use of a vacuum system in local treatment of the lesion and to determine factors influencing the evolution of fistulized patients.
Fifty four percent were smokers. Treatment of the endoscopic and clinical recurrence was probably the key to healing the ECF in these patients.
Regarding local lesion management, 92 cases All patients with a documented history of CD who developed an ECF during their clinical progress from to were included retrospectively. Demographics, patient characteristics and injury aspects were recorded. Enterocuatneas of anastomotic enterocutaneous fistulae due to Crohn’s disease by anti TNF alpha antibodies. ECF was spontaneous in Vacuum therapy was highly effective in output control and provided spontaneous healing in many cases.
J Clin Gastroenterol 2 Meanwhile, 1 patient did not receive previous biological treatment and was treated with adalimumab for enterocuutaneas mean duration of 16 months.
Evaluation of the effectiveness of octreotide in the conservative treatment of postoperative enterocutaneous fistulas. The results of these series, consistent with other studies  , support this procedure in patients with acute abdomen and those who, maintaining a good general condition, developed early fistulas.
Initial surgery is a valid option in patients maintaining a good general condition and is a necessity in cases where the fistula coexists with acute abdomen. Both EN and PN are resources that the specialist team should handle so as to indicate them, either in combination or alternatively, according to the case nature.
Patients who underwent surgery had resection of the bowel segment that gave rise to the fistula as well as resection of the fistula tract to the skin. A multivariate model to determine prognostic in gastrointestinal f istulas. Worl J Surg ; The indication for surgery, the response or lack thereof to treatment of both the disease and the ECF, as well as the correlation between one and the other was evaluated in all patients.
Moreover, some recent publications have suggested, after observing certain complications that may be related to the method, taking caution in the application of negative pressure therapy  – .
Location was jejunoileal in 87 cases Lastly, 49 patients A good medical-surgical combination with monitoring of times may be the enterlcutaneas treatment option in these patients.
A systematized management of ECF allows to optimizing treatment results.
The inflammatory activity of the disease was measured using the Harvey-Bradshaw index.