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Table 1 Fundamentals of the current multispecialist approach to enterocutaneous fistula management

From: Enterocutaneous fistulas: a primer for radiologists with emphasis on CT and MRI

Step no. Treatment basics Comments
1 Control of sepsis Often requiring intensive care support
Imaging-guided drainage of abscess collections
2 Limiting output volume Octreotide administration
Bowel rest, enteral, or parenteral nutrition
3 Wound or skin care Use of dressings or bags depending on output
Suction or Vacuum-Assisted Closure (VAC) devices if available
4 Metabolic and nutritional optimisation Adequate hydration, electrolytes balance, nutritional status
Proximal versus location in the bowel influences nutritional and fluid requirements
5 Assessing likelihood of spontaneous closure Versus percutaneous treatment or elective surgical repair
Factors associated with favourable healing:
- narrow-calibre and/or relatively long (>2 cm) ECFs,
- small enteric defect or anastomotic dehiscence (<1 cm)
Factors associated with probable non-healing:
- presence of foreign bodies,
- history of irradiation,
- active infection,
- untreated chronic inflammatory bowel disease,
- untreated tumours,
- distal obstruction