medical notes

Apr 17th, 2015
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INTESTINAL FISTULADefinitionA fistula is an abnormal tract between two or more epithelial lined surfaces. Tract is line by granulation or epithelial tissueIt may involve a communication tract from one body cavity or hollow organ to another hollow organ or to the skin Enterocutaneous fistula is an .abnormal communication between bowel and skinClassificationThere are several ways to classify fistulae and these are useful in selecting measures for management and for comparison of therapeutic approaches. 1. Descriptive includes the sites of origin and termination: e g jejunocutaneous , ileovesical fistulas 2.Anatomical ClassificationModified Sitges-Serra classificationType 1 fistula are esophageal, gastric, and duodenal fistulaeType II fistula Involve small bowelType III fistula Involve large bowel andType IV fistula where all the above drains through a large abdominal wall defect.2. Internal versus externalInternal fistulae include ileocolic or ileoileo fistulae.Rarely follow a surgical procedure; usually result from local perforation of diseased bowel. An abscess forms that affects an adjacent structure.External fistulae include duodenocutaneous or ileovaginal. 3

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