A technique to establish fistuloclysis for high-output jejunocutaneous fistula through percutaneous enterostomy: A case report

• Published in: Medicine (Baltimore) Vol. 98; no. 10; p. e14653
• Main Authors: Niu, Dong-Guang, Yang, Fan, Tian, Wei-Liang, Zhao, Yun-Zhao, Li, Chen, Ding, Lian-An, Fang, Hong-Chun, Huang, Qian
• Format: Journal Article
• Language: English
• Published: United States Wolters Kluwer Health 01.03.2019
• Subjects: Adult; Clinical Case Report; Enteral Nutrition - methods; Enterostomy - methods; Fluid Therapy - methods; Humans; Intestinal Fistula - diagnosis; Intestinal Fistula - etiology; Intestinal Fistula - physiopathology; Intestinal Fistula - surgery; Intestines - diagnostic imaging; Intestines - physiopathology; Male; Nutritional Status; Postoperative Complications - therapy; Radiography, Abdominal - methods; Sepsis - etiology; Sepsis - therapy; Surgical Stomas; Treatment Outcome; Water-Electrolyte Imbalance - etiology; Water-Electrolyte Imbalance - therapy
• DOI: 10.1097/MD.0000000000014653
• ISSN: 0025-7974

Currently, fistucolysis helps to establish intestinal nutrition and succus entericus reinfusion in the case of controllable mature high-output enterocutaneous fistula. However, if the tube cannot reach the distal limb of a fistula, fistuloclysis is not achieved. We proposed a strategy to establish succus entericus reinfusion for intractable intestinal fistula through percutaneous enterostomy. A 43-year-old man was transferred to our facility for postoperative enterocutaneous fistulae, sepsis, malnutrition, and electrolyte and fluid imbalance. The contrast X-ray demonstrated the breakdown of the primary anastomosis, with fistula output ranging from 1500 to 2000 mL/d, despite the administration of medications to reduce gastrointestinal secretions. The patient was diagnosed with high-output anastomosis fistula by gastrointestinal radiography. We used percutaneous enterostomy to establish fistuloclysis. Fistuloclysis was established by percutaneous enterostomy successfully. No complications were found during the past 4-month follow-up after percutaneous enterostomy. He is waiting for reconstruction surgery after 6 months' enteral nutrition (EN). Fistuloclysis-assisted EN, if used appropriately, avoids the complications of long-term parenteral nutrition (PN) and may promote faster fistula healing.