Enteric Fistula
An enteric fistula is an abnormal connection between two organs, at least one of which is part of the gastrointestinal tract.
A fistula is an abnormal connection between two organs that allows the contents of those organs to leak out. When one of these abnormalities is located in the gastrointestinal tract, it’s referred to as an enteric fistula.
There are four main types of enteric fistulas:
- Complex, which involves multiple channels that affect multiple organs
- External, which occurs when the gastrointestinal tract is connected to the skin
- Extraintestinal, which occurs when the intestines are connected to another organ within the body
- Intestinal, which occurs when one portion of the intestines connects to another section of intestines
Causes of an Enteric Fistula
The large majority of enteric fistulas develop as a complication of surgery, but other potential causes include:
- An intestinal blockage
- An infection, such as diverticulitis
- A perforated peptic ulcer
- Inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis
- Cancer
- A traumatic injury, such as a gunshot or stabbing wound
- The ingestion of a caustic substance, such as lye
- A history of radiation to the abdomen, such as the radiation administered to treat cancer
Symptoms of an Enteric Fistula
Symptoms will vary depending on where the enteric fistula is located, and some enteric fistulas don’t cause any noticeable symptoms. However, some common symptoms include:
- Abdominal pain
- Diarrhea
- Vomiting
- Dehydration
- Malabsorption
- Malnutrition
- Fever
- Increased heart rate
External fistulas (ones involving the skin) can also cause skin issues, since they allow stomach acid and other substances to leak through the opening and onto the skin. If you think you might have an enteric fistula, it’s important to promptly seek treatment. This type of abnormality can lead to sepsis, which is a life-threatening condition.
Diagnosing an Enteric Fistula
If a physician suspects that a patient may have an enteric fistula, one or more of the following tests may be ordered to confirm the diagnosis:
- Barium enema
- Barium swallow (esophagram)
- Computed tomography (CT) scan
- Fistulogram
Treatment for an Enteric Fistula
Some of the conservative methods commonly used to treat enteric fistulas include:
- Antibiotics
- Immune-suppressing medication
- Medication to reduce the amount of fluid within the abdomen
- Intravenous feeding until the fistula heals (parenteral nutrition)
In some cases, an enteric fistula will heal on its own, without the need for surgery. This may take weeks or even months. However, if this does not occur, or if certain complications develop, surgery may be necessary to repair the fistula. Tampa General Hospital’s team of experienced gastroenterologists will be able to recommend the course of treatment that’s right for your needs.