About Abdominal Fistulas

Although not talked about much, abdominal fistulas are dangerous and difficult to manage for both the medical team and the patient.

By definition, a fistula is an open passage connecting the abdominal organs to the external surface; in layman's terms, it's a hole between a one of the abdominal organs out to the skin's surface.

Causes

• There are generally three causes of abdominal fistulas: disease, complications from surgery, and trauma or injury.

  Fistulas caused by disease is usually caused by cancer or an abscess, which causes a weakening and eventually a hole in the organ, which can ultimately grow to involve another organ or grow outward towards the skin.

  Fistulas caused by complications from surgery may involve an incomplete closure of an incision made on an organ or from an inadvertent nick by the scalpel that doesn't heal and may become infected.

  The third type often occurs in blunt-force injury, such as a car accident or in assault. The abrupt force can cause a small tear in an internal organ that eventually grows into a fistula.

Types

• Stedman's Medical Dictionary defines an abdominal fistula as "a fistulous passage connecting one of the abdominal viscera to the external surface"; Wikipedia's definition is a bit more understandable to those without medical degrees: "an abnormal connection or passageway between two organs or vessels that normally do not connect."

  A few of the more common abdominal fistulas are:
  -enterocutaneous fistula (between the intestine and the outside skin)
  -gastric fistula (between the stomach and the outside skin)
  -anorectal fistula (between the rectum or anorectal area and the outside skin)
  -enteroenteral fistula (between two different parts of the intestines)
  -pancreatic fistula (between the pancreas and any other internal organ)

  Whatever organ is involved, the fluids, cells or excretion from the organ empties out through the fistula, which carries much risk for infections.

  There are three types of fistulas: only one end is open (Blind fistula); has both internal and external openings (Complete fistula); and an Incomplete fistula, where there is an external skin opening but it doesn't connect to any internal organ.

Treatment

• Treatment involves a combination of surgery to correct the openings involved and a course of antibiotic medications to eliminate any present infection as well as prevention of further infection.

Prevention

• There really is no prevention of abdominal fistulas, but awareness of the possibility of developing an abdominal fistula is important. After an injury, surgery or diagnosis of cancer, it is important to see your doctor immediately at the first sign of infection.

Misdiagnosis

• As with any medical condition, it is important to be informed to talk intelligently with your physician about your condition and symptoms. Self-diagnosis from information on any website is never a good idea. If you suspect an abdominal fistula, see your doctor right away.