Study of feacal fistula after exploratory laparotomy

Background: Anabberent connection between the intraabdominal gastrointestinal tract and skin/wound called enterocutaneousfistula or faecal fistula. Historically gastrointestinal tract fistulas have been attended by a high mortality rate. Until quite recently fistulas in general had a poor prognosis. The high morbidity rate and the leaking wound encouraged many surgeons to undertake operative interventions even though with the operative intervention the prognosis was grave. most common cause is some type of operative injury.
Methords: The cases for the present study was taken from the patients admitted in the Upgraded Department of Surgery, Darbhanga Medical College & Hospital over a period of 1 year extending from the period June 2012 to September 2013. The study included only those patients who developed faecal fistula after exploratory laparotomy. Initially a complete and thorough history was taken. general examination was done and cause of cause of exploratory laparotomy associated comorbidities are noted
Results: Chances of postoperative fistula formation is equal in male and female. maximum incidence of faecal fistula is with resection and anastomosis. In the present series we divided gastrointestinal fistula and into three clinical groups according to site of origin viz gastroduodenal, small bowel and large bowel. Small bowel fistulas constituted the largest number ) while gastroduodenal fistulas lead the highest mortality rate. large bowel fistulas are easy to treat they often have a poor prognosis. Wrong surgical techniques and poor selection of cases have often been quoted as an important factor in the formation of fistulas
Conclusions: The present study concluded the fact that high output fistula has a higher mortality rate in comparison to low output fistula patients. Patients treated with enteral nutrition gave a comparable result as with the patient treated with total parenteral nutrition in the treatment of faecal fistula. The emergency surgery done under lot of stress and constraints of time has a higher chances of fistula rate formation and associated mortality.