Whole-course management of abdominal opening with enteroatmospheric fistula
10.3760/cma.j.cn441530-20240215-00065
- VernacularTitle:一例腹腔开放合并肠空气瘘患者的全程管理经验
- Author:
Weidong ZHONG
1
;
Gen HU
;
Zhenguo ZHAO
;
Zhen WANG
;
Jinchun LIU
;
Wei LI
;
Liqiang DAI
;
Lingxiao PU
;
Surui WANG
;
Yuefan SHEN
;
Xuxia XUE
;
Guoyi SHAO
Author Information
1. 徐州医科大学江阴临床学院，江阴市人民医院综合普外一科，江阴 214400
- Publication Type:Journal Article
- Keywords:
Intra-abdominal infection;
Enteroatmospheric fistula;
Anastomotic Fistula;
Open Abdomen;
Negative pressure wound therapy;
Damage control surgery
- From:
Chinese Journal of Gastrointestinal Surgery
2025;28(3):323-326
- CountryChina
- Language:Chinese
-
Abstract:
Severe intra-abdominal infections are life-threatening conditions and a significant challenge for surgeons. This article presents a case of an elderly patient with a severe intra-abdominal infection complicated by an anastomotic leak. This patient had experienced prolonged sepsis and multiple surgical traumas. Upon admission to our department, exploratory surgery revealed extensive bowel edema and adhesions, an anastomotic leak, and abdominal contamination with infection. In accordance with the principles of damage control surgery, the anastomotic leak was exteriorized, the abdomen was left open, and continuous intra-abdominal lavage with dual-lumen catheters was implemented to effectively control the infection. Negative pressure wound therapy was used to manage the open abdomen, and a negative pressure-assisted drainage device was used to manage the enteroatmospheric fistula. After granulation of the abdominal wound, split-thickness skin grafting was performed. The enteroatmospheric fistula was converted into an enterocutaneous fistula. A 3D-printed stoma baseplate was used to manage the digestive fistula. Concurrently, enhanced parenteral and enteral nutritional support was provided. Six months later, the patient successfully underwent definitive fistula resection and abdominal wall defect repair.
