Enterocutaneous fistula mimicking subcutaneous emphysema after stoma closure: a rarity
DOI:
https://doi.org/10.18203/2349-3291.ijcp20251487Keywords:
Anorectal malformation, Congenital, Enterocutaneous fistula, Nutrition, PaediatricAbstract
Enterocutaneous fistulas, abnormal connections between the intestinal tract and the skin, are rare but serious postoperative complications associated with significant morbidity. This case presents a one-year-old male with anorectal malformation who developed subcutaneous emphysema secondary to an enterocutaneous fistula after colostomy closure and concurrent ureteric reimplantation. The fistula was managed with surgical excision and end-to-end bowel anastomosis, leading to full recovery with no recurrence. This report highlights the importance of considering rare differentials like enterocutaneous fistula in cases of subcutaneous emphysema at the wound site. It also underscores the complexity of managing multiple surgical procedures in pediatric patients and the importance of considering staged surgeries when feasible to reduce postoperative complications and improve outcomes. Timely diagnostic measures such as lateral abdominal X-ray played a critical role in early recognition and successful management.
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References
Uba FA, Uba SC, Ojo EO. Management of postoperative enterocutaneous fistulae in children: a decade experience in a single centre. Afr J Paediatr Surg AJPS. 2012;9(1):40–6. DOI: https://doi.org/10.4103/0189-6725.93302
Steinau G, Ruhl K, Hörnchen H, Schumpelick V. Enterostomy complications in infancy and childhood. Langenbecks Arch Surg. 2001;386(5):346–9. DOI: https://doi.org/10.1007/s004230100243
Mamaniya U, Suryawanshi P. Enterocutaneous fistula–a case presentation. Int J Curr Med Appl Sci. 2020;28(2):9-11.
Ostertag-Hill CA, Delaplain PT, Lee T, Dickie BH. Updates on the Care of Cloacal Exstrophy. Children. 2024;11(5):544. DOI: https://doi.org/10.3390/children11050544
Gangopadhyay AN, Pandey V. Anorectal malformations. J Indian Assoc Pediatr Surg. 2015;20(1):10–5. DOI: https://doi.org/10.4103/0971-9261.145438
Makhdoom ZA, Komar MJ, Still CD. Nutrition and Enterocutaneous Fistulas. J Clin Gastroenterol. 2000;31(3):195. DOI: https://doi.org/10.1097/00004836-200010000-00003
Martinez JL, Luque-de-Leon E, Mier J, Blanco-Benavides R, Robledo F. Systematic Management of Postoperative Enterocutaneous Fistulas: Factors Related to Outcomes. World J Surg. 2008;32(3):436–43. DOI: https://doi.org/10.1007/s00268-007-9304-z
8. Sitges-Serra A, Jaurrieta E, Sitges-Creus A. Management of postoperative enterocutaneous fistulas: The roles of parenteral nutrition and surgery. Br J Surg. 1982;69(3):147–50. DOI: https://doi.org/10.1002/bjs.1800690310
Fekete CN, Ricour C, Duhamel JF, Lecoultre C, Pellerin D. Enterocutaneous fistulas of the small bowel in children (25 cases). J Pediatr Surg. 1978;13(1):1–4. DOI: https://doi.org/10.1016/S0022-3468(78)80201-2
Denicu MM, Cartu D, Ciorbagiu M, Nemes RN, Surlin V, Ramboiu S, et al. Therapeutic Options in Postoperative Enterocutaneous Fistula-A Retrospective Case Series. Med Kaunas Lith. 2022;58(7):880. DOI: https://doi.org/10.3390/medicina58070880
Kumar P, Maroju NK, Kate V. Enterocutaneous fistulae: etiology, treatment, and outcome - a study from South India. Saudi J Gastroenterol Off J Saudi Gastroenterol Assoc. 2011;17(6):391–5. DOI: https://doi.org/10.4103/1319-3767.87180