Management of Enteroatmospheric Fistulas: What you need to know.

Brian Jurewitsch, Kareem Khalaf, Joao B Rezende-Neto, Charline Ductan, Paulo R Lima Carreiro, Natalia Causada Calo, Matthew Wu, Samar Abdullah Aljehani, Fernanda Y Takamatsu

Journal: The journal of trauma and acute care surgery 2025;99(3):328-338

PMID: 40189751

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Abstract

An enteroatmospheric fistula (EAF) is a disastrous complication of abdominal surgery. Most EAFs occur in open abdomens after damage-control procedures in trauma and emergency general surgery. The absence of a defined fistulous tract and abdominal wall coverage preclude spontaneous closure and entail several challenges. Therefore, the primary objective is to manage those challenges to allow for the surgical take down of the fistulized bowel and reestablish gastrointestinal continuity. This work discusses a multidisciplinary approach indicating practical strategies from at least six different disciplines involved in the care of EAF patients.

Address: From the Division of General Surgery, Department of Surgery (J.B.R.-N., C.D., B.J.), University of Toronto, St. Michael's Hospital, Toronto, ON, Canada; Department of Surgery (P.R.L.C.), Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Division of Gastroenterology, Department of Medicine (N.C.C., K.K.), University of Toronto, Medical and Diagnostic Imaging Department (M.W., S.A.A.), St. Michael's Hospital; and Division of Gastroenterology, Hepatology, and Nutrition (F.Y.T.), Hospital for Sick Children, Toronto, ON, Canada.

DOI: 10.1097/TA.0000000000004608

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MeSH Terms: Humans, Intestinal Fistula, Postoperative Complications, Abdominal Injuries