Fig. Enterocutaneous Fistula

Symptoms & Diagnosis

Enterocutaneous fistula (ECF) is an abnormal connection that develops between the intestinal tract or stomach and the skin. As a result, contents of the stomach or intestines leak through to the skin. Most ECFs occur after bowel surgery.


Enterocutaneous fistulas (ECFs) can cause contents of the intestines or stomach to leak through a wound or opening in the skin. It also can cause:

  1. Dehydration
  2. Diarrhea
  3. Malnutrition


The doctor will conduct a thorough physical exam and may prescribe the following tests to confirm a diagnosis of enterocutaneous fistula (ECF) :

  1. Abdominal CT scan
  2. Barium enema, if the fistula involves the colon
  3. Barium swallow, also called an esophagram. This test is a series of X-rays of the esophagus. You drink a liquid containing barium, which coats the inside of your esophagus. The barium causes changes in the shape of the esophagus to show up on the X-rays.
  4. Fistulogram, which involves injecting contrast dye into the opening of the skin of an ECF and taking X-rays.

Treatment and Recovery:

If the enterocutaneous fistula (ECF) doesn’t heal on its own after a few weeks or months, a complex surgery is required to close the fistula and reconnect the gastrointestinal tract.

Patients with ECFs often need specialized wound care, nutritional rehabilitation and physical rehabilitation.

In addition to surgeons, specialists in nursing, nutrition, intensive-care medicine, wound care, plastic surgery, pharmacology and infectious disease may be part of the treatment team.


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