Our approach
Treating intestinal fistulas requires a comprehensive approach.
The first priorities are controlling infection, correcting fluid and electrolyte imbalances, providing adequate nutritional support, and determining whether the fistula can close on its own. If conservative treatment is ineffective or there are indications for surgery, a radical surgical procedure is performed.
What is an intestinal fistula?
An intestinal fistula is an abnormal channel through which intestinal contents pass into other organs or to the outside.
The most common types are:
- enterocutaneous fistulas (to the skin)
- enteroenteric (between loops of the bowel)
- enterocolic
- enterovesical (to the bladder)
- enterovaginal
Why do intestinal fistulas develop?
The main causes are:
- postoperative complications
- Crohn's disease
- bowel injuries
- intra-abdominal abscesses
- radiation damage
- tumors
- inflammatory processes
Symptoms
The manifestations depend on the type of fistula.
Possible symptoms:
- discharge of intestinal contents through a surgical wound or the skin
- abdominal pain
- fever
- weight loss
- dehydration
- electrolyte imbalance
- recurrent infections
- nutritional deficiency
When to see a doctor
A consultation is recommended if:
- intestinal contents are discharging after surgery
- an intestinal fistula has been diagnosed
- the fistula does not close on its own
- there are signs of infection or sepsis
- the indications for surgical treatment need to be determined
How is the diagnosis made?
The following are used to establish the diagnosis:
- consultation with a surgeon
- laboratory tests
- contrast-enhanced computed tomography
- fistulography when indicated
- endoscopic methods
- assessment of nutritional status
- additional tests depending on the clinical situation
How is it treated?
Treatment is carried out in stages.
Options may include:
- infection control
- antibiotic therapy
- drainage of abscesses
- nutritional support
- correction of fluid and electrolyte imbalances
- reconstructive bowel surgery
- resection of the affected segment of the small bowel
Surgical treatment
At MSI we perform:
- resection of the small bowel segment with the fistula
- reconstruction of bowel continuity
- elimination of intra-abdominal abscesses
- adhesiolysis
- laparoscopic or open reconstructive operations depending on the complexity of the case
Surgery is performed after the patient's condition has been stabilized and thorough preoperative preparation has been completed, if the clinical situation allows.
Recovery after treatment
After surgery, modern ERAS protocols, early nutritional support, and an individual rehabilitation plan are used.
Further follow-up is aimed at preventing recurrence and restoring normal bowel function.
Why choose MSI
- Experience in treating complex postoperative complications
- A comprehensive multidisciplinary approach
- Modern reconstructive bowel surgery
- Individual treatment planning
- Enhanced recovery protocols (ERAS)
- Thorough preoperative nutritional preparation
Frequently Asked Questions
No. Some fistulas can close on their own once the infection is controlled and with adequate nutritional support and conservative treatment.
Surgery is indicated if the fistula does not close on its own, has a high output, is related to a tumor or Crohn's disease, or is accompanied by serious complications.
In some patients, yes. The final choice of approach depends on the extent of adhesions, the location of the fistula, previous operations, and the patient's overall condition.
In most cases, yes. The affected bowel segment is usually resected together with the fistula, and bowel continuity is restored.
The outlook depends on the cause of the fistula and the patient's overall condition. With proper preoperative preparation and radical surgical treatment, the fistula can be completely eliminated and normal bowel function restored in most patients.