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The Use Of Negative Pressure Wound Therapy (NPWT) In The Management Of Enteroatmospheric Fistula—Case Report And Literature Review

Rajmund Jaguścik, Dominik A Walczak, Joanna Porzeżyńska, Piotr W Trzeciak
Polski Przeglad Chirurgiczny 2015, 87 (10): 522-7
26812753
An enteric fistula that occurs in an open abdomen is called an enteroatmospheric fistula (EAF) and is the most challenging complication for a surgical team to deal with. The treatment of EAF requires a multidisciplinary approach. First of all, sepsis has to be managed. Any fluid, electrolyte and metabolic disorders need to be corrected. Oral intake must be stopped and total parenteral nutrition introduced. The control and drainage of the effluent from the fistula is a separate issue. Since there are no fixed algorithms for the treatment of EAF, surgeons need to develop their own, often highly unconventional solutions. We present the case of a 24-year-old man who developed enteroatmospheric fistula after laparotomy and relaparotomy due to acute necrotic pancreatitis. Both the laparostomy and the fistula were successfully managed using modified negative pressure wound therapy. The literature regarding this issue was also reviewed.

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