External Duodenal Fistula: Causes, Complications, and Treatment

J. A. Rossi, L. L. Sollenberger, Robert V Rege, J. Glenn, R. J. Joehl

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

We reviewed records of 18 patients with external duodenal fistula. Fourteen patients developed duodenal fistulas following an operation, two following abdominal trauma, and two as a complication of other diseases. Copious drainage of intestinal juice from the abdomen was the most common presenting sign. Contrast fistulography, upper gastrointestinal tract roentgenography, and T-tube cholangiography were useful diagnostic studies. Nine patients were treated nonoperatively; nine patients required at least one operation. Complications occurred frequently; of special interest were three patients who developed postoperative acute cholecystitis. Six patients died (33% mortality). Factors associated with mortality were advanced age (65 years), uncontrolled infection and multiple organ failure, high-output fistula, malnutrition, delay in diagnosis (more than three days), and multiple reoperations to treat the fistula or complications. External duodenal fistula continues to be a life-threatening problem whether it is postoperative, posttraumatic, or secondary to a disease process.

Original languageEnglish (US)
Pages (from-to)908-912
Number of pages5
JournalArchives of Surgery
Volume121
Issue number8
DOIs
StatePublished - Aug 1986

ASJC Scopus subject areas

  • Surgery

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