Fistula Enterokutan High Output : Laporan Kasus

Khalikul Razi; Muhammad yusuf; Ferry Erdani; Zulham Effendi

doi:10.35324/jknamed.v7i1.288

Khalikul Razi FK USk
Muhammad yusuf Divisi Bedah Digestif, Departemen Ilmu Bedah, Fakulats Kedokteran Universitas syiah kuala ? Rumah sakit Zainoel Abidin, Banda Aceh
Ferry Erdani Divisi Bedah Digestif, Departemen Ilmu Bedah, Fakulats Kedokteran Universitas syiah kuala ? Rumah sakit Zainoel Abidin, Banda Aceh
Zulham Effendi Program Studi Pendidikan Dokter Spesialis Ilmu Bedah, Fakultas Kedokteran Universitas Syiah Kuala, Banda Aceh.

DOI: https://doi.org/10.35324/jknamed.v7i1.288

Abstract

Enterocutaneous Fistula Associated with morbidity and complications can also be significant. Enterocutaneous fistulas most commonly occur as a surgical complication, but can also occur due to trauma, malignancy, inflammatory bowel disease, or ischemia.

Case description: A 19-years female comes with a chief complaint of wound dehiscence and pain after abdominal surgery for 7 days. The patient had a history of laparotomy appendectomy surgery 1 month ago and the wound didn't heal. On physical examination, we found the general condition moderate, pulse: 110 beats/min, respiratory rates 20 breaths/min, temp 36.7^oC. abdominal symmetrical, distension (-), burst abdomen (+) with size 7cm x3 cm, faeces (+), surgical scars(+), bowel sound (+) , pain (+), muscular rigidity (-), liver dullness (-). A patient was diagnosed with Burst abdomen post-Laparotomi Explorasi due to appendicitis perforation and high output Fistel Enterocutan. For patient management, we perform drainage incision debridmen and laparotomy Exploration prepare for stoma. During surgical management, we found enteric content In the abdominal Cavity 300 cc, severe Intestinal adhesion, ileum perforation, and multiple pocket abscesses in the caecum. Then we performed debridement. After surgery, the patient had good stable hemodynamics, observed for acute abdomen and wound care.

Discussion: The key management for enterocutaneus fistula is to replace any fluids and electrolytes, infection control and sepsis have to be identified. Surgical procedures in some cases needed to control management and output

Conclusion: The outcome of enterocutaneus fistula depends on the cause of the fistula, surgical procedure may need to repeat. In some cases, it will months or years to close.

Keyword: Fistel Enterocutaneus, Laparotomy Surgery