The role of intensive care unit in the therapy of intestinal fistulas

Abstract

Intestinal fistulas (IF) are defined as abnormal communications between two hollow organs or between a hollow organ and the skin. When a IF is diagnosed, a high rate of morbidity and lengthy hospitalization can be anticipated. The successful management of a highoutput IF is better accomplished by a multidisciplinary and intensive care approach following an organized treatment plan, including infections, correction of patient’s volume, electrolytes, acidbase deficits and sttoping oral intake and instituting enteral or parenteral nutrition, in order to prevent further losses and malnutrition. In more than 50% of patients there is a spontaneous closure of the IF. However, definitive surgical closure should be performed if a high-output IF still remains after 6-8 weeks from the inicial event.