Treatment of enterocutaneous small intestine fistula using parenteral nutrition therapy

A retrospective and prospective analysis was carried out of 48 patients with 54 enterocutaneous small bowel fistulae. 31 patients received total parenteral nutrition (TPN) by 17 patients only the daily losses of fluids and electrolytes were covered. In 19 fistulae (39,5%) closed spontaneously (48,5% with TPN and 14,3% without TPN). 10 patients underwent surgery; 5 fistulae closed operatively. The efficacy of treatment of enterocutaneous fistulae was influenced by the location of fistula, by the daily output, by the septic complications and by the use of TPN. Total parenteral nutrition can be the primary treatment or an effective adjunct to supplement the surgical management of postoperative small bowel fistulae.