Barreto, Isabel; Kohler, Arnold; Fahrner, René (2024). Spontaneous duodenocutaneous fistula: a rare presentation of perforated duodenal ulcer. Innovative surgical sciences, 9(2), pp. 109-112. de Gruyter 10.1515/iss-2023-0051
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OBJECTIVES
Fistula formation between the duodenum and the skin of the anterior abdominal wall is a rare complication and reported most often following surgery. To the best of our knowledge, the development of a spontaneous duodenocutaneous fistula in association with duodenal ulcer has only been reported once.
CASE PRESENTATION
A 52-year-old female patient presented at the emergency department with a painful ulcer and erythema on the right abdominal wall. On admission, she was in extremely poor general and nutritional condition. Laboratory analysis revealed inflammation. An empiric antibiotic therapy was initiated; parenteral nutrition, fluid, and electrolyte resuscitation were started. An enterocutaneous fistula was postulated and confirmed by endoscopy identifying a perforated duodenal ulcer. Surgery was not a valuable option and a Foley catheter was inserted through the fistula. During further endoscopic interventions, the Foley catheter was first replaced by a jejunal tube and later by a percutaneous endoscopic gastrostomy with a jejunal limb for enteral nutrition. The fistula output decreased, the local infection was controlled and the nutritional status improved.
CONCLUSIONS
Three months later the fistula was closed and the gastrostomy tube was removed. After 2 years the patient was in good general and nutritional condition.
Item Type: |
Journal Article (Further Contribution) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Vascular Surgery |
UniBE Contributor: |
Fahrner, René |
ISSN: |
2364-7485 |
Publisher: |
de Gruyter |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
05 Aug 2024 16:08 |
Last Modified: |
06 Aug 2024 15:25 |
Publisher DOI: |
10.1515/iss-2023-0051 |
PubMed ID: |
39100721 |
Uncontrolled Keywords: |
complication duodenal ulcer duodenocutaneous fistula non-surgical treatment nutrition |
BORIS DOI: |
10.48350/199496 |
URI: |
https://boris.unibe.ch/id/eprint/199496 |
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