A TECHNIQUE FOR THE OPERATIVE CLOSURE OF PERSISTENT EXTERNAL SMALL‐BOWEL FISTULAS

Abstract

A technique is presented for the operative closure of persistent small bowel fistulas. This is a radical procedure involving complete dissection of the whole of the small intestine, resection of the segment of bowel containing the fistula and primary 2-layer anastomosis. A consecutive series of 50 patients with small bowel fistulas is presented. Twenty-three required surgery, 7 of whom underwent a procedure soon after the establishment of the fistula and in only 2 of these was the fistula successfully closed. The other 16 patients underwent surgery some 2 mo. after establishment of the fistula, free of sepsis and in a sound nutritional state. In 15 patients the fistula was successfully closed and the other has a persistent fistula which is of nuisance value only.