Behind the Knife, the Surgery Podcast, relevant and engaging content designed to help you

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Welcome back Behind the knife listeners.

Today I have my team, Dr. Cavalukas, Walshinsky, and Glandiac with me to go through several case scenarios surrounding the prevention and management of enterocutaneous fistulas.

To review an anterioricutaneous or EC, fistula, is an abnormal connection between the gastrointestinal

tract and skin.

Considering most EC fistula's result from surgery, this is a dreaded complication and a

postoperative issue common to most surgeons.

Today we'll focus discussion on prevention and management

of post-operative EC fistulas. Let's use a complicated case to highlight important tips and tricks.

All right, so let's say that you have a 64-year-old man who presented to the hospital and you did

a urgent small bowel obstruction due to a closed loop

stricter or closed loop obstruction in the setting of prior radiation that the patient

had maybe gotten 10 years ago. So you see him back in clinic. It's his two-week follow-up

and he says he's now doing so hot. He has some fevers, chills, and abdominal pain. And when you look

at his abdominal exam, he has some erythema, swelling, and tenderness over his abdominal wall.

So you're concerned and you admit the patient to the hospital which will further work out.

So Dr. Bolshinsky, it's two weeks out. What do you think, are you, do you think this guy should go back to the OR or what kind of

things, how do you think you're going to manage this patient?

Yes, this is a incredibly challenging problem that all abdominal visceral surgeons face,

not only colorectal surgeons.

I certainly tell many trainees, and that was what I've been

...