Emergency War Surgery NATO Handbook: Part IV: Regional Wounds and Injuries: Chapter XXX: Reoperative Abdominal Surgery

Specific Reasons for Reoperations: Fistulae

United States Department of Defense

A well-formed fistula, regardless of source, may be treated by high-volume suction. This suction may be directed at the gut above the fistula, the fistula itself or both. Closure usually occurs when distal obstruction is not present. When it is associated with abscess or peritonitis, operative intervention is indicated. Closure with adequate drainage, resection, exteriorization, repair, and proximal diversion, singly or in combination, should be employed as the local situation dictates. Healing of fistulae always requires adequate nutrition. Nutritional support should be vigorously pursued, either enterally or parenterally.

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Operational Medicine 2001

Health Care in Military Settings

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