Heterotopic mesenteric ossification as a cause of persistent enterocutaneous fistula: overview of the literature and addition of a new case*

Abstract

BACKGROUND: Heterotopic mesenteric ossification (HMO) is rare condition with unclear multifactorial etiology. When presented with enterocutaneous fistulae, HMO may be devastating for the patient. METHODS: We herein present the case of a 59-year-old woman with persistent enterocutaneous fistula secondary to heterotopic mesenteric ossification, which developed after a complicated gynecologic laparoscopic oophorectomy, abdominal sepsis, multiple small-bowel resections, and skin grafting for an open abdomen. RESULTS: Nonoperative management with nil per os status and total parenteral nutrition of her fistulae was unsuccessful. The patient subsequently underwent en masse resection of her mesenteric ossification with associated small and large intestine. CONCLUSIONS: This case represents a rare occurrence of chronic enterocutaneous and/or enteroatmospheric fistulae secondary to heterotopic mesenteric ossification. Diagnosis, treatment, and histologic appearance of heterotopic mesenteric ossification are discussed in a review of the literature.