Abstract
Twenty patients, fifteen female and five male, with external gastrointestinal tract fistulas were treated at Freedmen's Hospital from 1965 to 1970. The locations of the fistulas were the colon, seven patients; ileum, six patients; jejunum, five patients; stomach, two patients. There were no duodenal fistulas. Operative injury secondary to lysis of adhesions for intestinal obstruction was the most common cause of these fistulas. There were six deaths. The proper management of complications of fistulas, that is, sepsis, malnutrition, skin excoriation, and fluid and electrolyte imbalance, is discussed. The proper timing of operative correction is emphasized noting that, as a rule, fistulas involving the upper small intestine require early surgery whereas lower small bowel and colonic fistulas may be treated successfully by nonsurgical means.
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