Repair of gastrocutaneous fistula utilizing thickened fluids: application of Poiseuille’s Law to fistula healing

Abstract

Enterocutaneous fistulas are a rare occurrence after placement of a PEG tube. The key risk factor for their development is the time the PEG tube is in situ, giving time for the fistula tract to mature. Enterocutaneous fistulae are traditionally treated with parenteral nutrition or surgical management. We present a case of a 69-year-old woman who underwent surgical closure of an enterocutaneous fistula with a fibrin plug. The fistula recurred on post-operative Day 5, and the patient was placed on thickened fluids to increase the viscosity of the fluid exiting the fistula tract. This approach decreased the output and lead to subsequent closure of the fistula by outpatient follow up at 4 weeks. This case demonstrates an application of Poiseuille’s law to closure of fistula tracts.