Management of an open abdomen complicated by a high output entero-atmosferic fistula after a gastric by-pass

There is a wide spectrum of indications for negative pressure wound therapy (NPWT) including enterocutaneous fistulas, open abdomen management, abdominal wound dehiscence, open fractures, amputation wounds, sternal wound infections, vascular bypass site infection and many others.The article shows a case report of a patient with an entero-atmospheric fistula managed with NPWT. Control of intestinal contents from an entero-atmospheric fistula with the NPWT minimizes the damage to the healing bed of granulation tissue until the definitive closure of the fistula can be undertaken six to twelve monthslater. After a laparoscopic gastric bypass and 5 emergency interventions because of leaks at the jejunojenunal anastomosis and complications of the abdominal wall, an entero-atmospheric fistula appeared. This fistula was managed with the NPWT during two months. In the described case, the application of negative pressuredressing system allowed the management of the entero-atmospheric fistula until it became a stoma.