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NonInvasive Approach for Refractory Enterovaginal Fistula
Author(s) -
Hidefumi Nishimori,
Hata Fumitake,
Furuhata Tomohisa,
Ishiyama Gentaro,
Hirata Koichi
Publication year - 2005
Publication title -
wound repair and regeneration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.847
H-Index - 109
eISSN - 1524-475X
pISSN - 1067-1927
DOI - 10.1111/j.1067-1927.2005.130116ac.x
Subject(s) - medicine , fistula , surgery , percutaneous , catheter , refractory (planetary science) , pelvic cavity , adhesion , radiology , physics , astrobiology , chemistry , organic chemistry
Enterovaginal fistula is generally difficult to treat, and a surgical treatment is often chosen. There are many cases that require extended bowel resection for severe adhesion in the pelvic cavity and just as many cases of postoperative complications. The present case involves a 61‐year‐old female. After radical operation for ovarian cancer, a recurrence was recognized in the pelvic cavity despite chemotherapy. After that, recurrence was found in the pelvic cavity, and low anterior resection combined with the resection of recurrent tumor was performed. Enterovaginal fistula and pelvovaginal fistula were found from the 10 th postoperative day; therefore urethral catheter was placed transvaginally. Those fistulas were simplified afterwards, and the tube for percutaneous transhepatic cholangio drainage (PTCD) was placed and then removed after several exchanges. After that, enteric juice was identified for a few days, but the fistula was completely closed, and no recurrence was found. It is easy for discharge from enterovaginal fistula to increase because of the anatomical position the fistula; since there is no appropriate device for this fistula, treatment is difficult. It seems that, in selected cases in which the patient heals conservatively without losing quality of life for patients, it is possible to place a tube in an appropriate position under the x‐ray and change it step by step.