Abstract
Enterocutaneous fistulas (ECF) represent a catastrophic problem for patients and continue to be complex and labor intensive for healthcare providers. In addition to the many physiologic and mental stressors the patients must endure, the development of ECFs also puts a strain on healthcare systems resulting in prolonged hospital stays, multiple readmissions, and increased resource consumption. The management of ECFs has improved significantly, resulting in decreased mortality rates, from 50% in the 1950s to approximately 5%–15% at present. As many as 85% of ECFs present as a complication after abdominal surgery, providing further challenges to already compromised postoperative patients. Most ECFs develop as a result of one of the following conditions: extension of bowel disease to surrounding structures, extension of disease of the surrounding structures to the bowel, unrecognized bowel injury, or breakdown of a gastrointestinal tract anastomosis. Multiple preoperative patient factors can increase the likelihood of ECF development.