Digestive Disease Interventions 2018; 02(02): 131-140
DOI: 10.1055/s-0038-1660452
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Percutaneous Management of Enterocutaneous Fistulae and Abscess–Fistula Complexes

David H. Ballard
1   Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
,
Abigail E.M. Erickson
1   Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
,
Chaitanya Ahuja
2   Department of Radiology, Louisiana State University Health Shreveport, Shreveport, Louisiana
,
Romulo Vea
2   Department of Radiology, Louisiana State University Health Shreveport, Shreveport, Louisiana
,
Guillermo P. Sangster
2   Department of Radiology, Louisiana State University Health Shreveport, Shreveport, Louisiana
,
Horacio B. D'Agostino
2   Department of Radiology, Louisiana State University Health Shreveport, Shreveport, Louisiana
› Author Affiliations
Further Information

Publication History

12 March 2018

20 April 2018

Publication Date:
08 June 2018 (online)

Abstract

Abscess–fistula complexes and enterocutaneous fistulae are due to postoperative, spontaneous, and inflammatory etiologies. Conservative, percutaneous, endoscopic, and surgical treatment options are available options. Interventional radiologists have an array of different treatment strategies, often starting with percutaneous drainage of associated intra-abdominal abscesses. This review article details different percutaneous management strategies, focusing on percutaneous catheter strategies for abscess-fistula complexes along with tract closures strategies for enterocutaneous fistulae.

 
  • References

  • 1 Ballard DH, Hamidian Jahromi A, Li AY, Vea R, Ahuja C, D'Agostino HB. Abscess-fistula complexes: a systematic approach for percutaneous catheter management. J Vasc Interv Radiol 2015; 26 (09) 1363-1367
  • 2 Lee JK, Stein SL. Radiographic and endoscopic diagnosis and treatment of enterocutaneous fistulas. Clin Colon Rectal Surg 2010; 23 (03) 149-160
  • 3 Rahman FN, Stavas JM. Interventional radiologic management and treatment of enterocutaneous fistulae. J Vasc Interv Radiol 2015; 26 (01) 7-19 , quiz 20
  • 4 Kerlan Jr RK, Jeffrey Jr RB, Pogany AC, Ring EJ. Abdominal abscess with low-output fistula: successful percutaneous drainage. Radiology 1985; 155 (01) 73-75
  • 5 Lee SS, Kim AY, Yang S-K. , et al. Crohn disease of the small bowel: comparison of CT enterography, MR enterography, and small-bowel follow-through as diagnostic techniques. Radiology 2009; 251 (03) 751-761
  • 6 Amzallag-Bellenger E, Oudjit A, Ruiz A, Cadiot G, Soyer PA, Hoeffel CC. Effectiveness of MR enterography for the assessment of small-bowel diseases beyond Crohn disease. Radiographics 2012; 32 (05) 1423-1444
  • 7 Gayral F, Campion J-P, Regimbeau J-M. , et al; Lanreotide Digestive Fistula. Randomized, placebo-controlled, double-blind study of the efficacy of lanreotide 30 mg PR in the treatment of pancreatic and enterocutaneous fistulae. Ann Surg 2009; 250 (06) 872-877
  • 8 Rahbour G, Siddiqui MR, Ullah MR, Gabe SM, Warusavitarne J, Vaizey CJ. A meta-analysis of outcomes following use of somatostatin and its analogues for the management of enterocutaneous fistulas. Ann Surg 2012; 256 (06) 946-954
  • 9 Kwon SH, Oh JH, Kim HJ, Park SJ, Park HC. Interventional management of gastrointestinal fistulas. Korean J Radiol 2008; 9 (06) 541-549
  • 10 D'Harcour JB, Boverie JH, Dondelinger RF. Percutaneous management of enterocutaneous fistulas. AJR Am J Roentgenol 1996; 167 (01) 33-38
  • 11 McLean GK, Mackie JA, Freiman DB, Ring EJ. Enterocutaneous fistulae: interventional radiologic management. AJR Am J Roentgenol 1982; 138 (04) 615-619
  • 12 Papanicolaou N, Mueller PR, Ferrucci Jr JT. , et al. Abscess-fistula association: radiologic recognition and percutaneous management. AJR Am J Roentgenol 1984; 143 (04) 811-815
  • 13 LaBerge JM, Kerlan Jr RK, Gordon RL, Ring EJ. Nonoperative treatment of enteric fistulas: results in 53 patients. J Vasc Interv Radiol 1992; 3 (02) 353-357
  • 14 Young S, D'Souza D, Hunter D, Golzarian J, Rosenberg M. The use of latex catheters to close enterocutaneous fistulas: an institutional protocol and retrospective review. AJR Am J Roentgenol 2017; 208 (06) 1373-1377
  • 15 AAssar OS, LaBerge JM, Gordon RL. , et al. Percutaneous management of abscess and fistula following pancreaticoduodenectomy. Cardiovasc Intervent Radiol 1999; 22 (01) 25-28
  • 16 Lambiase RE, Cronan JJ, Dorfman GS, Paolella LP, Haas RA. Postoperative abscesses with enteric communication: percutaneous treatment. Radiology 1989; 171 (02) 497-500
  • 17 Flancbaum L, Nosher JL, Brolin RE. Percutaneous catheter drainage of abdominal abscesses associated with perforated viscus. Am Surg 1990; 56 (01) 52-56
  • 18 Ballard DH, Alexander JS, Weisman JA, Orchard MA, Williams JT, D'Agostino HB. Number and location of drainage catheter side holes: in vitro evaluation. Clin Radiol 2015; 70 (09) 974-980
  • 19 Ballard DH, Flanagan ST, Li H, D'Agostino HB. In vitro evaluation of percutaneous drainage catheters: flow related to connections and liquid characteristics. Diagn Interv Imaging 2018; 99 (02) 99-104
  • 20 Buchanan GN, Sibbons P, Osborn M. , et al. Pilot study: fibrin sealant in anal fistula model. Dis Colon Rectum 2005; 48 (03) 532-539
  • 21 Avalos-González J, Portilla-deBuen E, Leal-Cortés CA. , et al. Reduction of the closure time of postoperative enterocutaneous fistulas with fibrin sealant. World J Gastroenterol 2010; 16 (22) 2793-2800
  • 22 Wu X, Ren J, Gu G. , et al. Autologous platelet rich fibrin glue for sealing of low-output enterocutaneous fistulas: an observational cohort study. Surgery 2014; 155 (03) 434-441
  • 23 Cambj Sapunar L, Sekovski B, Matić D, Tripković A, Grandić L, Družijanić N. Percutaneous embolization of persistent low-output enterocutaneous fistulas. Eur Radiol 2012; 22 (09) 1991-1997
  • 24 Gribovskaja-Rupp I, Melton GB. Enterocutaneous fistula: proven strategies and updates. Clin Colon Rectal Surg 2016; 29 (02) 130-137
  • 25 Chung W, Kazemi P, Ko D. , et al. Anal fistula plug and fibrin glue versus conventional treatment in repair of complex anal fistulas. Am J Surg 2009; 197 (05) 604-608
  • 26 Lyon JW, Hodde JP, Hucks D, Changkuon DI. First experience with the use of a collagen fistula plug to treat enterocutaneous fistulas. J Vasc Interv Radiol 2013; 24 (10) 1559-1565
  • 27 Crespo Vallejo E, Martinez-Galdamez M, Del Olmo Martínez L, Crespo Brunet E, Santos Martin E. Percutaneous treatment of a duodenocutaneous high-flow fistula using a new biological plug. Diagn Interv Radiol 2015; 21 (03) 247-251
  • 28 Wadhwa V, Leeper WR, Tamrazi A. Percutaneous BioOrganic sealing of duodenal fistulas: case report and review of biological sealants with potential use in interventional radiology. Cardiovasc Intervent Radiol 2015; 38 (04) 1036-1042
  • 29 Lisle DA, Hunter JC, Pollard CW, Borrowdale RC. Percutaneous gelfoam embolization of chronic enterocutaneous fistulas: report of three cases. Dis Colon Rectum 2007; 50 (02) 251-256
  • 30 Rábago LR, Ventosa N, Castro JL, Marco J, Herrera N, Gea F. Endoscopic treatment of postoperative fistulas resistant to conservative management using biological fibrin glue. Endoscopy 2002; 34 (08) 632-638
  • 31 Kang YJ, Oh JH, Yoon Y. , et al. Covered metallic stent placement in the treatment of postoperative fistula resistant to conservative management after Billroth I operation. Cardiovasc Intervent Radiol 2005; 28 (01) 90-92
  • 32 Limengka Y, Jeo WS. Spontaneous closure of multiple enterocutaneous fistula due to abdominal tuberculosis using negative pressure wound therapy: a case report. J Surg Case Rep 2018; 2018 (01) rjy001
  • 33 Musa N, Aquilino F, Panzera P, Martines G. Successful conservative treatment of enterocutaneous fistula with cyanoacrylate surgical sealant: case report. G Chir 2017; 38 (05) 256-259
  • 34 Srinivasa RN, Srinivasa RN, Gemmete JJ, Hage AN, Sherk W, Chick JFB. Laser ablation facilitates closure of chronic enterocutaneous fistulae. J Vasc Interv Radiol 2018; 29: 335-339
  • 35 Huang J-J, Ren J-A, Wang G-F. , et al. 3D-printed “fistula stent” designed for management of enterocutaneous fistula: an advanced strategy. World J Gastroenterol 2017; 23 (41) 7489-7494
  • 36 Ballard DH, Trace AP, Ali S. , et al. Clinical applications of 3D printing: primer for radiologists. Acad Radiol 2018; 25 (01) 52-65