Management of Enterocutaneous Fistula: A Plea to Make Haste Slowly

Initial management of enterocutaneous fistulae should be non-surgical. We have, however, observed that in many of our referred cases, immediate surgical correction had been attempted before the referral. More often than not, however, this was to no avail inspite of the complicated nature of the problem, many of these cases were successfully managed conservatively. Surgical intervention became inevitable when there was an obvious failure of conservative management. Five cases have been presented in order to illustrate the importance of this line of management. Also discussed are the essential points in the conservative management of enterocutaenous fistulae. Immediate operation should be reserved only for patients with haemorrhage or intra abdominal abscess with uncontrolled sepsis. There should not necessarily be a time frame in relation to when to abandon conservative management. One should be strictly guided by the clinical progress. Nigerian Medical Practitioner Vol. 45 No 4, 2004.(49-51