Complicated Enterocutaneous Fistula after Pancreaticoduodenal Trauma Surgery Responded Well to Non-Surgical Treatments: A Case Report.
Pham Van Nhan
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Case in brief
A 30-year-old man developed a complicated enterocutaneous fistula after four emergency operations for pancreaticoduodenal trauma. Despite serious complications, he was managed non-surgically for more than 7 months before jejunostomy closure. The approach combined infection control and nutritional support with other measures, including fistuloclysis and chyme reinfusion. The fistula was successfully managed without surgery during this period, and the jejunostomy was subsequently closed.
What made this case unusual
The complicated fistula responded to prolonged non-surgical management for more than 7 months, despite the report noting that surgery is generally considered when spontaneous closure has not occurred after 2–6 months.
Diagnostic / clinical pearl
In this case, coordinated infection control and nutritional support were central to prolonged non-surgical management; fistuloclysis and chyme reinfusion were also reported as beneficial.