Management of digestive tract fistulas. A review.

摘要: Digestive tract fistulas are a complex subject in terms both of classification and management. There is still lack firm epidemiological data regarding the their incidence, though prognostic factors conditioning prognosis these patients now well known. They related mainly to nutritional status presence or otherwise sepsis. Instrumental investigations should be aimed not merely at identifying complication, but also guiding clinicians choice therapeutic According various situations arising, treatment will surgical, endoscopic conservative medical. In latter case, clinician establish first all whether, as result site fistula status, patient requires total parenteral enteral artificial nutrition, whenever possible. those cases which nutrition indicated, ideal drug with best proven ability shorten healing times reduce number complications when used combination naturally occurring somatostatin dose 250 micrograms/h over 24 h. other cases, if clinically important, its synthetic analogue, octreotide, can administered subcutaneously. The amount octreotide ranges from 300 600 micrograms/day 3 4 daily doses.