Enterocutaneous Fistula Treated Successfully with Musculocutaneous Flap—A Case Report—

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  • 筋皮弁移植により閉鎖した難治性腸管皮膚瘻の1例
  • 症例 筋皮弁移植により閉鎖した難治性腸管皮膚誉の1例
  • ショウレイ キン ヒベン イショク ニ ヨリ ヘイサ シタ ナンチセイ チョウカン ヒフ ヨ ノ 1レイ

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Abstract

We report a case of an intractable enterocutaneous fistula that was successfully treated with a fascial graft and musculocutaneous flap. An 85-year-old man who had undergone distal gastrectomy with Roux-en-Y repair for early gastric cancer was diagnosed with general peritonitis due to postoperative pancreatic fistula seven days after the operation. Emergency open drainage and enterostomy were performed. An enterocutaneous fistula, located on the jejunal limb, was noted at the site of the surgical incision, causing mucosal eversion. After re-peritonealization was observed, the fistula was closed, and the skin defect was covered with a fascial and skin graft. Oral intake was initiated on postoperative day (POD) 3. On POD 9, intestinal discharge was observed from the site of the surgical incision, with recurrence of the enterocutaneous fistula. A reoperation was performed following re-peritonealization. The fistula was closed again, and the skin defect covered with a musculocutaneous flap. On POD 27 after the re-operation, oral intake was re-started, and the fistula was noted to be cured.

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