Management of fistula of ileal conduit in open abdomen by intra-condoit negative pressure system

Abstract INTRODUCTION We aimed to present the management of a patient with fistula of ileal conduit in open abdomen by intra-condoid negative pressure in conjunction with VAC Therapy and dynamic wound closure system (ABRA). PRESENTATION OF CASE 65-Year old man with bladder cancer underwent radical c...

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Bibliographic Details
Published in:International journal of surgery case reports 2014-01, Vol.5 (7), p.385-388
Main Authors: Yetişir, Fahri, Salman, A. Ebru, Aygar, Muhittin, Yaylak, Faik, Aksoy, Mustafa, Yalçin, Abdussamet
Format: Article
Language:English
Subjects:
Dynamic closure
Entero atmospheric fistula
Ileal conduit
Negative pressure
Open abdomen
Surgery
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Summary:Abstract INTRODUCTION We aimed to present the management of a patient with fistula of ileal conduit in open abdomen by intra-condoid negative pressure in conjunction with VAC Therapy and dynamic wound closure system (ABRA). PRESENTATION OF CASE 65-Year old man with bladder cancer underwent radical cystectomy and ileal conduit operation. Fistula from uretero-ileostomy anastomosis and ileus occurred. The APACHE II score was 23, Mannheim peritoneal index score was 38 and Björck score was 3. The patient was referred to our clinic with ileus, open abdomen and fistula of ileal conduit. Patient was treated with intra-conduid negative pressure, abdominal VAC therapy and ABRA. DISCUSSION Management of urine fistula like EAF in the OA may be extremely challenging. Especially three different treatment modalities of EAF are established in recent literature. They are isolation of the enteric effluent from OA, sealing of EAF with fibrin glue or skin flep and resection of intestine including EAF and re-anastomosis. None of these systems were convenient to our case, since urinary fistula was deeply situated in this patient with generalized peritonitis and ileus. CONCLUSION Application of intra-conduid negative pressure in conjunction with VAC therapy and ABRA is life saving strategies to manage open abdomen with fistula of ileal conduit.
ISSN:2210-2612
2210-2612
DOI:10.1016/j.ijscr.2014.04.030