SIR 2024
Gastrointestinal Interventions
Kate Clancy, DO, MPH
Resident
University of Rochester
Financial relationships: Full list of relationships is listed on the CME information page.
David Lee, MD
Associate Professor Imaging Sciences
University of Rochester Medical Center Department of Radiology
Disclosure information not submitted.
Cantos J. Andrew, MD
Attending Physician / IR Residency Program Director
University of Rochester/Strong Memorial Hospital
Disclosure information not submitted.
1. Review background and classification of enterocutaneous fistula
2. Pictorial review of various enterocutaneous fistula closure techniques
3. Tips and tricks for challenging enterocutaneous fistula management
Background:
Enterocutaneous fistulas are a notoriously challenging entity to treat with many medical fields offering different treatment options ranging from nutritional support to GI to surgery to IR. Fistulas with shorter distances, narrow lumens, and low output have a better prognosis for spontaneous closure than others. However, other types such as high output enterocutaneous fistulas, are challenging to treat and can cause increased hospital stays, electrolyte imbalances, and have a negative impact on patient quality of life and mental health {1}. The interventional radiologist has multiple techniques at their disposal to treat fistulas. Radiographic and physical evaluation of a fistula is important prior to intervention.
Clinical Findings/Procedure Details:
This exhibit will start by reviewing the background of enterocutaneous fistula and different classification types. Next, using a pictorial review, the different types of enterocutaneous fistula will be reviewed. Finally, through a case series, we will outline techniques for safe and effective enterocutaneous fistula management, including catheter drainage, tract embolization with glue, plugs, extracellular matrix material, laser ablation {1,2}.
Conclusion and/or Teaching Points:
1. Enterocutaneous fistulas are challenging to manage and treat.
2. There are multiple interventions an interventional radiologist can offer.
3. Various tips and tricks for challenging non healing enterocutaneous fistula.