Gastrointestinal fistula with thigh extension and intractable pain

BMJ Support Palliat Care. 2022 Jul;12(e2):e178-e180. doi: 10.1136/bmjspcare-2018-001748. Epub 2019 Jun 14.

Abstract

Spontaneous enterocutaneous fistulae are a rare complication in patients with cancer, especially following irradiation, chemotherapy or cytoreductive operations. They are associated with worse prognosis, higher costs of treatment and impaired quality of life. Proper recognition of the problem and fast implementation of selective therapy including water electrolyte resuscitation, infection control, nutritional support, control of output volume, proper wound care and, ultimately, surgical treatment in selected patients may result in better symptom relief and improved quality of life of patients. We describe a case of a patient with advanced rectal cancer and acute pain in the lateral aspect of thigh caused by the presumptive presence of an enterocutaneous fistula, in whom therapy with antibiotics and surgical incision enabled rapid pain relief and comfort of dying.

Keywords: advanced cancer; enterocutaneous fistula; gastrointestinal fistula; management.

Publication types

  • Case Reports

MeSH terms

  • Humans
  • Intestinal Fistula* / complications
  • Intestinal Fistula* / surgery
  • Pain, Intractable*
  • Quality of Life
  • Thigh