Delayed enterocutaneous fistula after 17 years of gunshot wound injury: a case report

Ann Med Surg (Lond). 2023 Jun 5;85(8):4050-4052. doi: 10.1097/MS9.0000000000000886. eCollection 2023 Aug.

Abstract

Enterocutaneous fistula (ECF) is a common complication of abdominal surgery. Postoperatively, it may be the result of a small intestinal injury or an anastomosis leak, and it typically manifests days or weeks following surgery.

Case presentation: A 56-year-old man with a history of a gunshot wound injury in the abdomen with colon injury managed for colocolic anastomosis 17 years earlier presented to our hospital's general surgery clinic with the complaint of drainage at the scar area. It was discovered that he had an ECF. The patient underwent a laparotomy. Fistula tract excision and segmental colon resection with colocolic anastomosis were done.

Clinical discussion: ECF formation after an extraordinarily long latency due to an anastomotic leak, which has not been previously documented in the literature, is a distinctive aspect of the case. As a result, surgeons should consider ECF in their differentials for patients with a history of abdominal operations.

Conclusion: Surgical management is the definitive treatment of ECF after proper resuscitation and stabilization of the patient's condition. Preoperative imaging is crucial for determining the anatomy of the fistula and any associated intra-abdominal pathology.

Keywords: a case report; colocolic anastomosis; enterocutaneous fistula; gunshot.