INTESTINAL FISTULAS: HISTORY AND VARIANTS OF CLASSIFICATIONS

Abstract

Enterocutaneous fistulas (ECF) are the most serious postoperative complication of various surgical interventions in abdominal surgery, which pose a threat to the life of the patient. Treatment of patients with ECF is associated with the frequent development of life-threatening complications, such as sepsis and septic shock, intestinal failure, severe water-electrolyte disorders, which causes high mortality rates both according to local authors 35-75%, and according to foreign colleagues 6%-33%. This question is especially relevant in cases of enteroatmospheric fistulas, as well as with high ECF with losses of intestinal contents more than 500 ml per day. In the absence of correct conservative therapy, this quickly leads to the progression of sepsis and the development of multi-organ failure. Surgery performed during this period of time without complex pre-op interview can be fatal and lead to a aggravation of symptoms and death of the patient in the early postoperative period. Each patient requires an individual approach, however, there are general principles of treatment. This review describes the main historical aspects of the formation of medical tactics and the classification of intestinal fistulas.