Colon Fistula: A Conditioning Treatment
DOI:
https://doi.org/10.14738/bjhr.1206.19522Keywords:
Fistula, Colon fistula, Diverticulitis, Fecal transplant, CT scanAbstract
Introduction: colon or rectal fistula is a medical/surgical challenge that, with precedents and resilience, is presented as a complication of another real cause and fistula is defined as the path in abnormal communication between one epithelium and another. Objective: to present the experience of seven years in diagnosis and treatment in four hospitals in Mexico City. Method: this is a study with a multicenter, retrospective, longitudinal, observational and descriptive design. In the Colon and Rectal Surgery services, as well as General Surgery of the second and third level of health care. Results: from 118 records, a total of 46 patients with colon fistula were chosen, of which 17 were male (36.95 %) and 29 were female (63.04 %). With an age range of 21 to 82 years, with an average of 61 years and a bimodal value of 33 and 64 years. Its etiology was diverse, but its presentation was documented as entero-cutaneous, entero-bladder, entero-vaginal, entero-uterine, entero-enteric fistulas. Discussion: the diagnosis of colon fistula is made with a complete medical history, which is mostly clinically evident with the classic triad. The gold standard for confirming a diagnosis of acute diverticulitis and evaluating complications is CT scan with contrast of the abdomen; the treatment alternatives for colon fistulas to another organ varies according to the case, the clinical conditions and/or their prognosis of cure according to the Chapman and Sheldon stages; successful conservative management or treatment in hemodynamically stable patients, offering less invasive alternatives in selected clinical scenarios, or even fecal transplants in patients with complicated diverticulitis; however, surgical intervention remains the definitive treatment for symptomatic or complicated fistulas. Conclusions: regarding the treatment of colon fistulas, this will be conditioned according to each patient, by the hemodynamic conditions, the etiology, the characteristics of nutrition/infection and of course the surgeon's expertise, as well as the infrastructure of the installed capacity that is available.
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Copyright (c) 2025 Carlos Alberto Martínez Cordero, Astrid Ortiz Vargas, Dan Jeerebai Castro Solórzano, Mariana González Valiente, Samuel Abraham Gómez Acevedo, Adolfo García Ramírez, Katia Berenice Pineda Miranda, Max Cristopher Rodriguez Castillo, Elsa Nalleli Romero Guzmán, Morelos Adolfo García Sánchez
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