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Delayed enterocutaneous fistula formation secondary to an inverted non-absorbable suture post midline laparotomy closure
Yershov, Danylo Murphy, P. D. Ferguson, H.
Yershov, Danylo
Murphy, P. D.
Ferguson, H.
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Affiliation
South Warwickshire University NHS Foundation Trust
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Publication date
2020
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Abstract
Introduction: Enterocutaneous fistula is a well recognised complication of intra-abdominal surgery. Postoperatively, it may occur due to a small bowel injury or an anastomotic leak and usually presents within days or weeks after surgery.
Methods: We present a case report. Information was obtained through a retrospective review of the notes, clinic letters, images and the histology report.
Results: We present a case of a patient who developed an enterocutaneous fistula 34 years after panproctocolectomy for ulcerative colitis. Imaging was consistent with an enterocutaneous fistula arising from mid-small bowel. A laparotomy and small bowel resection was performed. The enterocutaneous fistula occurred due to an inverted non-absorbable suture post midline laparotomy closure.
Conclusion: Suture-related enterocutaneous fistula can be a rare delayed complication of a midline laparotomy closure when a knot is inverted intra-peritoneally. Consideration should be given to either leaving a knot in the subcutaneous fat tissue or feeding it between the rectus sheath and the suture bites.
Citation
Yershov D, Murphy P, Ferguson H. Delayed enterocutaneous fistula formation secondary to an inverted non-absorbable suture post midline laparotomy closure. Int J Surg Case Rep. 2020;72:402-405. doi: 10.1016/j.ijscr.2020.05.035. Epub 2020 Jun 1.
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Report