A clinical review is made on 48 cases of external intestinal fistula which have been treated at the
Department of General Surgery, Taegu Military Hospital from April 1967 to April 1971.
External intestinal fistulas represent abnormal communication from some part of the gastrointestinal
tract to the skin. They have external drainage of gastric and enteric contents over 48 hours and per
sisted over 4 weeks after withdrawal of the artificial tubes. In this paper, however, pancreatic and bil
iary fistulas as well as congenital and internal intestinal fistulas were excluded.
From this study, the authors have been able to summarize as follows:
1. The incidence of this study was 2.7% (29 cases) of 1,056 laparotomised patients. In remainder
19 cases, initial operation was performed elsewhere.
2. The age and sex distribution was not available because most cases of this report were young male.
3. Origination of internal opening arised from small bowel was 25 cases(52.1%, form large bowel
19 cases (39.6%), and from stomach 4 cases (8.3%). Of these small bowel cases, ileum (19 cases,
39.6%) was the most frequent site and then next was cecum (12 cases, 25%).
4. Inflammation (23 cases, 47.9%) and surgical complication (18 cases, 37.5) were implicated as
the most important etiologic factors.
5. Trauma (11 cases, 23%), typhoid fever and appendicitis (each 10 cases, 21%) were implicated
as common diseases which was followed by fisrula after operation.
6. Latent duration of fistula after the previous operation was 6∼10 dats in the majority (31 cases,
54.6%).
7. The most frequent complication of intestinal fistula was infection (18 cases, 37.5%) and then
next malnutrition(14 cases, 29%), dermatitis(13 cases, 27.3%) generalized peritonitis(8 cases, 16.6%),
intraabdominal abscess(6 cases, 12.7%), fluid and electrolyte imbalance and intestinal obstruction
(each 5 cases, 10.5%) in decreasing order.
8. Twenty patients were treated by conservatively and twenty-eight by surgery. The over-all cure
rate of this study was 77.1% (37 cases).
9. The over-all mortlaity and recurrent rate were 14.6%(7 cases) and 8.3%(4 cases). Mortality
rate of the patient treated conservatively was 25%(5 cases) and of those treated surgically was 7.1%
(2 cases).
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