Week 6 | Enterocutaneous Fistula Management (16171-SP)

Illustration of an ostomy bag in situ.

Content Outline

  • Clinical presentation 
  • Etiology: Postoperative vs Spontaneous 
  • Risk Factors 
  • Fistula Terminology 
  • Fistula Classification 
    • Simple or Complex 
    • Location 
    • Volume of output 
  • Enteroatmospheric Fistulas 
  • Principles of ECF management 
    • Recognition and stabilization 
    • Anatomic definition and decision 
    • Definitive operation  
  • Medical Management 
    • Spontaneous closure 
    • Factors that prevent spontaneous closure 
  • Surgical Management Options  
  • Nursing goals 
  • Comprehensive nursing assessment 
  • ​Treatment Decisions 
    • Skin protection 
    • Containment Devices 
      • Dressings 
      • Pouches 
      • Drains 
      • Negative pressure wound therapy 
  • Odor Control 

Objectives for Learning Outcomes

At the end of this course work the learner will be able to:

  1. Identify etiologic factors and indicators of enterocutaneous fistula development. 

  2. Describe the medical and surgical management of a patient with an 
    enterocutaneous fistula.

Additional Information

Course summary

Nancy Unger, MN, MPH, APN‐BC, RN‐BC, CWON
Wound Ostomy ARNP, Harborview Medical Center, Seattle, WA


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