what is the pathophysiology of enterocutaneous fistula?

Answer 1

Enterocutaneous fistulas most commonly develop as a postoperative complication of bowel surgery, though in 15% to 20% of cases fistulas occur spontaneously. Spontaneous fistulas may arise in patients with inflammatory bowel disease, radiation enteritis, diverticular disease, perforated duodenal ulcers, and pancreatic or gynecologic malignancies.[5] Crohn's disease is the most common primary bowel disease leading to enterocutaneous fistulas,[5] and surgical treatment may be difficult because additional enterocutaneous fistulas will develop in many of these patients postoperatively.
The vast majority of fistulas occur in the post-operative setting. Development is more frequent after emergency surgery when the patient preparation is poor or in the chronically debilitated, malnourished patient.[5] Causes include disruption of the anastomotic suture line, unintentional enterotomy, or inadvertent small bowel injury at the time of closure.[5] Careful planning and meticulous technique can certainly lessen the risk of postoperative fistula formation.