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What Causes Chronic Fistula?

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Posted on Mon, 14 Jul 2014
Question: Within 24 hrs of my 31 year old daughters colon resection due to a blockage, it literally came undone. She was in extreme pain and was crying out. Nurses were assuming she was a drug seeker and didnt respond to her pain. Stool started oozing from one of her laproscopic incisions. Her MD was called in and removed a staple, the stool ran down her side. He proceeded to get her ready for emergency surgery and I helped her up to the toilet. While washing her hands at the sink one of her incisions EXPLODED and forcefully projected brown stool covering the sink, the wall, the toilet and the floor. I whisked her back to bed where she eventually went back to surgery….. this was Oct. 2013…….. many attempts to correct the surgery have taken place including a failed iliostomy. She is suffering from repeated fistulas that break through to the skin. The 'wound managers' have to be changed 2 times a week at Mayo because of the extensive procedure. Some have been as long as 6 inches. She has been on TPN and lipids since late October. When in the ICU it was then discovered she had NO protein in her body! She was never given a blood test prior to surgery and was also on a steroid for her crohns flare up. Again, once she was diagnosed at 26 there was never a management program started, only treating flare ups with prednisone. My question is, are the chronic fistula problems from the crohns or from the fact her abdomen was filled with stool and there were so many pockets that were never flushed out? She's had many infections and cellulitus as well! What should we do, it's very hard to be confident with any decisions we've made! Should we agree with this renowned surgeon?
doctor
Answered by Dr. Ajit Naniksingh Kukreja (1 hour later)
Brief Answer:
Crohns is the culprit

Detailed Answer:
Hi

Thanks for writing in

It is really sad your daughter has passed through such a bad situation

It is crohns that is the culprit

Yes the patient should be managed regularly for the disease rather than treating her for flare up only

Also I presume the surgeon would never had got the chance to prepare her for the surgery properly as it would have been an emergency surgery

Adequate nutrition and supplements will play a major role in the management along with the would care

What is the future plan of the surgeon ?
DO get back to me with the blood reports that would have been done lately

Wishing your child a very speedy recovery
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Ajit Naniksingh Kukreja

Gastrointestinal Surgeon

Practicing since :1984

Answered : 925 Questions

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What Causes Chronic Fistula?

Brief Answer: Crohns is the culprit Detailed Answer: Hi Thanks for writing in It is really sad your daughter has passed through such a bad situation It is crohns that is the culprit Yes the patient should be managed regularly for the disease rather than treating her for flare up only Also I presume the surgeon would never had got the chance to prepare her for the surgery properly as it would have been an emergency surgery Adequate nutrition and supplements will play a major role in the management along with the would care What is the future plan of the surgeon ? DO get back to me with the blood reports that would have been done lately Wishing your child a very speedy recovery