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Abstract : Enterocutaneous fistula management is challenging because of massive fluid loss that leads to severe dehydration and malnutrition, that consider being the major cause of morbidity and mortality. To describe the outcome of our experience in the management of enterocutaneous fistula (ECF) in Al Sader teaching hospital, Najaf, Iraq. Prospective descriptive study comprised 93 patients presenting with enterocutaneous fistula (ECF). We try to treat all patients conservatively primarily for 6-8 weeks, and surgical intervention that involves one-stage repair was only adopted when the fistula does not heal after this period. Enteral nutrition is used in the management. Patients in the high output fistula group received doses of octreotide 100 µg every 8 hours for a maximum of 7 days. There were 32(34.41%) female, and 61(65.599%) male patients. Only one patient presented with a spontaneous fistula the remaining fistula resulted as consequences of post-operative complications for different causes. The most common anatomical type was colonic fistula 46patients. There were 35(37.63%) patients who had high output fistula and 58(62.37%) with a low output. In 69(74.19%) patients their fistula closed spontaneously with conservative treatment with a mean duration of 10.32 weeks ranging from 2-20 weeks. In the remaining 24(25.81%) patients, the fistula was successfully closed with surgical intervention. Normal or low serum albumin does not affect the outcome. Haemoglobin <10gm/dl have a higher mortality rate and less spontaneous closure rate. Postoperative iatrogenic complication consider to be the main cause of ECF in almost all patients. The conservative treatment using enteral nutrition was effective in spontaneous closure. Octreotide did not affect the closure rate or mortality rate. Higher mortality rate found in patients with high output fistula.

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