Large enterocutaneous fistulas of the small intestine are rare and difficult to close, particularly if the fistula is associated with massive leakage of digestive juice and the residual intestinal tract is too short for anastomosis. We present a patient who underwent small bowel resection and secondary anastomosis following massive necrosis of the small intestine due to superior mesenteric artery thrombosis. After resection of an enterocutaneous fistula and reanastomosis, the residual small bowel was only 70 cm long with a persistent fistula. We successfully closed the fistula by employing a hinged rectus abdominis musculocutaneous flap. Here, we report our procedure for treating a large enterocutaneous fistula without performing laparotomy and bowel resection.
From the *Department of Plastic and Reconstructive Surgery and Maxillofacial Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
†Division of Microscopic and Developmental Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan
‡Department of Plastic and Reconstructive Surgery, National Kyushu Medical Center, Fukuoka-shi, Fukuoka, Japan.
Published online 5 June 2019.
Received for publication September 5, 2018; accepted March 18, 2019.
Disclosure: The authors have no financial interest to declare in relation to the content of this article.
Hideaki Rikimaru, MD, PhD, Department of Plastic and Reconstructive Surgery and Maxillofacial Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan, E-mail: Hi_rikimaru@yahoo.co.jp
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