Management of entero-atmospheric fistulas by chyme reinfusion: a retrospective study

Summary Background and aims High output entero-cutaneous fistulas may lead to intestinal failure with parenteral nutrition (PN) as the gold standard treatment to prevent dehydration and malnutrition. However in case of entero-atmospheric fistula (EAF) with the distal limb of the fistula accessible, chyme reinfusion (CR), a technique that restores artificially digestive continuity can be performed until the surgical repair. Our aim was to study the efficacy of CR in EAF regarding nutritional status, intestinal function, weaning PN and liver tests. Methods Retrospective study of 37 patients admitted for EAF and treated by CR from 1993 to 2017. Results Location of EAF: jejunum (28), ileum (9). The length of the upstream intestine was estimated in 21 patients: 19 had a bowel length 2N) decreased from 94 to 41% (p Conclusion When the efferent part of the small bowel is accessible, CR is a safe and inexpensive method that restores bowel function. In most cases, it makes it possible to stop PN and helps to improve the nutritional status until surgical reconstruction.