[Digestive fistulas in XXXX ].

@entity1 @entity295 @entity834 @entity548 @entity254 @entity292 @entity1017 @entity3147 @entity30
From 1977 up to 1983, 29 @entity1 were operated upon for @entity30 with digestive fistula (dead fistulae, ileocecal and contiguous ileoileal fistulae being excluded). The majority of the fistulae arose from the distal ileum (n = 22). After an average duration of the disease of 7 1/2 years, the @entity1 were admitted for surgical treatment, either electively (group I, n = 19), or in urgency (group II, n = 10). Eleven @entity1 exhibited some signs of @entity3147 , 13 needed a total parenteral nutrition for an average of 10 days; one @entity1 had to be operated upon in emergency ( @entity548 and @entity295 ); the others had a normal bowel preparation. The resection of the diseased bowel at the origin of the fistulae included right ileocolic resections (n = 25), left (n = 1) or total (n = 3) colectomies, with primary @entity254 in all but two cases. The "target bowel" was treated as conservatively as possible: limited small bowel resection, single suture of the gastric, duodenal or sigmoidal walls, and bladder drainage. A segmental resection of the sigmoid colon was realized in 5 cases where a single closure of the wall defect was impossible. There was no postoperative death, no septic complications, and no signs of @entity834 dehiscence. @entity292 recurrence "in situ" occurred only once. A spectacular health improvement, with a significant @entity1017 , was observed in 85% of the cases. Further outcome of the disease remains out of control.
