Enterocutaneous fistula: A complication of posterior iliac bone graft harvesting not previously described
Enterocutaneous fistula: A complication of posterior iliac bone graft harvesting not previously described
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DOI：
10.1007/s007010050219
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发表时间：
1998-01-01
影响因子：
2.4
通讯作者：
Mutlu, F
中科院分区：
文献类型：
--
作者：
Dosoglu, M;Orakdogen, M;Mutlu, F
一例肠外瘘在供区介绍。1例患者因退行性C-5-C-6脊椎滑脱接受后路Cs-Cs钢丝融合术，自体植骨取自后上级髂嵴。在采集过程中，骨凿尖端向前滑动，但未观察到神经血管或腹膜损伤。术后第12天，观察到供体部位有成形粪便溢出。瘘管造影显示肠外瘘至降结肠。瘘管在一周内自行闭合，而骨收获后发生肠外瘘管的病例，至今尚未有文献报告。先天性畸形和后天原因可能会造成脆弱的腹膜区。小肠或降结肠可能与腹膜关系密切，甚至在局部腹膜炎时与腹膜粘连。此区域的小病变可能在瘘的发生中起作用，并且可能出现低流量的假瘘道。热损伤和可能的缺血性坏死，由于烧灼可能是诱发因素，在这种瘘的病因。无异物和自发性闭合均与感染源有关。本报告的目的是介绍和分析这种以前没有描述过的并发症的原因。
A case of enterocutaneous fistula at the donor site is presented. A patient underwent posterior Cs-Cs wire fusion with autologous bone graft taken from the posterior superior iliac crest for degenerative C-5-C-6 spondylolisthesis. The tip of the osteotome slipped anteriorly during the procurement but neither neurovascular nor peritoneal injury were observed. Spillage of formed faecal material was observed from the donor site on the 12(th) postoperative day. Fistulogram showed an enterocutaneous fistula to descending colon. The fistula closed spontaneously in a week.Enterocutaneous fistula after bone harvesting has never been reported in the literature as far as we know. Congenital malformations and acquired causes may create a vulnerable peritoneal area. Small bowel or descending colon may show a close relationship or even an adhesion to peritoneum in the presence of local peritonitis. A small lesion in this area may play a role in the occurrence of a fistula, and a low flow pseudofistulous tract may appear. The thermal injury and possible ischaemic necrosis due to cauterisation may be predisposing factors in the aetiology of this kind of fistula. The lack of foreign material and spontaneous closure were against an infectious origin. The aims of this report are to present and analyse the reasons of this complication, not previously described.