ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ ĐIỀU TRỊ PHẪU THUẬT RÒ TIÊU HÓA TỰ PHÁT (KHÔNG DO PHẪU THUẬT)

Abstract

Aim of study: 1) Evaluate the clinical and paraclinical characteristics of Spontanous gastro intestinal fistulas. 2) The treatment results of Spontanous gastro intestinal fistulas

Results: There were 21 , male 71,4%, female 28,6%, Mean age 59,60±15,03. Symptoms: pain in 81%; Fever 52,4%, Obstruction and Sub Obstruction in 61,9%. Panpable mass in 33,3%; Medium and low anemie in 23,8%. Elevated white cell counts > 10 G/L in 81%; Ctscan showed intra abdominal tumor in 33,3%; intra abdominal absceses in 42,9%. MRI revealed diffusse perineal abscess and anal fistulas in 19%; MRI showed subphrenic abscess and biloma in 4,8%. Gastroduodenalscopy showed duodeno colic operning hole and gastro- abscess opening hole. Pusculture possitive in 8 patients (6 Ecoli (+), 2 Klebsiella (+)). Hemoculture (+) (Ecoli)

Treatment: Intervention under ultrasound guide in 4,8%, Surgery in 95,2%. No death per and postoperation. Complication in 3 patients (14,3%). Pathology: Inflammatory gastrointestinal fistulas in 52,4% (Inflammatory, Diverticulitis, Tubeculosis, ischemic colitis, Crohn, anal fistula, Fournier’s, bile fistulas); Colorectal cancer in 38%, Inflammatory Myofibroblastic tumor in 4,8%.

Conclusion: The prevalence of spontanous gastrointestinal (GI) fistulas was lower than GI fistulas postoperation. The main reasons of spontanous gastrointestinal (GI) fistulas were inflammatory (Inflammatory, Diverticulitis, Tubeculosis, ischemic colitis, Crohn, anal fistula, Fournier’s, bile fistulas) in 52,4% or due to colorectal cancer in 38%; Due to Inflammatory Myofibroblastic tumor in 4,8%. Surgical treatment in 95,2%, Intervention under ultrasound in 4,8%.