Abstract

ALMEIDA VARELA, Ricardo et al. High output fistula. Rev Cubana Cir [online]. 2012, vol.51, n.2, pp. 187-200. ISSN 0034-7493.

A 37 years-old multi-traumatized male patient went to our emergency service. He had many injures in the thorax and the abdomen, together with symptoms and signs suggestive of multiple costal fractures, with right hemothorax and hemoperitoneum, all of which was confirmed by imaging techniques and by abdominal puncture. Minimal intermediate pleurostomy and exploratory laparoscopy were performed. We found hepatic lesions in the 6th, 5th, 8th and 4th segments, over 3 cm deep; additionally, the loss of serosa from the intestinal ansae and from the colon. Hepatorrhaphy and hepatic packing were also performed. Later on, more complications appeared, so he had to be re-operated more than 60 times. The occurrence of a high output fistula led him to malnutrition and his abdomen remained exposed for 7 months until he was finally discharged from hospital. This paper also presented a literature review on this topic.

Keywords : multitrauma; hepatic trauma; packing; exposed abdomen; Bogota's bag; intestinal fistula.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )