Closure of enteroenteric or enterocolic fistula
CPT4 code
Name of the Procedure:
Closure of Enteroenteric or Enterocolic Fistula
Summary
The closure of enteroenteric or enterocolic fistula is a surgical procedure to correct an abnormal connection between two parts of the intestine or between the intestine and the colon. This procedure helps to restore normal digestive function and alleviate symptoms.
Purpose
The purpose of this surgery is to treat an abnormal passageway that causes the contents of one part of the intestine to pass into another part, leading to issues like infection, malnutrition, and severe discomfort. The main goals are to close the fistula, reduce symptoms, prevent further complications, and promote normal intestinal function.
Indications
- Persistent abdominal pain
- Recurrent infections or abscesses
- Unexplained weight loss
- Diarrhea or malabsorption
- Symptoms of malnutrition
- Presence of Crohn's disease or other inflammatory bowel diseases
Preparation
- Fasting 8-12 hours before surgery
- Bowel preparation, such as enemas or laxatives, as instructed
- Blood tests, imaging studies like CT scans or MRIs, and endoscopic evaluations
- Medication adjustments, including stopping certain drugs as advised
Procedure Description
- An incision is made in the abdomen to access the intestines.
- The fistula tract is carefully identified.
- The abnormal connection is surgically removed or sealed.
- Healthy sections of the intestine are reconnected (anastomosis).
- The incision is then closed with sutures or staples.
- Tools include surgical blades, retractors, and suturing materials.
- General anesthesia is typically used to ensure the patient is unconscious and pain-free.
Duration
The procedure generally takes 2-4 hours, depending on the complexity.
Setting
This surgery is performed in a hospital operating room.
Personnel
- Surgeons specialized in gastrointestinal surgery
- Anesthesiologists
- Surgical nurses
- Operating room technicians
Risks and Complications
- Infection
- Bleeding
- Injury to surrounding organs
- Anastomotic leak
- Bowel obstruction
- Adverse reactions to anesthesia
Benefits
- Relief from pain and discomfort
- Reduced risk of recurrent infections and abscesses
- Improved nutritional absorption and overall health
- Restoration of normal bowel function
- Benefits may be noticeable within a few days to weeks after recovery.
Recovery
- Hospital stay of several days for monitoring
- Gradual return to a normal diet, starting with liquids
- Instructions on wound care and activity restrictions
- Follow-up appointments for progress assessment
- Full recovery may take several weeks.
Alternatives
- Medical management with medications (e.g., antibiotics, anti-inflammatory drugs)
- Nutritional support and dietary modifications
- Minimally invasive procedures like endoscopic therapy
- Each alternative has its pros and cons, such as being less invasive but potentially less effective for severe cases.
Patient Experience
During the procedure, the patient will be under general anesthesia and feel no pain. Postoperatively, there may be some discomfort, managed with pain medications. It is normal to experience fatigue, mild pain at the incision site, and temporary changes in bowel habits. Full recovery and return to normal activities should be expected within a few weeks, with periodic follow-up to ensure healing.