Chapter 46: Fistulas

Question 1

What is a fistula?

Answer 1

Abnormal communication between two hollow organs or a hollow organ and the skin (i.e., two epithelial cell layers)

Question 2

What are the predisposing factors and conditions that maintain
patency of a fistula?

Answer 2

• *The acronym “HIS FRIEND”:**
• *H**igh output fistula (>500 cc/day)
• *I**ntestinal destruction (>50% of circumference)
• *S**hort-segment fistula <2.5 cm
• *F**oreign body (e.g., G-tube)
• *R**adiation
• *I**nfection
• *E**pithelialization (e.g., colostomy)
• *N**eoplasm
• *D**istal obstruction