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Acute Management of Stoma-Related Colocutaneous Fistula by Temporary Placement of a Self-Expanding Plastic Stent

Department of Surgery, University Hospitals, Cleveland, Ohio

Brad Champagne, MD

Department of Surgery, University Hospitals, Cleveland, Ohio

Harry L. Reynolds, MD

Department of Surgery, University Hospitals, Cleveland, Ohio

Benjamin K. Poulose, MD

Department of Surgery, University Hospitals, Cleveland, Ohio

Jeffrey L. Ponsky, MD

Department of Surgery, University Hospitals, Cleveland, Ohio

Jeffrey M. Marks, MD

Department of Surgery, University Hospitals, Cleveland, Ohio, Jeffrey.marks{at}uhhospitals.org

Colocutaneous fistulas are frequently the result of complications related to previous operative procedures and are a major cause of morbidity. Most are initially treated conservatively, with a large percentage eventually requiring further surgery for definitive treatment. The use of a temporary colonic stent for the management of colostomy-related colocutaneous fistula has not been previously described. Two patients with colocutaneous fistula related to end colostomies and opening into midline laparotomy wounds were treated by temporary plastic stenting. A removable Polyflex silicone stent was inserted into the stoma. Stent redeployment was needed on several occasions following partial stent expulsion. Midline wound healing was achieved in both cases by 6 weeks post—stent insertion, and complete fistula closure occurred in 1 case. Temporary stent placement in certain cases may aid in the management of a colocutaneous fistula associated with a colostomy to allow fecal diversion from wounds and aid fistula closure.

Key Words: colocutaneous fistula • stent • sepsis • wound infection • colostomy

This version was published on September 1, 2009

Surgical Innovation, Vol. 16, No. 3, 270-273 (2009)
DOI: 10.1177/1553350609345851


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