Background/Objectives: Crohn's disease is a chronic inflammatory condition with periods of exacerbation and remission that can involve any part of the gastrointestinal tract. The basic intestinal manifestation is frequently accompanied by extraintestinal involvement and may lead to complications such as perforations, fistulas and abscesses. Despite Crohn's disease being the most common reason of intestinal perforation, the other causes should be considered as well. Internalization of a foreign body, although rare, may still occur, especially in the pediatric population. Methods: The following case report presents the medical history of an 11-year-old patient who developed an enterocutaneous fistula two years after the diagnosis of Crohn's disease. Data analysis was carried out on the basis of patient medical records. Results: The fistula formed in the course of biological treatment during a period free of other symptoms indicating disease exacerbation. The imaging tests revealed the presence of a foreign body in the gastrointestinal tract, which could have been a potential cause of the observed inflammation that resulted in the development of the fistula. Conclusions: The presented case report as well as the literature indicate a correlation between the formation of intestinal fistulas and an active disease process. However, in the absence of symptoms of Crohn's disease exacerbation, other causes should be considered.

Enterocutaneous (EC) fistula incidence has been increasing in China, along with increases in the volume and complexity of surgeries. The conservative treatment strategy has been analyzed to improve the treatment outcomes for patients with EC fistulas and reduce the need for reoperation.

To analyze the clinical data of patients undergoing conservative treatment for EC fistulas and identify the factors that promote self-healing. These findings provide a reference for improving the clinical cure rate of EC fistulas with conservative treatment.

The clinical data of 91 patients with EC fistulas who underwent conservative treatment were collected. The relationships between the cure rate and characteristics such as age, sex, body mass index, albumin level, primary disease, cause of the fistula, location of the fistula, number of fistulas, nature of the fistula, infection status, diagnostic methods, nutritional support methods, somatostatin therapy, growth hormone therapy, and fibrin glue therapy were analyzed.

A comparison of the basic patient characteristics between the two groups revealed statistically significant differences in primary disease (P = 0.044), location of the fistula (P = 0.006), number of fistulas (P = 0.007), and use of adhesive sealing (χ 2 = 12.194, P < 0.001) between the uncured and cured groups. The use of fibrin glue was a significant factor associated with a cure for fistulas (odds ratio = 5.459, 95%CI: 1.958-15.219, P = 0.01).

The cure rate of patients with a single EC fistula can be effectively improved via conservative treatment combined with the use of biological fibrin glue to seal the fistula.

To describe the intervention of fistuloclysis in enteroatmospheric fistulas.

This is a descriptive case report constructed according to the Consensus-based Clinical Case Reporting Guideline Development, carried out with a male patient in a medium-sized philanthropic hospital in a city in Minas Gerais, Brazil. The study was previously approved by a Research Ethics Committee.

T: Patient with a history of radical prostatectomy and elective cholecystectomy, with progression of colon ischemic necrosis, which required left colectomy and Hartmann colostomy, developed spontaneous enteroatmospheric fistulas and was on enteral nutrition for nine months. Due to complications, fistuloclysis was initiated, which resulted in significant nutritional improvement.

The description of the procedure and care allows its reproduction in a safe manner for effluent control, nutritional restoration, and other clinical responses. The care provided by the stomatherapy nurse stands out, taking into account the benefits, complexity, and challenges of fistuloclysis.

There is one reported case of a pancreatoduodenal fistula that was managed using combined coil embolization and fibrin glue after the failure of other methods. Herein, we document this case to highlight the value of coil embolization and fibrin glue as surgical alternatives for fistula treatment. We present a case of a 39-year-old female patient who has a known case of Crohn's disease (CD) and presented with an enterocutaneous fistula (ECF) after her most recent surgery. With the failure of conservative approaches and as she refused any surgical interventions, fibrin glue injection and coiling were used. As a conclusion, embolization may work well as a surgical management alternative due to its simplicity.

Radiation enteritis poses a treatment challenge for patients undergoing or completing radiation therapy. A significant issue has been the patient's and surgeon's lack of awareness of the condition and the radiotherapy or associated surgical treatments. A 66-year-old female presented with acute onset of diffuse abdominal pain and peritonitis for one day, status post radiation therapy following a diagnosis of cervical cancer. A review of systems was positive for diffuse sweating, chills, and nausea. The patient was diagnosed with an entero-colonic fistula with mesenteric edema. An entero-colonic fistula due to radiation enterocolitis is a rare but important complication that can occur after radiation therapy for abdominal or pelvic malignancies. With any patient who has a history of abdominal or pelvic cancer and has received radiotherapy and shows up with acute abdomen, bowel perforation should be considered in the differential diagnosis with the possible management of acute complications.

Anastomotic leakage (AL) is the most severe and devastating complication of colorectal surgery. The objectives of this study were to identify the risk factors involved in the development of AL, evaluate diagnostic methods and explore therapeutic options in case of colorectal cancer surgery.

we conducted a retrospective study on 28 AL recorded after 315 elective colorectal cancer surgeries performed in 1st Surgery Clinic of Craiova over an 8-year period (2014-2022).

The overall incidence of AL was 8.88%. The identified risk factors were rectal cancer (22.38%), low anterior rectal resection (50%), open approach, advanced age (82.15% over 60 years old), male sex (3:1), and the presence of two or more co-morbidities. Medical conservative treatment was the primary line of treatment in all cases. Leakage closure was achieved in 22 cases (78.56%), with exclusive conservative treatment in 15 cases (46.42%) and combined conservative and surgical treatment in 7 cases (25.0%). Overall morbidity was recorded at 64.28%, with 8 cases of general evolving complications and 10 cases of local complications. General mortality was reported at 6 (21.42%), with 3 (16.66%) occurring after conservative treatment and 3 after re-interventions (30%).

our study identified advanced age, the presence of two or more co-morbidities, male sex, rectal surgery, and neoadjuvant chemoradiation as the most important risk factors for AL. Medical conservative treatment was the primary treatment modality, while reoperation was necessary in cases of uncontrollable sepsis and MODS. Mortality after re-intervention was nearly double compared to conservative treatment.

A man in his early 20s with heart failure with reduced ejection fraction secondary to non-compaction cardiomyopathy (Titin (TTN) gene mutation positive) was transitioned from left ventricular assist device (LVAD) mechanical support to heart transplantation. Transplantation was successful; however, LVAD explantation resulted in innumerable complications secondary to penetration of the driveline into the peritoneal cavity. He developed an enterocutaneous fistula which led to concurrent malnutrition, poor wound healing, systemic infection, and allograft rejection in a patient less than 1 month after heart transplantation on immunosuppression.

In recent years, the incidence of Crohn's disease (CD) in the Asia-Pacific region is gradually increasing, and the onset age is decreased at the same time. The relapse of illness and long course of disease easily lead to malnutrition, which will affect the treatment effect of the disease and even worsen the disease. Therefore, it is very important to find the risk factors affecting the nutritional status of children with CD and to carry out effective nursing intervention accordingly. In our study, a total of 180 children with CD who were admitted to our hospital from April 2017 to April 2020 were analyzed retrospectively. The multivariate analysis showed that Pediatric Crohn's Disease Activity Index (PCDAI), platelet (PLT), hemoglobin (HB), hematocrit (HCT), and albumin (ALB) were independent risk factors affecting the nutritional status of children with CD. The results of AUC showed that combined monitoring of the PCDAI score and the expression of PLT, HB, HCT, and ALB indexes was of great value to evaluate the nutritional status of children with CD. Finally, a series of nursing intervention measures were proposed based on these results. It provides a theoretical basis for improving the nutritional status of children with CD and promoting the clinical outcome.