What is Enteric-genital Fistula Inflammatory Genesis?
Fistulas of inflammatory genesis are quite common
Causes of Enteric-genital Fistula Inflammatory Genesis
In 75.8% of cases, they are formed as a result of perforation of a pelvic abscess or uterine appendages, which complicated purulent inflammatory diseases of the internal genitalia or previous operations, into the large intestine, bladder, through the anterior abdominal wall or into several organs at once.
Symptoms of Enteric-genital Fistula Inflammatory Genesis
Clinic of intestinal fistulas is determined by the severity and vastness of the purulent process, the stage of the inflammatory response. The most frequently observed are different in intensity pains in the lower abdomen, as well as an increase in body temperature up to 38 ° C and higher with occasional chills, tenesmus, pain in the lower abdomen radiating to the rectum, an abundance of mucus and pus in the feces, and diarrhea. These symptoms can be regarded as a threat of perforation of the pelvic abscess into the intestine. After the abscess breaks through into the hollow organ, the condition of the patients improves significantly, the temperature decreases, the pain decreases or disappears, the size of the formation in the small pelvis decreases by palpation. The abscess emptying during perforation is never complete, the fistulous opening is quickly obliterated, and purulent exudate builds up again in the abscess cavity, which leads to a new exacerbation of the disease. The clinical course of the disease is intermittent, recurrent. A short-term improvement in the condition of patients does not exclude, but confirms the need for surgical treatment.
Diagnosis of Enteric-genital Fistula Inflammatory Genesis
Diagnosis of intestinal genital fistula inflammatory Genesis is difficult, because these fistulas are located in the abdominal cavity and are not available for inspection. Diagnostic measures are aimed at determining the localization of a purulent process in the pelvis, the degree of intestinal involvement in the pathological process and the depth of tissue destruction, the anatomical and functional characteristics of a fistula that is being formed or formed.
Diagnostic methods include a two-handed rectovaginal examination, an ultrasound scan of abdominal and vaginal sensors, a colonoscopy, a rectoromanoscopy. Fistulography is performed for complex fistulas through the most accessible fistulous opening, which allows to determine the localization of the fistulous passage, branches and flows. Rather complete information about the localization and nature of the purulent process in the pelvis, the condition of the uterus and uterine appendages, the dynamics of the formation of intestinal genital fistulas gives computed tomography.
Treatment of Enteric-genital Fistula Inflammatory Genesis
Treatment of intestinal genital fistula inflammatory Genesis should only be surgical, including the “intestinal” and gynecological stages.
In case of genital fistulae of inflammatory genesis, the possibility of reconstructive organ-sparing operations is limited due to the extensiveness of purulent-destructive changes and a high risk of disease recurrence. It is advisable to perform a radical operation in the volume of extirpation of the uterus with adequate revision, rehabilitation and drainage of the abdominal cavity.
Prevention of Enteric-genital Fistula Inflammatory Genesis
Prevention of genital fistula – prevention of obstetric injuries, qualified and careful performance of all obstetric and gynecological operations. Prevention of intestinal genital fistulas of inflammatory etiology is the adequate treatment of chronic inflammatory diseases of the internal genital organs, preventing the development of a purulent process in the pelvis.