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Case report
Gastrointestinal fistula with thigh extension and intractable pain
  1. Ewa Deskur-Śmielecka1,2,
  2. Mateusz Sopata3,
  3. Michal Chojnicki4 and
  4. Maciej Sopata1,2
  1. 1 Chair and Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland
  2. 2 Palliative Medicine Unit, University Hospital of Lord’s Transfiguration, Poznan, Poland
  3. 3 Faculty of Mechanical Engineering and Management, Institute of Materials Engineering, Poznan University of Technology, Poznan, Poland
  4. 4 Department of Biology and Environmental Protection, Poznan University of Medical Sciences, Poznan, Poland
  1. Correspondence to Dr Ewa Deskur-Śmielecka, Chair and Department of Palliative Medicine, Poznan University of Medical Sciences, Poznań 61-701, Poland; edeskur{at}ump.edu.pl

Abstract

Spontaneous enterocutaneous fistulae are a rare complication in patients with cancer, especially following irradiation, chemotherapy or cytoreductive operations. They are associated with worse prognosis, higher costs of treatment and impaired quality of life. Proper recognition of the problem and fast implementation of selective therapy including water electrolyte resuscitation, infection control, nutritional support, control of output volume, proper wound care and, ultimately, surgical treatment in selected patients may result in better symptom relief and improved quality of life of patients. We describe a case of a patient with advanced rectal cancer and acute pain in the lateral aspect of thigh caused by the presumptive presence of an enterocutaneous fistula, in whom therapy with antibiotics and surgical incision enabled rapid pain relief and comfort of dying.

  • enterocutaneous fistula
  • gastrointestinal fistula
  • advanced cancer
  • management

https://doi.org/10.1136/bmjspcare-2018-001748

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    Footnotes

    • Contributors EDŚ revised the literature and is the main contributor in conception and writing of the manuscript. MatS and MC substantially contributed in writing the manuscript. MacS was involved in revising the manuscript critically for important intellectual content, and gave final approval of the version to be published. All authors read and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.