enterocutane

Enterocutane is a medical term used to describe the interface or communication between the intestinal tract and the skin. The concept is most commonly encountered in reference to enterocutaneous fistulas, abnormal passages that connect the lumen of the gut to the skin and allow intestinal contents to exit externally.

Etymology and scope: The term derives from Latin enteron (intestine) and cutis (skin). It denotes a connection between the gastrointestinal tract and the cutaneous surface, most often in the context of a fistula rather than a normal anatomical feature.

Clinical context: Enterocutaneous fistulas may arise after abdominal surgery, from inflammatory bowel disease such as Crohn’s disease, due to trauma, radiation, or infection. They can vary by location (small intestine or colon) and by output (low, moderate, or high), which influences management decisions and prognosis.

Diagnosis: Diagnosis is typically based on clinical examination of external drainage and imaging studies. CT scan with fistulography, MRI, or conventional fistulography can delineate the tract’s course, its connections to the bowel, and relationships to nearby structures, guiding treatment planning.

Management: Care is multidisciplinary. Initial priorities include stabilization, infection control, and drainage management, along with nutritional support (often specialized enteral or parenteral nutrition). Wound care and measures to protect skin are important. Many low-output fistulas close spontaneously with conservative care, especially when the underlying disease is controlled. High-output fistulas or persistent cases may require surgical intervention, such as repair or resection with restoration of continuity, after optimization of nutrition and infection control.

Prognosis: Outcomes depend on fistula output, duration, infection, and the underlying disease. Spontaneous closure is possible in suitable cases, but some fistulas require definitive surgical management. See also: enterocutaneous fistula.