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E

nte
rov
esi
calfis
tul
a(E
VF)r
epr
ese
ntsa
nabnor
malc
ommuni
ca on be
twe
ent
hei
nte
snea
nd t
hebl
adde
r.E
VFi
sa
c
ompl
i
ca onofi
nfla
mma
tor
yorne
opl
ascdi
sea
se,a
ndt
rauma cori
atr
oge
nici
nj
uri
es.Di
agnos
isofE
VFc
anbec
hal
l
eng
ing
a
ndi
so e
nde
lay
edf
ors
eve
ralmont
hsa e
rsy
mpt
omsbe
gin.E
VFi
sre
lav
elyr
arei
tca
use
ssi
gni
fica
ntmor
bidi
tya
ndma
y
ma
rke
dlya
ffec
tpa e
nt’
squa
li
tyofl
i
fe.

T
hiss
tudya
ime
dtode
ter
minet
hec
har
act
eri
scsofpa e
ntswi
the
nte
rov
esi
calfis
tul
ainUr
olog
y
De
par
tme
ntofDr
.Ha
sanS
adi
ki
nHos
pit
aldur
ingJ
anua
ry2015t
oDe
cembe
r2019.

T
heme
thodsoft
hisr
ese
arc
hwa
sconduc
tedbyc
ros
sse
cona
lre
tros
pecv
ede
scr
ipv
efr
om me
dic
alr
ecor
dst
atusof
pa e
ntswi
the
nte
rov
esi
cal
fist
ulat
hatt
rea
tedi
nur
olog
yde
par
temntofHa
sanS
adi
ki
nHos
pit
aldur
ingJ
anua
ry1st,
2015t
o
De
cembe
r31st,
2019

Dur
ingpe
riodJ
anua
ry2
015t
oDe
cembe
r20
19,t
her
ewe
re5
8ca
sesof
e
nte
rov
esi
cal
fist
ula
.Di
st
ri
bu onofa
gewa
sfr
om1
3to6
5ye
arsol
d,mos
tl
y
be
twe
en4
1and5
0ye
arsol
d(4
5%)
.Ma
ler
aowa
shi
ghe
rtha
nfe
mal
e.T
her
e
we
re4
5ca
ses(
77.
6%)ofr
ect
ove
sic
alfis
tul
a,1
1ca
ses(
19%)c
olov
esi
cal
fis
tul
a,a
nd2c
ase
s(3
.4%)
il
eov
esi
cal
fist
ula
. T
abl
e1-
Typeof
Ent
erov
esi
cal
Fis
tul
a
1
7 ,
3%
T
hemos
tfr
eque
ntl
yoc
cur
redi
nas
e ngof Di
vercul
is
68
,9%
ma
li
gna
ncy
,appr
oxi
mat
ely6
8.9
%. T
he Mali
gna
ncy
13,8%
mos
tcommon s
ympt
omsofE
VF we
re T
rauma/
I
atr
ogeni
c
pne
uma
tur
iaa
ndf
aec
alur
ia
,not
edi
n51
.7%
(
30)
and3
4.5
%(2
0)of
pae
ntsr
espe
cve
ly.
Eol
ogyof
Ent
erov
esi
cal
Fis
tul
a T
abl
e2-
Sympt
oms

T
hepr
edomi
nantor
gani
smof
uri
nec
ult
urewa
sEs
che
ric
iac
oli7
2,4
%.F
rom5
8ca
sesof
ent
erov
esi
cal
fist
ula
,29pae
nts(
50%)
wer
ema
lnut
rion
,
18pae
nts(
31.
1%)we
redi
abe
tesme
ll
it
usa
nd1
1pae
nts(
18.
9%)wi
thoutc
omor
bidi
ty
.Thema
nag
eme
ntwe
rec
yst
osc
opywi
thfis
tul
abi
ops
y,
r
epa
irfis
tul
a,a
ndur
ethr
alc
athe
terdr
ai
nag
enot
edi
n43
,1%,
29,
3%,
and1
5,5
%re
spe
cve
ly. 12,
1%
NoI
nte
rve
n on 2
9,3%
F
ist
ulaRe
pai
r
15
,5%
Uret
hral
Cat
hethe
r

43,
1%
Cys
tosc
opy+
Fi
st
ulaBi
ops
y

T
abl
e3-
Typeof
Mic
roor
gani
smi
nUr
ineCul
tur
e T
abl
e4-
Comor
bidi
ty Ma
nag
eme
ntof
Ent
erov
esi
cal
Fis
tul
a

E
VFi
sar
arec
ompl
i
caon,
butma
yde
vel
opi
npae
ntsf
oll
owi
ngbot
hma
li
gna
nta
ndbe
nig
ndi
sor
der
s.T
hedi
agnos
isofE
VFma
y,
howe
ver
,bec
hal
l
eng
ing
.Pne
uma
tur
iaa
ndf
eca
lur
iaa
sthemos
tsi
gni
fica
nts
ympt
oms
.Appr
opr
ia
tedi
agnosci
nve
sga
¬on,
and
pae
nts
’comor
bidi
tys
houl
dbeus
edt
oai
dcl
i
nic
iansi
nthee
arl
yre
cog
nionofE
VFa
nda
voi
danyde
layi
ntr
eat
ment
.Sur
gi
cal
i
nte
rve
n onof
thefis
tul
aisf
eas
ibl
eandr
ema
inst
het
rea
tme
ntof
choi
ce.

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