ABSTRACT
This chapter describes the medical condition of fistula. A fistula is an abnormal connection between two hollow organs, or between a hollow organ and the surface of the body. Fistulae may form as a result of the malignancy itself eating into the tissues, after infection or following surgery or radiotherapy. Once it has formed, a fistula often fails to heal for the following reasons. A Silastic foam plug made from a cast of the fistula and retained by a simple dressing may reduce fluid loss in larger fistulae. A colostomy bag fitted over the opening may help to collect effluent when a fistula develops between the bowel and the abdominal wall. Octreotide administered by subcutaneous injection or syringe driver may help to reduce the volume of secretions from the fistula. A small fistula may be sealed temporarily with an oesophageal tube, but the usual outcome is aspiration pneumonia.
