Gastric and duodenal cutaneous fistulas

Forty‐seven patients, 18 with gastric and 29 with duodenal cutaneous fistulas, managed at the Cleveland Clinic Foundation between 1956 and 1976 are analyzed. This is done with the intention of defining factors responsible for increased rates of morbidity and mortality. The location and number, output, associated sepsis, and nutritional status are reviewed. Treatment modalities ranged from nonsurgical medical treatment to conservative surgical and radical surgical treatment. Overall mortality rate was 29.8% with a 34.5% mortality rate from duodenal fistulas and 22.2% from gastric fistulas. A review of the literature and guidelines for management of gastric and duodenocutaneous fistulas are presented.