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A duodenal fistula is an abnormal opening between the duodenum and another organ or the skin, causing leaks and potential life-threatening effects. Surgery is the best treatment option, and antibiotic treatment and fluid and electrolyte replacement may also be used.
A fistula is an abnormal opening between two parts of the body. The duodenum is a portion of the small intestine and a fistula here can result from a variety of causes. Trauma to the area, development of cancer, or disease to the area can cause normally complete tissue openings, resulting in leaks and potentially life-threatening effects. A duodenal fistula can open into other organs, into the abdominal space, or even be a hole in the skin of the abdomen, exposing the organs to the outside environment.
The digestive system is made up of several parts. After food enters the stomach, it moves to the first part of the small intestine, which is the duodenum. Here, stomach acid mixed with food is neutralized, before moving to the rest of the small intestine for nutrient absorption. The entire digestive system is basically a tube, which moves food through the body without the food coming into contact with the rest of the body, other than broken down nutrients. It is lined with cells that keep the system flexible and protected against invading material such as bacteria, some of which are skin cells.
Epithelial cells are the same type of cells that make up the skin. A fistula is technically defined as a hole that brings two epithelial surfaces into contact with each other, and a duodenal fistula is therefore a hole in the duodenum that connects to another epithelial layer, such as a patient’s outer skin, or the epithelial layers of an organ. Wherever the duodenal fistula connects, there is a medical problem, as the normal movement of food and gastric products through the small intestine is impeded.
In addition to reducing the normal movement of products through the intestines, products have properties that are hazardous to health. Stomach juices mixed with food are very acidic and this can cause damage to the tissue with which the fistula connects. Even areas of the body that are not usually exposed to material such as semi-digested food can suffer from problems and the functioning of affected organs can deteriorate. A healthy, uninterrupted digestive system also prevents non-sterile food from entering the body, and duodenal fistula can expose body tissues to pathogens, thus leading to infections.
Surgery is generally the best treatment option for someone with a duodenal fistula. Ironically, surgery for unrelated issues is a significant cause of this type of fistula. Antibiotic treatment and fluid and electrolyte replacement may also be employed to help the patient recover.
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