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Enterocutaneous Fistula


An enterocutaneous fistula (ECF) is an abnormal connection that develops between the intestinal tract or stomach and the skin. As a result, contents of the stomach or intestines leak through to the skin.

Most ECFs occur after bowel surgery. Other causes include infection, perforated peptic ulcer and inflammatory bowel diseases such as Crohn's disease or ulcerative colitis. An ECF may also develop from an abdominal injury or trauma, such as a stabbing or gunshot.

Our approach to enterocutaneous fistula

UCSF offers state-of-the-art surgical repair and rehabilitation for patients with the most complicated abdominal conditions, including enterocutaneous fistulas. Depending on the patient's needs, the treatment team may include gastrointestinal surgeons, nutritionists, critical care specialists, plastic surgeons and infectious disease specialists, as well as nurses specializing in this disorder. Our experts work together to devise a treatment plan for each patient.

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Signs & symptoms

Enterocutaneous fistulas (ECFs) can cause contents of the intestines or stomach to leak through a wound or opening in the skin. It also can cause:

  • Dehydration
  • Diarrhea
  • Malnutrition


Your doctor will conduct a thorough physical exam and may prescribe the following tests to confirm a diagnosis of enterocutaneous fistula (ECF) :

  • Abdominal CT scan
  • Barium enema, if the fistula involves the colon
  • Barium swallow, also called an esophagram. This test is a series of X-rays of the esophagus. You drink a liquid containing barium, which coats the inside of your esophagus. The barium causes changes in the shape of the esophagus to show up on the X-rays.
  • Fistulogram, which involves injecting contrast dye into the opening of the skin of an ECF and taking X-rays.


If the enterocutaneous fistula (ECF) doesn't heal on its own after a few weeks or months, a complex surgery is required to close the fistula and reconnect the gastrointestinal tract.

Patients with ECFs often need specialized wound care, nutritional rehabilitation and physical rehabilitation.

In addition to surgeons, specialists in nursing, nutrition, intensive-care medicine, wound care, plastic surgery, pharmacology and infectious disease may be part of the treatment team.

At UCSF Medical Center, enterocutaneous fistulas are treated by specialists in the Complex Abdominal Surgery Program.

UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.

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