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, inflammatory bowel disease, Crohn's disease or ulcerative colitis. An ECF may also develop from an abdominal injury or trauma, such as a stabbing or gunshot.

Patients with ECFs often experience complex problems requiring a team approach that includes surgeons, nurses, enterostomal therapists, social workers and nutritionists to customize a treatment plan.

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 Research & Clinical Trials


Reviewed by health care specialists at UCSF Medical Center.

Related Information

UCSF Clinics & Centers

Gastrointestinal Surgery at Parnassus
400 Parnassus Ave., Sixth Floor
San Francisco, CA 94143-0388
Phone: (415) 353-2161
Fax: (415) 353-2505
Appointment information