A rare image of spontaneous enterocutaneous fistula in morbidly obese patient with metabolic syndrome
Ballah Akawu Denue, Salihu Aliyu Kwayabura
The Pan African Medical Journal. 2015;20:83. doi:10.11604/pamj.2015.20.83.5814

Create an account  |  Sign in
Case studies in Public health Supplement 2 Supplement
"Better health through knowledge sharing and information dissemination "

Images in medicine

A rare image of spontaneous enterocutaneous fistula in morbidly obese patient with metabolic syndrome

Cite this: The Pan African Medical Journal. 2015;20:83. doi:10.11604/pamj.2015.20.83.5814

Received: 24/11/2014 - Accepted: 22/12/2014 - Published: 29/01/2015

Key words: Spontaneous enterocutaneous fistula, morbid obesity, metabolic syndrome

© Ballah Akawu Denue et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.panafrican-med-journal.com/content/article/20/83/full

Corresponding author: Ballah Akawu Denue, Department of Medicine, University of Maiduguri Teaching Hospital, Bama Road, Maiduguri, Borno State, Nigeria (d_akawu@yahoo.co.uk)


A rare image of spontaneous enterocutaneous fistula in morbidly obese patient with metabolic syndrome

 

Ballah Akawu Denue1,&, Salihu Aliyu Kwayabura1

 

1Department of Medicine, University of Maiduguri Teaching Hospital, Bama Road, Maiduguri, Borno State, Nigeria

 

 

&Corresponding author
Ballah Akawu Denue, Department of Medicine, University of Maiduguri Teaching Hospital, Bama Road, Maiduguri, Borno State, Nigeria

 

 

Image in medicine

32 year old lady, a morbidly obese grand multipara developed spontaneous enterocutaneous fistula. Wound around right para-umblical region started as boil, it ruptured and started discharging purulent pus associated fever, colicky central abdominal pain, nausea and non projectile vomiting of recently ingested fluid. One week to presentation she started discharging feacal material from the wound site, she had intravenous ceftriazone 1gram twice daily and intravenous metronidazole 500 mg eight hourly for 5 days at referring hospital. On examination, she was morbidly obese (BMI = 45kg/m2), febrile, pale (Haematocrit = 9g/dl), anicteric, no pedal edema. She had elevated BP= BP = 170/80mmHg, E/U/Cr was normal, elevated uric acid was 9.0 mg (4.0 - 6.5)mg, Fasting lipid profile (Total Cholesterol 206 mmol/l, Triglyceride 157 mmol/l, HDL 39 mmol/l, LDL 172 mmol/l), Fasting blood glucose of [6.9mg/dl(2.5 - 6). Patient is a known dyspeptic and Diabetes mellitus. Spontaneous fistula is rare in clinical practice and often complicated by malnutrition, fluid and electrolyte imbalance, anemia and sepsis. The Triad of sepsis, malnutrition, and fluid/electrolytes disturbance is associated with high mortality. The index case presented with anemia and sepsis with no significant weight loss. In view of rarity of this presentation, an image of spontaneous enterocutaneous fistula with peri umblical sepsis in a young lady with metabolic syndrome is hereby presented.

 

 

Figure 1: spontaneous enterocutaneous fistula with periumblical sepsis in a lady with metabolic syndrome

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


The Pan African Medical Journal articles are archived on Pubmed Central. Access PAMJ archives on PMC here

Volume 28 (September - December 2017)

Article tools

Navigate this article

Rate this article

Altmetric

PAMJ is a member of the Committee on Publication Ethics
Next abstract

PAMJ is published in collaboration with the African Field Epidemiology Network (AFENET)
Currently tracked by: DOAJ, AIM, Google Scholar, AJOL, EBSCO, Scopus, Embase, IC, HINARI, Global Health, PubMed Central, PubMed/Medline, Ulrichsweb, More to come . Member of COPE.

ISSN: 1937-8688. © 2017 - Pan African Medical Journal. All rights reserved