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March 23, 1946

PRINCIPLES IN THE MANAGEMENT OF EXTERNAL FECAL FISTULAS

Author Affiliations

First Assistant in Surgery, Mayo Clinic Rochester, Minn.

From the Division of Surgery, Mayo Clinic.

JAMA. 1946;130(12):755-761. doi:10.1001/jama.1946.02870120001001
Abstract

Fecal fistulas are fairly frequently encountered by those engaged in the practice of surgery. Usually they arise as an unexpected and distressing complication of abdominal operations. Sometimes they heal spontaneously and all that is required of the surgeon is "masterly inactivity." The eradication of others, however, may be an extremely difficult task—one that will tax the skill of the most resourceful operator. There are certain well founded principles which may be used as a guide in the treatment of fecal fistulas and which may expedite the task of the physician and the recovery of the patient. To ignore these rules is often to invite poor results or disaster and, as many of them have not been clearly elucidated before, we will set them forth in the following paragraphs.

The few statistical deductions of this report are based on an analysis of data on 65 consecutive cases of persistent external fecal

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