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April 1964

Gastroenteric Cutaneous Fistula: Tract Occlusion for Treatment

Arch Surg. 1964;88(4):540-546. doi:10.1001/archsurg.1964.01310220030006

When one encounters an opening through which there is loss of fluid and valuable minerals, the natural inclination is to place a plug into it. Consequently, it is not surprising that some of the earliest attempts to treat gastroenteric fistulas utilized this principle. According to Ochsner, Reyband advocated insertion of wood or ivory plates into the fistulous opening as early as 1827, and in 1842 Kleybolte described two leather discs connected by a thread which were used for this purpose.4 During the ensuing 100 years, plugging of the external opening of an enteric fistula was advocated from time to time. The plugs were made of various materials including ordinary gauze packing, wet cotton, iodoform gauze, and substances such as chewing gum which could be readily molded to fit the opening.1,2 Some authors have reported the use of equipment made specifically for this purpose. Stone in 1941 described a