Innovative management of enterocutaneous fistula in a resource-limited setting: a case report

Abstract

This report describes the innovative management of a patient with an open abdomen and high-output enterocutaneous fistula, secondary to multiple reinterventions for intestinal obstruction and jejunal perforation. In a resource-limited setting, a temporary intestinal bypass was implemented using a pediatric corrugated tube, covered with sterile condoms, as a bridge between everted bowel loops, allowing the physiological flow of bile. The patient showed favorable clinical progress, including nutritional recovery, correction of electrolyte imbalances, and subsequent intestinal reconstruction with definitive anastomosis. This case highlights that context-adapted solutions can be both effective and safe when applied with sound clinical judgment.