Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 14, 2019; 25(14): 1775-1782
Published online Apr 14, 2019. doi: 10.3748/wjg.v25.i14.1775
Application of a 3D-printed ”fistula stent” in plugging enteroatmospheric fistula with open abdomen: A case report
Zi-Yan Xu, Hua-Jian Ren, Jin-Jian Huang, Zong-An Li, Jian-An Ren
Zi-Yan Xu, Hua-Jian Ren, Jin-Jian Huang, Jian-An Ren, Research Institute of General Surgery, Jinling Hospital, Nanjing 210002, Jiangsu Province, China
Zi-Yan Xu, School of Medicine, Nanjing University, Nanjing 210008, Jiangsu Province, China
Zong-An Li, NARI School of Electrical and Automation Engineering, Nanjing Normal University, Nanjing 210042, Jiangsu Province, China
Author contributions: Xu ZY, Ren HJ, and Ren JA designed this report; Ren HJ and Huang JJ implanted the fistula stent; Xu ZY and Li ZA fabricated this 3D-printed fistula stent; Xu ZY and Ren HJ followed the patient and recorded his medical information; Xu ZY wrote the paper; Xu ZY and Ren HJ contributed equally to this paper.
Informed consent statement: Written informed consent was obtained from the patient.
Conflict-of-interest statement: We declared no potential conflicts of interest with respect to the research, authorship, and publication of this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the guidelines of the CARE Checklist (2016) have been adopted.
Corresponding author: Jian-An Ren, MD, FACS, PhD, Chief Doctor, Professor, Surgeon, Research Institute of General Surgery, Jinling Hospital, 305 East Zhongshan Road, Nanjing 210002, Jiangsu Province, China. jiananr@gmail.com
Telephone: +86-13605169808 Fax: +86-25-80860376
Received: February 17, 2019
Peer-review started: February 18, 2019
First decision: February 26, 2019
Revised: March 7, 2019
Accepted: March 16, 2019
Article in press: March 16, 2019
Published online: April 14, 2019
Abstract
BACKGROUND

Open abdomen (OA) has been generally accepted for its magnificent superiority and effectiveness in patients with severe trauma, severe intra-abdominal infection, and abdominal compartment syndrome. In the meantime, OA calls for a mass of nursing and the subsequent enteroatomospheric fistula (EAF), which is one of the most common complications of OA therapy, remains a thorny challenge.

CASE SUMMARY

Our team applied thermoplastic polyurethane as a befitting material for producing a 3D-printed “fistula stent” in the management of an EAF patient, who was initially admitted to local hospital because of abdominal pain and distension and diagnosed with bowel obstruction. After a series of operations and OA therapy, the patient developed an EAF.

CONCLUSION

Application of this novel “fistula stent” resulted in a drastic reduction in the amount of lost enteric effluent and greatly accelerated rehabilitation processes.

Keywords: 3D printing, Enteroatmospheric fistula, Open abdomen, Isolation technique, Case report

Core tip: Few methods can be utilized to control enteroatomospheric fistulas (EAFs) which are unlikely to achieve spontaneous closure. The 3D-printed “fistula stent” presented here can be implanted to close EAF in the early stage of open abdomen. We think that this report could start the train of thought for plugging EAF to reduce the lost enteric effluent as well as avoid water electrolyte imbalance, corrosion on the wound surface, and intra-abdominal infection.