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MOSHE SCHEIN, MD, FCS(SA)
Johannesburg, South Africa

Arch Surg. 1990;125(11):1516-1517.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—In the June 1989 issue of the ARCHIVES, Mastboom et al¹ described what they call "noniatrogenic" small-bowel perforations of "unknown or uncertain" cause, which developed in 14 patients treated by open treatment who underwent 3 to 17 laparotomies, and claim that the "occurrence of intestinal perforation during open treatment has not been described so far."

In fact, the article by Mastboom et al deals with a well-known and documented entity. Intestinal fistulas commonly develop in the frequently laparotomized abdomen due to the repeated mobilization and separation of bowel involved in the obliterative process. Commonly, the end result of repeated explorations is an abdominal-wall defect with multiple intestinal fistulas in its base. SitgesSerra et al² pointed out the poor prognosis of this entity, which in their experience carried a mortality rate of 60%. Levy et al³ reported 120 cases of "exposed" intestinal fistulas opening into . . . [Full Text PDF of this Article]

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