Cure8 research brief
Patients with enterovesical fistulas and ileal pouches may face unique aspiration and airway risks during procedures that use continuous irrigation; recognizing this pathway could change monitoring and airway/drainage choices during surgery.
Surgeons, anesthetists, urologists, clinicians managing pouch/ostomy patients, and patients with ileal pouches or enterovesical fistulas.
This case report describes a patient with a chronic enterovesical fistula after restorative proctocolectomy with an ileal J-pouch and loop ileostomy who experienced intraoperative regurgitation of irrigation fluid into the oropharynx during cystolithotripsy.
The authors propose that irrigation fluid tracked retrograde from the bladder through the fistula into the ileal pouch and small bowel, distending the ileostomy and leading to regurgitation despite a supraglottic airway.
Key practical points highlighted by the report are: treat urinary–gastrointestinal fistulas as independent aspiration risks during procedures with continuous irrigation; use gastric-channel drainage when a supraglottic airway is in place; and monitor irrigation input, irrigation return, stomal output, and core temperature during such procedures.
The report did not find evidence of aspiration on imaging or blood gases and the patient recovered and was discharged on postoperative day 7.
Single-case report; structured content is based on the article abstract and not on broader evidence. The proposed mechanism is plausible but not proven as a common occurrence.
Review the original publication for the complete reporting, methods, and context.
This Cure8 brief is based on source text from the linked article. Cure8 is informational only and is not a substitute for professional medical advice, diagnosis, or treatment.
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