A fistula is an abnormal opening between two parts of the body. The duodenum is a portion of the small intestine, and a fistula here can result from a variety of causes. Trauma to the area, cancer development or disease of the area can all cause openings in normally complete tissues, resulting in leakages and potentially life-threatening effects. A duodenal fistula can open into other organs, into the abdominal space, or even be a hole in the skin of the abdomen, exposing the organs to the outside environment.
The digestive system is made up of several different parts. After food enters the stomach, it moves into the first part of the small intestine, which is the duodenum. Here, the stomach acid mixed up with the food is neutralized, before it moves onto the rest of the small intestine for nutrients to be absorbed. The whole digestive system is basically a tube, which moves food through the body without the food coming into contact with the rest of body, apart from the broken down nutrients. It is lined with cells that keep the system flexible and protected against invading material like bacteria, of which some are epithelial cells.
Epithelial cells are the same type of cells that makes up skin. A fistula is technically defined as a hole that brings two epithelial surfaces into contact with each other, and a duodenal fistula is therefore a hole in the duodenum that connects to another epithelial layer, such as the outer skin of a patient, or the epithelial layers of an organ. Wherever the duodenal fistula connects to, a medical problem exists, as the normal movement of food and gastric products through the small intestine is interfered with.
In addition to the reduction of normal movement of products through the intestine, the products have properties that are dangerous to health. The gastric juices mixed up with the food are very acidic, and this can cause damage to the tissue that the fistula connects with. Areas of the body that are not usually exposed to material like half-digested food can also suffer problems, and the workings of affected organs can deteriorate. A healthy, unbroken digestive system also prevents the non-sterile food from entering the body, and the duodenal fistula can expose bodily tissues to pathogens, thus resulting in infections.
Surgery is generally the best treatment option for a person with a duodenal fistula. Ironically, surgery for unrelated issues is a significant cause of this type of fistula. Antibiotic treatment and fluid and electrolyte replacement can also be employed to help the patient recover.