Aim: To observe & study the effect of early enteral feeding in post-operative enterocutaneous fistula. Material & Method: A prospective study of 30 patients presenting to VSS Institute of Medical Sciences and Research, Burla with a clinical diagnosis of postoperative enterocutaneous fistula between December 2022 and November 2024 is done. The study of site, amount, nature, and type of the postoperative enterocutaneous fistula was done and the effect of early enteral feeding was observed. Results: The maximum number of cases were in the age group of 50-59yrs (30 %) followed by 40- 49yrs (26.7 %) with a male to female ratio 3:2. The most common cause of the fistula was due to anastomotic leak, followed post appendicectomy, hollow viscous perforation and then inadvertent enterotomy. Majority of the cases in this study (93%) are done in an emergency setting either due to acute intestinal obstruction or hollow viscous perforation or acute gangrenous appendicitis. Only in 2 of the 30 patients’ elective surgery was done. Ileum was the most common site for formation of enterocutaneous fistula accounting for 40% of the cases, followed by colon, jejunum, caecum, and stomach. Almost all patients in this study were under nourished, only 4 patients had a serum total protein more than 6 g/dl, while 26 patients had protein level of 6 g/dl or lower. 6 patients in this study had severe hypoalbuminemia and 20 patients had mild to moderate hypoalbuminemia. In early enteral nutrition (before 14 days) group enterocutaneous fistula without distal obstruction, fistula closure occurred in 86% (12 out of 14 cases) within 30 days. Whereas in delayed enteral nutrition (after 14 days) group enterocutaneous fistula without distal obstruction, fistula closure occurred in 57% (8 out of 14 cases). Conclusions: Prompt identification and treatment, including sepsis management and nutritional support, can reduce the risk of complications. Determining the fistula's specific characteristics can help predict spontaneous closure or indicate the need for prompt surgery. Meticulous surgical planning and technique, along with a collaborative multidisciplinary approach, maximize the chances of successful fistula closure. Post-operative care involving sufficient nutrition and comprehensive support can facilitate the patient's return to a fulfilling and active life while ensuring the long-term success of the repair. Enteric fistulas, occurring spontaneously or in the postsurgical period, represent a significant management challenge and may result in both morbidity and occasionally mortality for the patient. The care in these patients may be complex and has led to the establishment of specialized intestinal failure units, aimed at optimizing outcome. So, by these studies, early enteral feeding favors the improvement of general condition of the patients and thereby early closure of entero- cutaneous fistula.

Post-operative; Small bowel; Enterocutaneous fistula.