The response of patients with fistulas of the gastrointestinal tract to parenteral nutrition.

Total parenteral nutrition is an effective form of therapy for fistulas of the gastrointestinal tract. In the series, reported mortality in unselected patients on total parenteral nutrition was 26 per cent. However, not all patients respond equally to total parenteral nutrition. Those less than 65 years of age, with nonmalignant disease or completely resected neoplasm have a close to 100 per cent fistula closure rate if no other significant disease is present. However, the elderly patient dies more easily, and there is little improvement in mortality with the use of total parenteral nutrition in this group. Patients with a fistula associated with residual intra-abdominal disease did poorly on total parenteral nutrition.