Which statement accurately describes the management of peristomal fistulas?

Which statement accurately describes the management of peristomal fistulas?

• A. They may spontaneously close, though rarely.
• B. They always require immediate surgical repair.
• C. They cannot be managed and require removal of the stoma.
• D. They heal only with antibiotics.

Answer: (A)

Peristomal fistulas can sometimes heal without surgery, especially when the fistula is small and output is low and the surrounding skin and stoma are well managed. The main approach is conservative: optimize ostomy care to protect the skin, minimize leakage around the fistula, ensure good nutrition and hydration to support healing, and treat any local infection. While many fistulas around a stoma require management and closer follow-up, spontaneous closure is possible, though not common. If healing does not occur or the fistula is high-output, persistent, or associated with underlying disease, surgical options or stoma relocation may be considered. Antibiotics may be used to treat infection but are not by themselves a cure for the fistula.

Peristomal fistulas can sometimes heal without surgery, especially when the fistula is small and output is low and the surrounding skin and stoma are well managed. The main approach is conservative: optimize ostomy care to protect the skin, minimize leakage around the fistula, ensure good nutrition and hydration to support healing, and treat any local infection. While many fistulas around a stoma require management and closer follow-up, spontaneous closure is possible, though not common. If healing does not occur or the fistula is high-output, persistent, or associated with underlying disease, surgical options or stoma relocation may be considered. Antibiotics may be used to treat infection but are not by themselves a cure for the fistula.