# Enterocutaneous Fistula Caused by an Ingested Chicken Bone in an Adult: A Case Report

## TL;DR

A rare case of an enterocutaneous fistula caused by a swallowed chicken bone in an adult is reported, emphasizing the value of conservative management in high-risk patients.

## Contribution

This case report presents a rare clinical scenario and advocates for individualized, conservative management strategies in high-risk patients with enterocutaneous fistulas.

## Key findings

- The patient's fistula location changed over time, influencing the decision to continue nonsurgical management.
- Prolonged conservative management led to skin healing and acceptable outcomes in a high-risk patient.
- A multidisciplinary approach using the SNAP framework is recommended for managing enterocutaneous fistulas.

## Abstract

Enterocutaneous fistulas (ECFs) caused by ingested foreign bodies are extremely rare. Accurate fistula localization is essential for guiding management, especially in comorbid patients at high surgical risk.

We report a 76‐year‐old woman who developed an ECF secondary to a swallowed chicken bone. Initial imaging suggesting a high small‐bowel fistula and severe peristomal skin breakdown prompted consideration of surgery. Extended conservative management allowed skin healing, and follow‐up imaging revealed a more distal fistula, supporting continuation of nonsurgical management.

Management of ECF is challenging due to morbidity from intestinal failure, electrolyte disturbances, sepsis, and skin damage. Optimal care requires multidisciplinary strategies guided by sepsis control, nutritional support, anatomical assessment, and procedure planning (SNAP framework).

This case highlights the importance of individualized management and careful assessment of fistula location. It also illustrates that prolonged conservative management can achieve acceptable outcomes in high‐risk patients.