Which describes high-output fistula?

• A. >500 cc in 24 hours
• B. <200 cc in 24 hours
• C. 200-500 cc in 24 hours
• D. 0-100 cc in 24 hours

Answer: (A)

High-output fistula means a large volume of drainage from an intestinal fistula, defined as more than 500 mL in 24 hours. This level of output matters because it leads to rapid losses of fluids, electrolytes, and nutrients, putting the patient at risk for dehydration, electrolyte disturbances, and malnutrition. Because of these losses, management emphasizes aggressive fluid and electrolyte replacement and careful nutritional support—using enteral feeding if possible, or parenteral nutrition if needed. Reducing the fistula output with medications such as octreotide can also be helpful when appropriate. It’s important to protect the surrounding skin from caustic drainage and to monitor weight and labs closely. Outputs under 500 mL per day are considered lower risk and don’t demand the same level of aggressive intervention.