An enterocutaneous fistula (ECF) is an abnormal connection that develops between the intestinal tract and the skin. As a result, contents of the GI tract leak through to the skin. Most ECFs occur after bowel surgery. Other causes include infection, perforated ulcer, Crohn's disease or ulcerative colitis. An ECF may also develop from an abdominal injury or trauma, such as a stabbing or gunshot. Patients with ECFs often experience complex problems that require long-term care. This care is provided by a multidisciplinary team including surgeons, nurses, wound therapists, social workers and nutritionists.