<prompt> Fistula leading to the highest electrolyte imbalance is?GastricDuodenalSigmoidRectal  <response>: Gastric REP: Sabiston 17 ed p. 324, CSDT 11th ed p. 696 Enterocutaneous fistula: Most common: iatrogenic High output 500 mld The more proximal the fistula, more severe are complications. Complications: fluid and electrolytes, malnutrition, necrosis of skin, sepsis leading to multi organ failure and death. 