Thirty-eight gastrointestinal-tract fistulas in 34 patients are reviewed. Thirty-six of the fistulas developed postoperatively, and most of these were secondary to inflammatory processes. The rate of spontaneous closure was 29 per cent. Twenty-two patients (64 per cent) needed surgical treatment to effect permanent closure of their fistulas. A course of hyperalimentation is recommended for the initial management of all gastrointestinal-tract fistulas, but a more aggressive approach is needed for those lesions that do not respond promptly.