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. 2011 Jul 14:5:313.
doi: 10.1186/1752-1947-5-313.

Benign gastro-colic fistula in a woman presenting with weight loss and intermittent vomiting: a case report

Kate Barrett  1 , Michael W Hii, Richard J Cade
Affiliations

Benign gastro-colic fistula in a woman presenting with weight loss and intermittent vomiting: a case report

Kate Barrett et al. J Med Case Rep. .

Abstract

Introduction: Benign gastro-colic fistula is a rare occurrence in modern surgery due to the progress in medical management of gastric ulcer disease. Here we report the first case of benign gastro-colic fistula occurring whilst on proton-pump inhibitor therapy. This is a case study of benign gastro-colic fistula and review of the available literature in regards to etiology, diagnosis, management and prognosis.

Case presentation: An 84-year-old woman of Caucasian background presented with 12 months of worsening abdominal pain, nausea, vomiting, diarrhea and weight loss on a background of known gastric ulcer disease.

Conclusion: The leading cause of gastro-colic fistulae has changed from benign to malignant due to improved medical management of gastric ulcer disease. The rarity and non-specific symptoms of gastro-colic fistula make the diagnosis difficult and it is best made by barium enema; however, computed tomography has not been formally evaluated. Surgical management with en bloc resection of the fistula tract is the preferred treatment. Benign gastro-colic fistulae are becoming exceedingly rare in the context of modern medical management of gastric ulcer disease. Surgical management is the gold standard for both benign and malignant disease.

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Figures

Figure 1
Figure 1
Coronal CT scan post-gastroscopy revealing gastro-colic fistula demonstrated by oral contrast in the stomach and distal transverse colon and absence of contrast in the duodenum. There are associated inflammatory changes around the transverse colon.
Figure 2
Figure 2
The operative field showing the stomach attached to omentum and transverse colon.
Figure 3
Figure 3
The operative field demonstrating the stomach attached to the transverse colon.
Figure 4
Figure 4
En bloc surgical resection of the distal stomach, transverse colon and surrounding inflammatory tissue.
See this image and copyright information in PMC

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