GASTROCOLIC FISTULA AS A CONSEQUENCE OF BENIGN PEPTIC ULCER

Abstract

We report a rare case of a 58-year-old male patient with a gastrocolic fistula (GCF) caused by a benign peptic ulcer who had been referred because of epigastric pain and weight loss. Emergent gastrointestinal endoscopy revealed a gastric ulcer at the posterior wall of the stomach. Conservative treatment with a proton pump inhibitor (PPI) was immediately initiated ; however, a second endoscopic examination showed a portion of exposed colonic wall located in the center of an active gastric ulcer on day 4 after the administration of PPI. Endoscopic findings of the penetration site implied that the colonic wall invaginated into the stomach might have functioned as a check valve that prevented the flow of gastric contents into the colon. Supportive parenteral nutrition was preoperatively provided. Resection due to adhesion between the transverse colon and posterior wall of the stomach was performed without gastrectomy and partial colectomy under laparoscopy.