Abstract
A 48-year-old woman was admitted to our hospital complaining of abdominal pain and diarrhea. On physical examination, abdominal mass and tenderness were present in the right hypochondric region. An upper gastrointestinal series disclosed an internal fistula in the greater curvature of the antrum and longitudinal ulcers in the terminal ileum. A barium enema confirmed the presence of a gastrocolic fistula between the greater curvature of the antrum and the transverse colon. Barium enema and colonof iberscopic findings showed cobblestone-like appearances, longitudinal ulcers and apthoid ulcers in the transverse colon and the sigmoid colon. Total colectomy and ileectomy were performed. The greater curvature of the antrum was adherent to the transverse colon. The wall of the ileum and the colon were edematous and thick with the longitudinal ulcers and cobblestone-like apperances. On microscopic findings, fissures, transmural inflammation and granulomas were noted. Fistula formation (perianal, enteroenteric or enterocutaneous) is well recognized in Crohn's disease. Gastrocolic fistula, however, are uncommon with only two patients except our case in Japan and thirteen patients in other countiries having been reported upon in the literature. This report describes a case of Crohn's disease with gastrocolic fistula.
