2005 Volume 47 Issue 8 Pages 1518-1525
A 63-year-old man was admitted to our hospital with the complaints of weight-loss and upper abdominal fullness. The upper gastrointestinal endoscopy showed a large ulcer at the gastric angle and a fistula with remnant gastric mucosa at the bottom of the ulcer. Histology of biopsy specimens, which were obtained from ulcer edge and around the fistula, did not show any malignant findings. Since the fistula was connected to a transverse colon, it was diagnosed as a gastro-colic fistula. The conservative treatment by taking a proton pump inhibitor was selected, because the patient refused surgical operation. Although the endoscopy performed at 63 weeks after start of the treatment showed that gastric ulcer was healed, the fistula was still present at the center of the scar. This case is rare and is valuable to report, since the long-term endoscopical observation of the gastro-colic fistula caused by the perforation of benign ulcer was possible.
