2013 Volume 33 Issue 1 Pages 105-109
A 54-year-old man was brought to an emergency hospital with severe diarrhea, malnutrition, and had difficulty in walking. Because a gastrocolic fistula was suspected based on upper gastrointestinal endoscopy and enema examination, the patient was referred and admitted to our hospital. Upper gastrointestinal endoscopy revealed a fistula on the posterior wall of the gastric angle, and the endoscope was easily inserted into the colon. Moreover, the cecum and rectum were observable through the fistula. There was a paucity of findings suggestive of malignancy, and histopathological examination also revealed no evidence of malignancy. Thus, we diagnosed a gastric ulcer penetrating the transverse colon, resulting in fistula formation. Due to extreme malnutrition, parenteral and enteral nutrition was provided. However, no improvement was observed, and surgery was thus planned. The stomach, transverse colon, and small intestine were partially resected. Histopathological examination of the resected specimens revealed no malignant findings, and a gastrocolic fistula due to a gastric ulcer was thus confirmed. We describe herein this gastrocolic fistula caused by a benign gastric ulcer with an analysis of 20 Japanese cases, including our present case, along with a literature review.
