A case of gastric cancer with gastrocolic fistula

Abstract

A 62-year-old man presented with aggravation of limb edema. Abdominal enhanced computed tomography revealed an increase in the wall thickness of the gastric corpus with a gastrocolic fistula. Endoscopic examination showed a type 3 tumor on the greater curvature of the middle body of the stomach, shown by tumor biopsy to be poorly differentiated adenocarcinoma. Gastrografin enema demonstrated complete obstruction of the transverse colon and gastrocolic fistula. Total gastrectomy, partial resection of transverse colon and splenectomy were performed. The tumor penetrated the transverse colon at two sites. Final pathological examination revealed poorly differentiated adenocarcinoma. Beyond the serosa, tumor had invaded the mucosa of the transverse colon. The patient died nine months postoperatively of peritonitis carcinomatosa. Gastric cancer with gastrocolic fistula is particularly rare. When a tumor is detected on the greater curvature of the stomach, it is advisable to perform barium enema in order to establish an early prognosis.