To the Editor.—In a recent issue of the Archives, an article on enteric fistulas of appendiceal origin was published. In this article the authors state that the existence of a calculus producing this entity could not be substantiated in any of the case reports that were reviewed.
I have recently cared for a case which seems to demonstrate that this can occur.
A 65-year-old man complained of colicky abdominal pain for three weeks, extending over the whole lower abdomen. Barium enema revealed a constricting lesion of the sigmoid colon. At laparotomy, in addition to a definite neoplastic lesion of the lower sigmoid, a matted mass of bowel was found adherent to the sigmoid mesentery. On dissection the mass consisted of a loop of mid jejunum adherent to the appendix.
These structures were resected along with the sigmoid. The lesion in the sigmoid colon was reported as adenocarcinoma. The bowel
ARLEN M. Appendico-Jejunal Fistula Secondary to Appendiceal Calculus. Arch Surg. 1970;101(1):94. doi:10.1001/archsurg.1970.01340250096025