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March 1, 1976

Gastrocolic Fistula As a Complication of Carcinoma of the Lung

Author Affiliations

From the Department of Surgery, The University of Texas, Southwestern Medical School, Dallas.

JAMA. 1976;235(9):934-935. doi:10.1001/jama.1976.03260350038026

HALLER described the first gastrocolic fistula caused by a malignant neoplasm in 1775. Since then, less than 250 malignant gastrocolic fistulas have been reported.1 Whereas these fistulas have all been caused by primary intra-abdominal tumors, the following case report is, apparently, the first description of such a condition arising from a primary neoplasm outside the peritoneal cavity.

Report of a Case  A 53-year-old man was admitted to the Dallas Veterans Administration Hospital in the spring of 1974 for evaluation of a cavitary mass in the left upper lobe. After a thorough diagnostic work-up, a left upper lobectomy was performed for a poorly differentiated bronchogenic carcinoma (Fig 1) with metastasis to one periaortic node. Postoperative irradiation totaling 5,000 rads was administered to the hilar area.The patient did well for seven months and then began having intermittent epigastric pain, anorexia, weakness, and a weight loss of 7 kg.After two