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July 1970

Appendico-Jejunal Fistula Secondary to Appendiceal Calculus

Author Affiliations

Brooklyn, NY

Arch Surg. 1970;101(1):94. doi:10.1001/archsurg.1970.01340250096025

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