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December 1979

Gastrocolic Fistula as a Complication of Benign Gastric Ulcer

Author Affiliations

From the Department of Surgical Oncology, New York State Department of Health, Roswell Park Memorial Institute, Buffalo, NY.

Arch Surg. 1979;114(12):1426-1428. doi:10.1001/archsurg.1979.01370360080011

• The symptoms, diagnosis, and management of three patients with gastrocolic fistula secondary to benign peptic ulcer disease are reviewed. To our knowledge, this brings the total of such cases reported in the literature to 50. The most frequent symptoms were abdominal pain, weight loss, diarrhea, and vomiting followed by anemia, foul eructations, and fecal vomiting. Barium meal demonstrated the fistula in about 70% of the patients, whereas barium enema examination demonstrated the fistula in nearly all of them. The diagnostic workup should rule out the possibility of a malignant cause for the fistula. The surgical management of these patients consists of the one-stage, when possible, resection of the involved portion of the antrum and the fistula of the transverse colon with appropriate reconstruction of gastrointestinal continuity. An increased awareness of the benign cause of some gastrocolic fistulas is necessary to avoid unduly extensive surgery in these cases.

(Arch Surg 114:1426-1428, 1979)