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September 1983

Perforated Benign Gastrocolic Fistula

Arch Surg. 1983;118(9):1105. doi:10.1001/archsurg.1983.01390090081022

To the Editor.—In reference to the article "Gastrocolic Fistula as a Complication of Benign Gastric Ulcer" (Archives 1979;114:1426-1428), we wish to report a case we treated of a gastrocolic fistula with free perforation secondary to a benign nonsurgically treated gastric ulcer. We know of only one case of free perforation of this type of fistula cited in the English literature.1

A 53-year-old man had a five-day history of constipation and colicky abdominal pain and a 5.4-kg weight loss. On admission his abdomen was rigid, the nasogastric aspirate was feculent, and a roentgenogram showed free intraperitoneal air. The patient was resuscitated and taken to the operating room. Exploratory surgery revealed free fecal material in the peritoneal cavity and a 4-cm perforation of the transverse colon along with a 5-cm perforation in the posterior portion of the greater curvature of the stomach. An en bloc resection of the stomach, gastrocolic