胃結腸瘻を来した胃潰瘍の１例

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  • A Case Report of Gastrocolic Fistula due to Gastric Ulcer

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Most gastrocolic fistulas have been reported in connection with malignant tumors or as a complication of stomal ulcers after a gastrojejunostomy. We report a case of gastrocolic fistula caused by a benign gastric ulcer. A 48-year-old man was admitted to our hospital complaining of abdominal pain and nausea. An upper GIexamination revealed a protrusion at the posterior wall of the stomach, and the barium leaked from the lesion to the colon. An endoscopic examination showed a gastric ulcer and fistula. A fiberscope could be inserted into the colon through the fistula. Barium enema examination showed the flow of barium from the transverse colon into the stomach. We concluded that the gastrocolic fistula had been created by the penetration of a gastric ulcer. The patient underwent surgery; the transverse colon had adhered to the posterior wall of the stomach, so a Billroth I distal gastrectomy and a partial resection of the transverse colon were performed. The resected specimen showed an ulcer in the posterior wall. Histology revealed that the gastrocolic fistula had originated from a peptic ulcer of the stomach, and no evidence of malignancy was found.

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