Wu Jin-Ming, Wang Ming-Yang, Lee Po-Huang, Lin Ming-Tsan
National Taiwan University Hospital, Department of Surgery, Taipei, Taiwan.
J Med Case Rep. 2008 Jun 4;2:193. doi: 10.1186/1752-1947-2-193.
Gastrojejunocolic (GJC) fistulae represent a significant post-surgical cause of morbidity and mortality. GJC fistulae represent rare post-surgical complications, and most are associated with gastric surgery. In the past, this complication has been under-recognized because a fistula may form years after surgery.
We describe two cases of gastrojejunocolic fistula in men aged 67 and 60 who both initially presented with watery diarrhea and weight loss. Upper GI studies with small bowel follow-through or barium contrast enema studies allowed a conclusive diagnosis to be made. Both patients underwent one-stage en bloc resection, and their postoperative course was uneventful.
With surgery, this condition is entirely correctable. Pre-operative nutritional status should be evaluated in patients undergoing corrective surgery, and total parenteral nutrition plays a major role in the provision of bowel rest to allow recovery in malnourished patients.
胃空肠结肠瘘是术后发病和死亡的一个重要原因。胃空肠结肠瘘是罕见的术后并发症,多数与胃部手术相关。过去,这种并发症未得到充分认识,因为瘘管可能在手术后数年形成。
我们描述了两例胃空肠结肠瘘病例,患者分别为67岁和60岁男性,最初均表现为水样腹泻和体重减轻。通过上消化道小肠造影或钡剂灌肠造影检查得以确诊。两名患者均接受了一期整块切除手术,术后恢复顺利。
通过手术,这种情况完全可以治愈。接受矫正手术的患者应评估术前营养状况,全胃肠外营养在让营养不良患者肠道休息以促进恢复方面发挥着重要作用。