Department of Rehabilitation Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Republic of Korea.
Arch Phys Med Rehabil. 2010 Nov;91(11):1790-2. doi: 10.1016/j.apmr.2010.07.224.
A 60-year-old man with a history of recurrent strokes secondary to moyamoya disease underwent insertion of a percutaneous radiologic gastrostomy tube because of severe dysphagia. Feeding was continued for 5 months after the procedure without complications. Persistent diarrhea began 2 weeks after admission for comprehensive rehabilitation. Conservative treatment was not effective. Sigmoidoscopy showed a U-shaped tube suggestive of a gastrocolic fistula in the transverse colon. This was confirmed by means of a tubogram obtained through a gastrostomy tube. The diarrhea resolved after changing the gastrostomy tube. This case report highlights the importance of considering other uncommon conditions, such as a gastrocolic fistula, in the differential diagnosis of persistent diarrhea in a patient with a gastrostomy tube.
一位 60 岁男性，因烟雾病反复发作性中风，行经皮放射科胃造口术，因严重吞咽困难。术后 5 个月进食无并发症。入院全面康复后 2 周开始持续腹泻。保守治疗无效。乙状结肠镜检查显示 U 形管，提示横结肠胃结肠瘘。通过胃造口管获得的 tubogram 证实了这一点。更换胃造口管后腹泻缓解。本病例报告强调了在有胃造口管的患者持续性腹泻的鉴别诊断中，考虑其他不常见情况（如胃结肠瘘）的重要性。
