Kim Kil Hwan, Jee Ye Seob
Department of Surgery, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
J Korean Surg Soc. 2013 Apr;84(4):252-5. doi: 10.4174/jkss.2013.84.4.252. Epub 2013 Mar 26.
Gastrojejunocolic fistula is a rare condition after gastrojejunostomy. It is severe complications of gastrojejunostomy, which results an inadequate resection or incomplete vagotomy during peptic ulcer surgery. The symptoms are diarrhea, upper abdominal pain, bleeding, vomiting and weight loss. A 55-year-old man with chronic diarrhea and weight loss for 6 months visited Dankook University Hospital. The patient had received a truncal vagotomy and gastrojejunostomy for duodenal ulcer obstruction 15 years previously. The patient underwent gastroscopy and upper gastrointestinal series evaluations, which detected the gastrojejunocolic fistula. After improving of malnutrition, an exploratory laparotomy was undertaken, which revealed that the gastrojejunostomy site and the T-colon formed adhesion and fistula. En block resection of the distal stomach and T-colon included the gastrojejunocolic fistula, and Roux-en-Y gastrojejunostomy was performed. Recovery was uneventful and the patient remained well at the follow-up. We report a gastrojejunocolic fistula, which is a rare case after gastrojejunostomy.
胃空肠结肠瘘是胃空肠吻合术后的一种罕见病症。它是胃空肠吻合术的严重并发症,是由消化性溃疡手术中切除不充分或迷走神经切断不完全导致的。症状包括腹泻、上腹痛、出血、呕吐和体重减轻。一名55岁男性因慢性腹泻和体重减轻6个月就诊于檀国大学医院。该患者15年前因十二指肠溃疡梗阻接受了迷走神经干切断术和胃空肠吻合术。患者接受了胃镜检查和上消化道造影评估,结果发现了胃空肠结肠瘘。在改善营养不良状况后,进行了剖腹探查术,发现胃空肠吻合部位与横结肠形成粘连并出现瘘管。将包括胃空肠结肠瘘在内的远端胃和横结肠整块切除,并进行了Roux-en-Y胃空肠吻合术。恢复过程顺利,患者在随访期间情况良好。我们报告了一例胃空肠结肠瘘,这是胃空肠吻合术后的罕见病例。