Sawaguchi Masayuki, Jin Mario, Matsuhashi Tamotsu, Ohba Reina, Hatakeyama Natsumi, Koizumi Shigeto, Onochi Kengo, Tawaraya Shin, Watanabe Noboru, Uchinami Hiroshi, Yamamoto Yuzo, Ohnishi Hirohide, Mashima Hirosato
Department of Gastroenterology, Akita University Graduate School of Medicine, Japan.
Intern Med. 2013;52(14):1579-83. doi: 10.2169/internalmedicine.52.0496. Epub 2013 Jul 15.
We herein describe the case of a 51-year-old man with a duodenocolic fistula (DCF) caused by a stomal ulcer. The patient complained of watery diarrhea, dysgeusia and malnutrition. His medical history included distal gastrectomy with Billroth I reconstruction for duodenal ulcer perforation. A combination study using endoscopy and contrast imaging confirmed the presence of DCF. Laparotomic fistulectomy was performed, which resulted in the patient's recovery from diarrhea and malnutrition. The histological findings suggested that the fistula had originated from a stomal ulcer. In patients with chronic watery diarrhea of obscure origin following gastrectomy, DCF is a possible cause of the diarrhea.
我们在此描述一例由吻合口溃疡导致十二指肠结肠瘘(DCF)的51岁男性病例。患者主诉水样腹泻、味觉障碍和营养不良。他的病史包括因十二指肠溃疡穿孔行毕罗Ⅰ式远端胃切除术。内镜检查和造影成像联合检查证实存在DCF。实施了剖腹瘘管切除术,结果患者的腹泻和营养不良症状得以缓解。组织学检查结果提示瘘管起源于吻合口溃疡。在胃切除术后原因不明的慢性水样腹泻患者中,DCF可能是腹泻的病因。