Gastrocolic fistula presenting as acute diarrhea.

Abdominal pain, diarrhea, weight loss, vomiting, foul eructation, feculent vomiting and melena are among the presenting symptoms of patients with a gastrocolic fistula. A routine physical examination is useful in ruling out the more common causes of the presenting complaints. Barium enema shows the gastrocolic fistula in 90 to 100 percent of cases. En bloc resection of the stomach and colon is the treatment of choice. Alternative therapies include a temporary diverting colostomy, total parenteral nutrition and antacid therapy.