Chime Chukwunonso, Ravi Madhavi, Daniel Myrta, Patel Harish, Balar Bhavna
Division of Gastroenterology, Bronx Care Health System-Affiliate of Mount Sinai Hospital System, New York, USA.
Case Rep Gastrointest Med. 2018 Oct 1;2018:6958925. doi: 10.1155/2018/6958925. eCollection 2018.
Gastrocolic fistulae have been described for benign conditions including penetrating peptic ulcer and complicated pancreatitis. Malignant etiology can arise from gastric or colon cancer and is a rare and late complication with an incidence of 0.3-0.4%. Usual presentation is the classic triad of weight loss, diarrhea, and feculent vomiting. Barium enema has been shown to have the highest diagnostic accuracy but endoscopy offers additional advantage of biopsy to aid in diagnosis of malignant etiology; the role of computed tomography (CT) scan is controversial. Treatment by one-stage en bloc surgical approach is the current acceptable standard of care with variable recurrence and survival rates. Adjuvant chemotherapy would be based on lymph node involvement and patient discussion.
胃结肠瘘已被描述为包括穿透性消化性溃疡和复杂性胰腺炎在内的良性疾病。恶性病因可源于胃癌或结肠癌，是一种罕见的晚期并发症，发病率为0.3 - 0.4%。常见表现为体重减轻、腹泻和粪样呕吐这一典型三联征。钡剂灌肠已被证明具有最高的诊断准确性，但内镜检查具有活检的额外优势，有助于诊断恶性病因；计算机断层扫描（CT）的作用存在争议。采用一期整块手术方法进行治疗是目前可接受的治疗标准，复发率和生存率各不相同。辅助化疗将基于淋巴结受累情况并与患者进行讨论。
