Aslam Farah, El-Saiety Nabil, Samee Abdus
Department of General Surgery, Newham University Hospital, Barts Health NHS Trust, London, UK.
Department of Radiology, Royal Oldham Hospital, Pennine Acute Hospitals NHS Trust, Manchester, UK.
BJR Case Rep. 2018 Dec;4(4):20170121. doi: 10.1259/bjrcr.20170121. Epub 2018 May 31.
A 77-year-old male presented with diarrhoea, weight loss and faeculent vomiting. CT scan identified a stricturing lesion in the transverse colon. The man, however, had no features suggestive of large bowel obstruction. This unusual presentation of faeculent vomiting raised a suspicion of a possible communication between the colon and stomach. A subsequent CT scan with oral contrast confirmed the presence of a gastrocolic fistula. During explorative laparotomy, a transverse colonic tumour communicating into the stomach via the gastrocolic fistula was detected. The patient underwent an extended right hemicolectomy and distal gastrectomy as a palliative measure. A gastrocolic fistula is a rare, yet important find and should be recognized as a possible sequel of this disease process.
一名77岁男性出现腹泻、体重减轻和粪样呕吐症状。CT扫描发现横结肠有一个狭窄性病变。然而,该男子没有提示大肠梗阻的特征。这种不寻常的粪样呕吐表现引发了结肠与胃之间可能存在相通的怀疑。随后口服对比剂的CT扫描证实了胃结肠瘘的存在。在剖腹探查术中,发现一个通过胃结肠瘘与胃相通的横结肠肿瘤。作为一种姑息性措施,患者接受了扩大右半结肠切除术和远端胃切除术。胃结肠瘘是一种罕见但重要的发现,应被视为该疾病过程的可能后遗症。