Hong Trudy, Koh Dion, Gray Andrew
Department of General Surgery, Monash Health, Clayton, Victoria, Australia.
J Surg Case Rep. 2021 May 14;2021(5):rjab181. doi: 10.1093/jscr/rjab181. eCollection 2021 May.
A gastrocolonic fistula is a rare surgical presentation, typically in the setting of gastric or colonic malignancy. This report presents the first reported Australian case of a gastrocolonic fistula following upper gastrointestinal surgery. A middle-aged woman presented to emergency with a short history of severe abdominal pain, faeculent vomiting, profuse diarrhoea and weight loss. This was in the setting of a previous pylorus-preserving pancreaticoduodenectomy complicated by marginal ulceration, for which a distal gastrectomy and Roux-en-Y reconstruction was required. The rarity of gastrocolonic fistulae and non-specific presentation with diarrhoea, vomiting and weight loss can make the diagnosis challenging. The mainstay of management is surgical resection in both benign and malignant disease.
胃结肠瘘是一种罕见的外科病症，通常发生在胃或结肠恶性肿瘤的情况下。本报告介绍了澳大利亚首例上消化道手术后发生胃结肠瘘的病例。一名中年女性因严重腹痛、粪样呕吐、大量腹泻和体重减轻的病史较短而急诊入院。此前她接受了保留幽门的胰十二指肠切除术，并伴有边缘溃疡并发症，为此需要进行远端胃切除术和Roux-en-Y重建术。胃结肠瘘的罕见性以及腹泻、呕吐和体重减轻等非特异性表现会使诊断具有挑战性。无论是良性还是恶性疾病，治疗的主要方法都是手术切除。
