Umer Keno M, Nureta Tilahun H, Akalu Tiruwork F, Shale Wongel T
Department of General Surgery, College of Medical Sciences, Dire Dawa.
Department of Gastrointestinal Surgery.
Ann Med Surg (Lond). 2023 Feb 14;85(3):439-442. doi: 10.1097/MS9.0000000000000128. eCollection 2023 Mar.
Gastrojejunocolic fistula (GJF) is an infrequent condition that presents late as a complication of gastroenterostomy conducted for complications of peptic ulcer disease and is believed to be a result of continuous acid secretion due to insufficient stomach resection and incomplete vagotomy. Symptoms of the fistula present late, usually 20 years or more after gastroenterostomy. Patients with GJF usually present with chronic on-and-off diarrhea, weight loss, fecal-smelling belching or vomiting, and malnutrition.
The case is of a 45-year-old man with GJF who presented with diarrhea, weight loss, and foul-smelling vomiting. The diagnosis was made intraoperatively despite preoperative investigations with computerized tomography scan and endoscopy. The patient underwent a single-stage operation, and the postoperative course was uneventful.
Knowledge of this uncommon illness can aid in prevention through improved operative strategy and medical treatment during the stomal ulcer phase with proton pump inhibitor and eradication.
胃空肠结肠瘘（GJF）是一种罕见病症，作为因消化性溃疡疾病并发症而行胃肠吻合术的并发症出现较晚，被认为是由于胃切除不足和迷走神经切断不完全导致持续胃酸分泌所致。瘘的症状出现较晚，通常在胃肠吻合术后20年或更长时间。GJF患者通常表现为慢性间歇性腹泻、体重减轻、有粪臭味的嗳气或呕吐以及营养不良。
该病例为一名45岁患有GJF的男性，表现为腹泻、体重减轻和有臭味的呕吐。尽管术前进行了计算机断层扫描和内镜检查，但术中仍做出了诊断。患者接受了一期手术，术后过程顺利。
了解这种罕见疾病有助于通过改进手术策略以及在吻合口溃疡阶段使用质子泵抑制剂进行药物治疗和根除来预防。
