Jacobson I M, Schapiro R H, Warshaw A L
Gastroenterology. 1985 Dec;89(6):1347-52. doi: 10.1016/0016-5085(85)90654-7.
We report gastric or duodenal fistulas in 6 patients with Crohn's colitis or ileocolitis. Two patients had duodenocolic fistulas, 1 had a duodenoileal fistula, 2 had gastrocolic fistulas, and 1 had gastric and duodenal fistulas from an ileocolic anastomosis. In each case the fistula originated from the lower bowel segment, and no patient in this series had primary gastroduodenal Crohn's disease. These cases illustrate the range of manifestations of fistulas to the stomach and duodenum in Crohn's disease, and emphasize that the predominant symptoms determining surgical intervention usually arise from the diseased ileum and colon, rather than from the fistula. Our experience demonstrates the simplicity and safety of excision of the fistula with primary closure of the stomach or duodenum when the stomach and duodenum are otherwise normal by endoscopic examination.
我们报告了6例克罗恩结肠炎或回结肠型克罗恩病患者出现胃或十二指肠瘘的情况。2例患者有十二指肠结肠瘘，1例有十二指肠回肠瘘，2例有胃结肠瘘，1例因回结肠吻合口出现胃和十二指肠瘘。在每例病例中，瘘管均起源于下消化道，本系列中无患者患有原发性胃十二指肠克罗恩病。这些病例说明了克罗恩病中胃和十二指肠瘘的各种表现，并强调决定手术干预的主要症状通常源于患病的回肠和结肠，而非瘘管。我们的经验表明，在内镜检查显示胃和十二指肠无其他异常时，切除瘘管并一期缝合胃或十二指肠既简单又安全。
