Gastrocolic fistula as a complication of benign gastric ulcer

The authors present 3 cases which illustrate the wide spectrum of clinical presentations of gastrocolic fistula. These complications include (a) pain, feculent vomiting, and diarrhea; (b) gastrointestinal hemorrhage; and (c) peritonitis. The gastric ulcer is easily detected by a barium meal study although a barium enema may be necessary to show the fistulous communication. The relationship of this condition to steroids and acetylsalicyclic acid is stressed. Two other cases are included to illustrate the development of such a fistula and show the distinguishing features of a gastrocolic fistula due to carcinoma of the colon.