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Gastrocolic fistulas.

C Palnaes Hansen¹, C Lanng, A Christensen

¹Department of Gastrointestinal Surgery C, Rigshospitalet, University of Copenhagen, Denmark.

Acta Chirurgica Scandinavica

|April 1, 1988

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Gastrocolic fistulas, often from peptic ulcers, require surgical resection but can sometimes be treated with medication. Diagnosis relies on barium studies, not gastroscopy.

Area of Science:

Gastroenterology
Surgical Oncology

Background:

Gastrocolic fistula is a rare complication, frequently stemming from peptic ulcer disease.
Symptoms include diarrhea, weight loss, and abdominal pain, necessitating effective diagnostic and treatment strategies.

Purpose of the Study:

To review the diagnosis and management of gastrocolic fistulas.
To evaluate surgical and non-surgical treatment outcomes.

Main Methods:

Retrospective analysis of sixteen patients treated for gastrocolic fistula.
Diagnostic modalities included barium meal, barium enema, and gastroscopy.
Surgical interventions encompassed en bloc resection, simple excision, gastric resection with colonic wall closure, and colectomy with gastric wall closure.

Main Results:

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Peptic ulcer disease was the most common cause (11 cases).
Barium studies were superior to gastroscopy for diagnosis.
Surgical resection was the primary treatment, with one case successfully managed with cimetidine.
Postoperative mortality was 25% (4 patients), and fistula recurrence occurred in two patients.

Conclusions:

Gastrocolic fistula management requires a tailored approach based on etiology and patient condition.
Surgical intervention remains a primary treatment, though non-surgical options may be considered.
Accurate diagnosis via barium studies is crucial for effective treatment planning.