Abstract
IntroductionBenign gastro-colic fistula is a rare occurrence in modern surgery due to the progress in medical management of gastric ulcer disease. Here we report the first case of benign gastro-colic fistula occurring whilst on proton-pump inhibitor therapy. This is a case study of benign gastro-colic fistula and review of the available literature in regards to etiology, diagnosis, management and prognosis.Case presentationAn 84-year-old woman of Caucasian background presented with 12 months of worsening abdominal pain, nausea, vomiting, diarrhea and weight loss on a background of known gastric ulcer disease.ConclusionThe leading cause of gastro-colic fistulae has changed from benign to malignant due to improved medical management of gastric ulcer disease. The rarity and non-specific symptoms of gastro-colic fistula make the diagnosis difficult and it is best made by barium enema; however, computed tomography has not been formally evaluated. Surgical management with en bloc resection of the fistula tract is the preferred treatment. Benign gastro-colic fistulae are becoming exceedingly rare in the context of modern medical management of gastric ulcer disease. Surgical management is the gold standard for both benign and malignant disease.
Highlights
Benign gastro-colic fistula is a rare occurrence in modern surgery due to the progress in medical management of gastric ulcer disease
The leading cause of gastro-colic fistulae has changed from benign to malignant due to improved medical management of gastric ulcer disease
The rarity and non-specific symptoms of gastro-colic fistula make the diagnosis difficult and it is best made by barium enema; computed tomography has not been formally evaluated
Summary
A gastro-colic fistula commonly presents with non-specific symptoms of diarrhea, nausea and vomiting and weight loss, making it a difficult diagnosis. The rarity of this condition, and alteration in the underlying etiology due to the advent of medical management of gastric ulcer disease, make benign gastro-colic fistula a very rare diagnosis. Case presentation An 84-year-old Caucasian woman presented for repeat gastroscopy for follow-up of a benign gastric ulcer She gave a 12-month history of worsening abdominal pain, nausea, non-feculent vomiting, diarrhea and approximately 20 kilogram weight loss. Competing interests The authors declare that they have no competing interests
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