Duodeno-colic and gastrojejuno-colic fistula: A complication of carcinoma

Abstract

Two cases of cancer of the colon with fistulous communication are presented, one a duodeno-colic and the other a gastrojejuno-colic fistula. This complication should be suspected if a patient with carcinoma of the bowel complains of intense pain, vomiting and diarrhea. The radiologic signs are pathognomonic in revealing the lesion in the bowel as well as the fistulous tract. Of particular interest is the case of duodenocolic fistula in which the roentgenograms revealed that the fistulous tract apparently entered the duodenum through the duodenal diverticulum. The involvement of the duodenal diverticulum in the fistulous communication is suggested by the absence of any other site of entrance in to the duodenum, the fact that the diverticulum contained some air and that the fistulous tract led directly into the duodenal diverticulum. The author wishes to express his appreciation to Dr. Alfred Ullman, Surgeon in Chief of the Sinai Hospital, for his kind cooperation in making the patients’ records available.