Abstract
A 77-year-old male presented with diarrhoea, weight loss and faeculent vomiting. CT scan identified a stricturing lesion in the transverse colon. The man, however, had no features suggestive of large bowel obstruction. This unusual presentation of faeculent vomiting raised a suspicion of a possible communication between the colon and stomach. A subsequent CT scan with oral contrast confirmed the presence of a gastrocolic fistula. During explorative laparotomy, a transverse colonic tumour communicating into the stomach via the gastrocolic fistula was detected. The patient underwent an extended right hemicolectomy and distal gastrectomy as a palliative measure. A gastrocolic fistula is a rare, yet important find and should be recognized as a possible sequel of this disease process.
Highlights
Clinical presentation A 77-year-old male presented with a 7 day history of “dark coloured faeculent” vomitus and diarrhoea
A gastrocolic fistula is an abnormal communication between a segment of large bowel with a portion of the stomach, most commonly the greater curvature.[1]
First described in 1755 by Albrecht von Haller, a gastrocolic fistula may result secondary to various pathologies including chronic pancreatitis, diverticular disease, malignancies of the stomach or colon or tumours invading the biliary tract, pancreas and duodenum.[2,3]
Summary
Clinical presentation A 77-year-old male presented with a 7 day history of “dark coloured faeculent” vomitus and diarrhoea. The initial CT scan with intravenous contrast revealed a stricturing mass in the proximal transverse colon in close proximity to the pylorus of the stomach.
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