Abstract
IntroductionGastrojejunocolic fistula is a rare condition after gastrojejunostomy. It was thought to be a late complication related to stomal ulcers as a result of inadequate gastrectomy or incomplete vagotomy. We report a case of gastrojejunocolic fistula after gastrojejunostomy for peptic ulcer treated with one-stage laparoscopic resection.Case presentationA 41-year-old Japanese man complained of diarrhea for 10 months, as well as severe weight loss and weakness. After admission, we immediately started intravenous hyperalimentation. On performing colonoscopy and barium swallow, gastrojejunocolic fistula was observed close to the gastrojejunostomy site leading to the transverse colon. After our patient's nutritional status had improved, one-stage surgical intervention was performed laparoscopically. After the operation, our patient recovered uneventfully and his body weight increased by 5 kg within three months.ConclusionsModern management of gastrojejunocolic fistula is a one-stage resection because of the possibility of early recovery from malnutrition using parenteral nutritional methods. Today, laparoscopic one-stage en bloc resection may be feasible for patients with gastrojejunocolic fistula due to the development of laparoscopic instruments and procedures. We describe the first case of gastrojejunocolic fistula treated laparoscopically by one-stage resection and review the literature.
Highlights
Gastrojejunocolic fistula is a rare condition after gastrojejunostomy
Laparoscopic one-stage en bloc resection may be feasible for patients with gastrojejunocolic fistula due to the development of laparoscopic instruments and procedures
We describe the first case of gastrojejunocolic fistula treated laparoscopically by onestage resection and review the literature
Summary
Gastrojejunocolic fistula is a rare condition after gastrojejunostomy. We report a case of gastrojejunocolic fistula after gastrojejunostomy for peptic ulcer treated with one-stage laparoscopic resection. On performing colonoscopy and barium swallow, gastrojejunocolic fistula was observed close to the gastrojejunostomy site leading to the transverse colon. After our patient’s nutritional status had improved, one-stage surgical intervention was performed laparoscopically. Our patient recovered uneventfully and his body weight increased by 5 kg within three months. Gastrojejunocolic (GJC) fistula is a rare condition after gastrojejunostomy. In the late 1930s, since patients with GJC fistula were usually malnourished, operative mortality and morbidity were high. Due to recent advances in parenteral nutritional support and intensive care, a onestage resection can be performed [4]. The aim of this study was to describe the first laparoscopic onestage resection of a GJC fistula
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