Malignant Gastrocolic Fistula Research Articles

Synchronic finding of a foreign body in colon and a malignant gastrocolic fistula

Synchronic finding of a foreign body in colon and a malignant gastrocolic fistula

Palliation of a malignant gastrocolic fistula with the use of an atrial septal defect occlusion device

Palliation of a malignant gastrocolic fistula with the use of an atrial septal defect occlusion device

Gastrocolic Fistula: A Rare Complication of Carcinoma Stomach: A Case Report

The development of fistula between segments of the gastrointestinal tract is a rare occurrence in malignant disease. Gastrocolic fistula can be caused by both benign and malignant conditions. Malignant gastrocolic fistula is most commonly associated with adenocarcinoma of the transverse colon [1]. It occurs when the tumour erodes into the adjacent viscera. Usually the patient presents with weight loss, faeculent vomiting and diarrhoea [1]. But in our case there is no history of diarrhoea. We are reporting a case of gastic carcinoma complicated by gastrocolic fistula.

Palliation of a Malignant Gastrocolic Fistula and Gastric Outlet Obstruction Using Combined Atrial Septal Closure Device and Duodenal Stent

Palliation of a Malignant Gastrocolic Fistula and Gastric Outlet Obstruction Using Combined Atrial Septal Closure Device and Duodenal Stent

Malignant Gastrocolic Fistula as a Late Complication of Radiation Therapy

Malignant gastrocolic fistula is a rare mode of presentation of gastric or colonic carcinoma [1–3]. A benign aetiology is more common, including peptic ulcer disease, particularly benign gastric ulcers which may relate to non-steroidal antiinflammatory use. Other benign causes include inflammatory bowel disease, post-PEG insertion, post-gastroenterostomy, pancreatitis, abdominal tuberculosis, trauma, perforated diverticular disease and infections including CMV, histoplasmosis, actinomycosis, amoebiasis, echinococcosis and lymphogranuloma venereum [2, 4–7]. A malignant gastrocolic fistula is most commonly found between the greater curvature of the stomach and the distal half of the transverse colon [8]. They are usually seen in the setting of large infiltrative tumours with a surrounding inflammatory reaction, and lymph node involvement is uncommon [8]. The colon rather than the stomach is the more usual site of origin. In a review of 1,500 cases of stomach cancer and 3,200 cases of colon cancer at the Lahey Clinic, 11 cases of gastrocolic fistula were reported, with 10 being of colonic origin [9]. Radiation therapy is associated with an increased risk of second cancers. Abdominal radiation therapy has been most frequently administered in the context of testicular cancer, where the overall cure rate is greater than 90 % [10]. The average age of presentation of testicular cancer is 35, and second neoplasms are uncommon but well-recognised complications where radiation therapy has been given [11–14]. Exposure to radiation may induce a broad variety of DNA damage including singleand double-stranded DNA breaks, cross-linking and damage to nucleotide bases [15]. Radiation-related genomic instability enhances the rate at which mutations and epigenetic changes are acquired in the descendants of that cell line after many generations of replication. In a cohort study of 40, 576 survivors of testicular cancer, Travis et al. reported on 2,285 second solid tumours observed where 1,619 new cancers were expected, demonstrating an elevated relative risk (ERR) as well as an excess absolute risk of developing a second neoplasm in comparison with the general population [16]. A further report of 5,142 patients treated with radiation therapy describes a 3.4fold increased risk of stomach cancer in survivors of testicular cancer and Hodgkin’s lymphoma [17]. This study found that the risk of second cancer begins approximately 10– 15 years after the original cancer diagnosis. We report herein a case of an adenocarcinoma presenting acutely as a J. Costelloe : C. O’Connell :O. Mc Cormack :N. Ravi : J. V. Reynolds Department of Surgery, St. James’s Hospital, Dublin, Ireland

Long-term survival from gastrocolic fistula secondary to adenocarcinoma of the transverse colon

BackgroundGastrocolic fistula is a rare presentation of both benign and malignant diseases of the gastrointestinal tract. Malignant gastrocolic fistula is most commonly associated with adenocarcinoma of the transverse colon in the Western World. Despite radical approaches to treatment, long-term survival is rarely documented.Case presentationWe report a case of a 24-year-old woman who presented with the classic triad of symptoms associated with gastrocolic fistula. Radical en-bloc surgery and adjuvant chemotherapy were performed. She is still alive ten years after treatment.ConclusionsGastrocolic fistula is an uncommon presentation of adenocarcinoma of the transverse colon. Radical en-bloc surgery with adjuvant chemotherapy may occasionally produce long-term survival.

A CASE OF GASTROCOLIC FISTULA DUE TO CANCER OF THE TRANSVERSE COLON DISCOVERED WITH AN ABSCESS OF THE ABDOMINAL WALL

A 56-year-old woman admitted to the hospital because of an enlarging left hypochondral painful mass and fever. There was high grade anemia and inflammatory reaction in her laboratory data. Absces formation in the abdominal wall was revealed by ultrasonography and CT scan. E. coli was detected by the culture from the abscess and X-ray with Urograffin showed the fistula between the abscess cavity and transverse colon accompanied with stomach. The patient was diagnosed as malignant gastrocolic fistula due to cancer of the transverse colon. Curative operation (transverse colectomy, gastrectomy and partial resection of the abdominal wall) was performed. Histopathologically it was well-differentiated adenocarcinoma without lympn node metastasis. The patient was discharged from the hospital 27 days after the operation with an uneventful clinical course. Only 27 cases of gastrocolic fistula due to colonic cancer have been reported in Japan, and colonic cancer with abdominal abscess and gastrocolic fistula is especially rare. Aggressive resection of the invaded organ appears to promise a favorable prognosis for malignant gastrocolic fistura.

Gastrocolic fistulas: the increasing role of aspirin.

Eight patients had gastrocolic fistulas depicted on barium studies at the authors' hospital during a 10-year period between 1982 and 1992. Seven of those patients (88%) had benign disease, including aspirin-induced gastric ulcers of the greater curvature (n = 4), granulomatous colitis (n = 1), tuberculosis (n = 1), and a penetrating anastomotic ulcer after partial gastrectomy (n = 1). The remaining patient had a malignant gastrocolic fistula caused by carcinoma of the transverse colon. Two patients (25%) experienced classic symptoms of gastrocolic fistulas (ie, feculent vomiting or foul-smelling eructations), but the other six (75%) experienced abdominal pain or other nonspecific clinical findings. In the four patients who were taking aspirin, upper gastrointestinal examinations revealed giant penetrating ulcers of the greater curvature that communicated with the superior border of the transverse colon via a fistula. Three of these patients exhibited marked clinical improvement after conservative medical treatment and did not need surgery. This experience suggests that aspirin-induced gastric ulcers of the greater curvature have become a more common cause of gastrocolic fistulas than is carcinoma of the stomach or transverse colon.