Details

Autor(en) / Beteiligte

• Muneyuki KOYAMA
• Hiroaki SHIBA
• Yuto YAMAHATA
• Lulu LEE
• Minako ODAKA
• Sho OTSUKA
• Yosuke KANEDA
• Masahisa OHKUMA
• Ken ETO

Titel

Gastric-transverse Colon Fistulas are Difficult to Diagnose Owing to Proximal Gastric Ulcers : A Case Report

Ist Teil von

• Jikeikai Medical Journal, 2022-03, Vol.69 (1), p.7-12

Ort / Verlag

The Jikei University School of Medicine Tokyo

Erscheinungsjahr

2022

Quelle

Electronic Journals Library

Beschreibungen/Notizen

• [ABSTRACT] A gastrocolic fistula arising from a benign gastric ulcer is rare and is extremely difficult to diagnose in the presence of other complications, such as a gastric ulcer and digestive tube bleeding. We present a case of gastrocolic fistula that was difficult to diagnose owing to a nearby giant ulcer. A 64-year-old man presented with 1-year history of preprandial and postprandial epigastric pain. Because laboratory studies revealed mild anemia, we suspected a hemorrhagic gastric ulcer and performed an emergent gastroscopic examination. It revealed a giant gastric ulcer on the upper and middle posterior walls of the stomach body. We started treatment with proton pump inhibitors. When we performed a follow-up gastroscopic examination, we suspected a gastrocolic fistula because of the patient's halitosis with a fecal odor and carefully observed the inside of the stomach. We found that the ulcer had improved but also found on the posterior wall of the middle gastric body near the ulcer a gastrocolic fistula leading to the transverse colon. Because gastrocolic fistulas near ulcers are difficult to diagnose with radiographic imaging and endoscopic examinations at initial presentation owing to inflammatory edema, we believe physical examination and follow-up imaging and endoscopic examinations are important.