Gastrocolic fistula: a case report

D. Frisone, N. Gobin, P. Renard, S. Malekzadeh, C. Constantin, L. Barberini
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Abstract

Introduction: Gastrocolic fistula (GCF) is a rarely reported complication of numerous diseases. When associated with malignancies, the prognosis is usually poor. The classic presentation includes diarrhea, feculent vomiting, and weight loss. Presentation of Case: We hereby report the case of a patient who presented with weight loss and dyspepsia for 2 months, in the absence of diarrhea. Diagnosis of a GCF was made by performing a gastroscopy and a computed tomography scan. The biopsy taken during gastroscopy showed a lower tract gastrointestinal cancer, and the patient underwent surgical treatment by “en bloc” resection. After an anastomosis leak, he recovered well and underwent adjuvant chemotherapy. After a 3-year follow-up, the patient is alive and disease free. Discussion: This case presentation, together with a literature review, underlines that variable symptoms and signs that can be associated to this rare condition. The role of new imaging techniques such as computed tomography scan, compared with barium enema, should also be evaluated in this setting. The absence of lymph-node involvement may predict a good prognosis. Conclusion: GCF is a rare presentation of malignant diseases. In order to diagnose this rare condition a high grade of suspicion is needed, as symptoms are variable and most diagnostic tools are not sensitive enough to recognize it.
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胃结肠瘘1例
摘要胃结肠瘘(GCF)是一种罕见的疾病并发症。当合并恶性肿瘤时,预后通常很差。典型的表现包括腹泻、多粪呕吐和体重减轻。病例介绍:我们在此报告一例患者,在没有腹泻的情况下,出现体重减轻和消化不良2个月。GCF的诊断是通过胃镜检查和计算机断层扫描进行的。胃镜检查活检显示为下消化道肿瘤,患者接受了“整体”切除手术治疗。吻合口漏后恢复良好,接受了辅助化疗。经过3年的随访,患者存活且无疾病。讨论:本病例报告,连同文献回顾,强调了与这种罕见疾病相关的各种症状和体征。与钡灌肠相比,计算机断层扫描等新成像技术的作用也应在这种情况下进行评估。没有淋巴结累及可能预示着良好的预后。结论:GCF是一种罕见的恶性疾病。为了诊断这种罕见的疾病,需要高度怀疑,因为症状是可变的,大多数诊断工具不够敏感,无法识别它。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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