Gastrocolonic fistula: a rare complication of upper gastrointestinal surgery

Hong, Trudy; Koh, Dion; Gray, Andrew

A gastrocolonic fistula is a rare surgical presentation, typically in the setting of gastric or colonic malignancy. This report presents the first reported Australian case of a gastrocolonic fistula following upper gastrointestinal surgery. A middle-aged woman presented to emergency with a short history of severe abdominal pain, faeculent vomiting, profuse diarrhoea and weight loss. This was in the setting of a previous pylorus-preserving pancreaticoduodenectomy complicated by marginal ulceration, for which a distal gastrectomy and Roux-en-Y reconstruction was required. The rarity of gastrocolonic fistulae and non-specific presentation with diarrhoea, vomiting and weight loss can make the diagnosis challenging. The mainstay of management is surgical resection in both benign and malignant disease.