Gastrocolic Fistula: An Extraordinary Gastrointestinal Fistula

Abstract

Gastrocolic (GC) fistula, a rare gastrointestinal pathological condition, is defined as an abnormal connection between the stomach and the colon. Mostly, it involves the greater curvature of the stomach and the transverse part of the colon. Its precise incidence rate is unknown and largely differs between western and eastern nations. Etiological causes differ as well between the two worlds. Although several precipitating diseases are reported, nowadays, the most common causes are malignant diseases of the stomach (eastern countries) and colon (western world). Patients with GC fistulas usually present late and complain mainly of vomiting, diarrhea, and severe weight loss. This in turn leads to malnutrition, vitamin deficiencies and electrolyte disturbances. Being a rare condition, and usually forgotten, diagnosis is usually challenging to the treating physicians. Workup usually involves a combination of radiological and endoscopic tests. Long-term survival is unknown, and patients usually have poor prognosis. The aim of this review is to summarize the relevant articles in the English literature for this abnormal medical condition, with emphasis on the different etiologies, pathogenesis, clinical presentation, and management, in order to increase physicians' awareness of such uncommon medical problem.

Chronic diarrhoea in an elderly woman: a challenging maze

“…A GCF is an abnormal communication between the stomach and the colon, most commonly due to neoplastic invasion, but also iatrogenic, following surgery or gastrostomy tube migration 1. The incidence of iatrogenic GCF is unknown, with few case reports predominantly related to bariatric surgery 2. The best diagnostic tool is a barium study 3.…”