Gastrocolic fistula secondary to adenocarcinoma of the transverse colon: a case report

Abstract

IntroductionGastrocolic fistula is a rare complication of adenocarcinoma of the colon. Despite radical resections, these patients usually have a poor prognosis with a mean survival of 23 months and long-term survival is rarely reported.Case presentationA 48-year-old Latino-American man presented with watery diarrhea, diffuse abdominal pain and weight loss for 3 months. A computed tomography scan revealed a mass in the splenic flexure that had infiltrated his stomach and diaphragm. Panendoscopy and colonoscopy confirmed the presence of a fistula between the distal transverse colon and the stomach, which was secondary to a colon cancer. His colon, stomach and left diaphragm were resected en bloc. A histological examination revealed a moderately differentiated adenocarcinoma of the colon that had infiltrated the full width of the gastric wall with 37 negative lymph nodes and clear surgical margins. Adjuvant chemotherapy with capecitabine and oxaliplatin was administered after surgery. Our patient is alive and without any recurrence 5 years after surgery.ConclusionsEn bloc resection with adjuvant chemotherapy offers the best treatment option for gastrocolic fistulas. This is one of the patients with greater survival reported in the medical literature.

A gastro-colic fistula secondary to high-grade B-cell gastric lymphoma in a patient with AIDS: a case report

“… 5 – 7 Malignant diseases are mainly related to gastric cancer and colon adenocarcinoma. 8 , 9 Colonic adenocarcinoma is the most common cause of malignant disease in Western countries, whereas gastric cancer is the primary cause in Japan and other Asian countries. 10 , 11 However, to our knowledge, there is no previous report of a GCF caused by primary high-grade B-cell gastric lymphoma in an AIDS patient.…”

Gastrocolic Fistula: A Rare Presentation of Colon Cancer

“…Gastrocolic fistula secondary to colon cancer is very rare; this may be attributed to prevention and early diagnosis of colon cancer with screening and surveillance colonoscopy [ 6 ]. Geographical location plays a role in etiology of malignant gastrocolic fistula, with gastric cancers being more common in Japan and eastern countries, while colon cancer is the most frequent etiology in western countries [ 7 ].…”

Gastrocolic fistula: a case report

“…Interesting to note, in our case no lymph-nodes (0/71) were found to be involved in the pathologic specimen. This could probably reflect a better prognosis, since another case of GCF with a disease-free survival of 5 years has been reported in a man whose specimen had 37 negative lymph-nodes [20] . We found another recent case report with absence of lymph-node involvement, for which we do not have long follow-up data [21] .…”