Duodenocolic Fistula Caused by a Peptic Stomal Ulcer Following Distal Gastrectomy

Abstract

We herein describe the case of a 51-year-old man with a duodenocolic fistula (DCF) caused by a stomal ulcer. The patient complained of watery diarrhea, dysgeusia and malnutrition. His medical history included distal gastrectomy with Billroth I reconstruction for duodenal ulcer perforation. A combination study using endoscopy and contrast imaging confirmed the presence of DCF. Laparotomic fistulectomy was performed, which resulted in the patient's recovery from diarrhea and malnutrition. The histological findings suggested that the fistula had originated from a stomal ulcer. In patients with chronic watery diarrhea of obscure origin following gastrectomy, DCF is a possible cause of the diarrhea.

Ileo-ileal fistula with severe malnutrition caused by strangulated ileus surgery while preserving ischemic ileum: A case report

“…Most reports of entero-enteric fistulae were caused by Crohn’s disease [ 4 , 8 , 9 ]. In several other cases, including duodenal ulcer, intestinal tuberculosis, Henoch-Schönlein purpura and necrotizing enteritis in children, iatrogenic and magnetic foreign body ingestion have been reported [ 4 , [10] , [11] , [12] , [13] ]. However, to the best of our knowledge, this is the first report of ileo-ileal fistula onset after surgery for strangulated ileus without intestinal resection was performed.…”

“…The clinical symptoms of entero-enteric fistulas differ depending on which intestinal tract form the fistula. Diarrhea, weight loss, abdominal pain and other symptoms have been reported, but they are not specific [ 4 ]. Furthermore, elderly people may not have confirmed subjective symptoms.…”

“…Therefore, judgment may be difficult in some cases [ [1] , [2] , [3] ]. Entero-enteric fistula is a rare complication that occurs in patients with inflammatory bowel disease and other intestinal diseases [ 4 ]. However, there has been no reported onset in cases where surgery was performed for strangulated ileus without intestinal resection.…”