One-stage laparoscopic-assisted resection of gastrojejunocolic fistula after gastrojejunostomy for duodenal ulcer: a case report

Abstract

IntroductionGastrojejunocolic fistula is a rare condition after gastrojejunostomy. It was thought to be a late complication related to stomal ulcers as a result of inadequate gastrectomy or incomplete vagotomy. We report a case of gastrojejunocolic fistula after gastrojejunostomy for peptic ulcer treated with one-stage laparoscopic resection.Case presentationA 41-year-old Japanese man complained of diarrhea for 10 months, as well as severe weight loss and weakness. After admission, we immediately started intravenous hyperalimentation. On performing colonoscopy and barium swallow, gastrojejunocolic fistula was observed close to the gastrojejunostomy site leading to the transverse colon. After our patient's nutritional status had improved, one-stage surgical intervention was performed laparoscopically. After the operation, our patient recovered uneventfully and his body weight increased by 5 kg within three months.ConclusionsModern management of gastrojejunocolic fistula is a one-stage resection because of the possibility of early recovery from malnutrition using parenteral nutritional methods. Today, laparoscopic one-stage en bloc resection may be feasible for patients with gastrojejunocolic fistula due to the development of laparoscopic instruments and procedures. We describe the first case of gastrojejunocolic fistula treated laparoscopically by one-stage resection and review the literature.

Duodenocolic Fistula Caused by a Peptic Stomal Ulcer Following Distal Gastrectomy

“…Several reports have shown gastrojejunocolic fistula to be a complication of partial gastrectomy and gastrojejunostomy with Billroth II (B-II) reconstruction (3,4). To our knowledge, this is the first report of DCF caused by a stomal ulcer developing 30 years after distal gastrectomy with B-I reconstruction.…”

Unusual case of gastro jejuno-colic fistula with perforation: a rare case report

“…Modern management of GJF is via a one-stage resection. Masashi Takemura and all have concluded that today, laparoscopic-assisted one-stage en bloc resection may be feasible for patients with GJC fistula [ 10 ].…”

Gastrojejunocolic fistula after gastrojejunostomy in Ayder referral hospital Northern Ethiopia: A report of two cases

“…Gastrojejunocolic fistula (GJCF) is a rare and late complication of gastrojejunostomy applied for recurrent peptic ulcer disease [1] . It was thought to be induced by a stomal ulcer, due to inadequate gastrectomy or incomplete vagotomy [1] , [2] . The symptoms in these situations include upper abdominal pain, weight loss, diarrhea, gastrointestinal bleeding, and fecal vomiting [3] .…”

“…These patients are cachectic and dehydrated, with labs showing malnutrition. Barium upper gastrointestinal series (UGIS), gastroscopy, and colonoscopy are used for diagnosis [1] . Although the occurrence of GJCF has decreased remarkably as a result of better treatment, the modern management of this condition and the generally accepted surgical treatment strategies must be discussed.…”