J Korean Surg Soc.  2013 Apr;84(4):252-255. 10.4174/jkss.2013.84.4.252.

Gastrojejuno-colic fistula after gastrojejunostomy

• Kim KH
• Jee YS

• KMID: 2212471
• DOI: http://doi.org/10.4174/jkss.2013.84.4.252

Abstract

Gastrojejunocolic fistula is a rare condition after gastrojejunostomy. It is severe complications of gastrojejunostomy, which results an inadequate resection or incomplete vagotomy during peptic ulcer surgery. The symptoms are diarrhea, upper abdominal pain, bleeding, vomiting and weight loss. A 55-year-old man with chronic diarrhea and weight loss for 6 months visited Dankook University Hospital. The patient had received a truncal vagotomy and gastrojejunostomy for duodenal ulcer obstruction 15 years previously. The patient underwent gastroscopy and upper gastrointestinal series evaluations, which detected the gastrojejunocolic fistula. After improving of malnutrition, an exploratory laparotomy was undertaken, which revealed that the gastrojejunostomy site and the T-colon formed adhesion and fistula. En block resection of the distal stomach and T-colon included the gastrojejunocolic fistula, and Roux-en-Y gastrojejunostomy was performed. Recovery was uneventful and the patient remained well at the follow-up. We report a gastrojejunocolic fistula, which is a rare case after gastrojejunostomy.

Keyword

Gastrojejunocolic fistula; Gastrojejunostomy; Peptic ulcer disease

MeSH Terms

Abdominal Pain
Diarrhea
Duodenal Ulcer
Fistula
Follow-Up Studies
Gastric Bypass
Gastroscopy
Hemorrhage
Humans
Laparotomy
Malnutrition
Peptic Ulcer
Stomach
Vagotomy
Vagotomy, Truncal
Vomiting
Weight Loss

Figure

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  Fig. 1 Upper gastrointestinal series assessment confirming the passage between the corpus of the stomach and the transverse colon (arrow).

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  Fig. 2 Esophago-gastroduodenoscopy showing a newly-formed gastrojejuno-colic fistula opening.

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  Fig. 3 At surgery, gastrojejuno-colic fistula was identified and gatrojejunostomy was performed by retrocolic fashion, as in the previous surgery.

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  Fig. 4 The postoperative specimen of en bloc resection includes the distal portion of stomach, jejunum, and transverse colon.

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  Fig. 5 The first catheter passes through gastrojejuno-stomy (G-J stomy) from the previous surgery and the second catheter passes through the newly formed gastrojejuno-colic (G-C) fistula.

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