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Case Report: Spontaneous Healing Of A Gastro-colic Fistula Due To A Benign Gastric Ulcer

Mccullough & Gregson, 1987Stomach cancer

Clinical Radiology 38(4): July 1987; 431-433

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Abstract

Gastro-colic fistula is an uncommon complication of a benign gastric ulcer. The commonest causes of a gastro-colic fistula are carcinoma of the stomach, carcinoma of the colon and previous gastric surgery for peptic ulcer disease and surgery is the treatment of choice. We report a case of gastro-colic fistula due to a benign gastric ulcer, which healed spontaneously without treatment. Only one previous case of spontaneous healing of a gastro-colic fistula has been described and this patient subsequently had surgery to exclude an underlying malignant disease.

Case Details

Personal Characteristics

62-year-old man, history of hypertension and testicular seminoma, taking digoxin, cyclopenthiazide with potassium chloride and guanethidine, recently started on naproxen for a painful right knee

Clinical Characteristics

6-week history of epigastric pain and intermittent diarrhea, fistula between the transverse colon and the greater curve of the stomach, large gastric ulcer, healed gastric ulcer on the greater curve of the stomach with mucosal folds radiating towards the site of the scar, chronic inflammatory cell infiltrate in the lamina propria

Remission Characteristics

Healed gastric ulcer on the greater curve of the stomach, normal transverse colon with no evidence of a gastro-colic fistula

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

Barium enema, barium meal, endoscopy, biopsies

Additional Notes

The patient remains alive and well 3 years later