Gastrocolic fistulas

Sixteen patients were treated for gastrocolic fistula arising as a complication of peptic ulcer (11 cases), colonic perforation (2), gastric cancer (1), colonic cancer (1) or pancreatitis (1). The predominant symptoms were diarrhoea, weight loss and abdominal pain. Barium meal and barium enema were the most reliable means of diagnosis, and no fistula was gastroscopically demonstrable. A one-stage en bloc resection of the involved gastrocolic region was performed in eight cases. Other operations were simple excision (3), gastric resection with closure of the colonic wall (2) and colectomy with closure of the gastric wall (2). In one case cure was achieved with cimetidine, without surgical intervention. Four patients died postoperatively and two had recurrence of fistula.