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Báo cáo y học: "Benign gastro-colic fistula in a woman presenting with weight loss and intermittent vomiting: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Benign gastro-colic fistula in a woman presenting with weight loss and intermittent vomiting: a case report. | Barrett et al. Journal of Medical Case Reports 2011 5 313 http www.jmedicalcasereports.eom content 5 1 313 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Benign gastro-colic fistula in a woman presenting with weight loss and intermittent vomiting a case report Kate Barrett Michael W Hii and Richard J Cade Abstract Introduction Benign gastro-colic fistula is a rare occurrence in modern surgery due to the progress in medical management of gastric ulcer disease. Here we report the first case of benign gastro-colic fistula occurring whilst on proton-pump inhibitor therapy. This is a case study of benign gastro-colic fistula and review of the available literature in regards to etiology diagnosis management and prognosis. Case presentation An 84-year-old woman of Caucasian background presented with 12 months of worsening abdominal pain nausea vomiting diarrhea and weight loss on a background of known gastric ulcer disease. Conclusion The leading cause of gastro-colic fistulae has changed from benign to malignant due to improved medical management of gastric ulcer disease. The rarity and non-specific symptoms of gastro-colic fistula make the diagnosis difficult and it is best made by barium enema however computed tomography has not been formally evaluated. Surgical management with en bloc resection of the fistula tract is the preferred treatment. Benign gastro-colic fistulae are becoming exceedingly rare in the context of modern medical management of gastric ulcer disease. Surgical management is the gold standard for both benign and malignant disease. Introduction Gastro-colic fistulae are described as presenting with the clinical triad of diarrhea nausea vomiting and weight loss 1 . However all three features are said to occur in only 30 of patients. Other symptoms include malnutrition with cachexia anemia abdominal pain and fecal halitosis that is present in over 50 of patients 1 2 . Malignant gastro-colic fistulae were first described in 1755 by Haller 3 . .