Duodenocolic Fistula Caused by a Peptic Stomal Ulcer Following Distal Gastrectomy

Masayuki Sawaguchi; Mario Jin; Tamotsu Matsuhashi; Reina Ohba; Natsumi Hatakeyama; Shigeto Koizumi; Kengo Onochi; Shin Tawaraya; Noboru Watanabe; Hiroshi Uchinami; Yuzo Yamamoto; Hirohide Ohnishi; Hirosato Mashima

doi:10.2169/internalmedicine.52.0496

CASE REPORTS

Duodenocolic Fistula Caused by a Peptic Stomal Ulcer Following Distal Gastrectomy

Masayuki Sawaguchi, Mario Jin, Tamotsu Matsuhashi, Reina Ohba, Natsumi Hatakeyama, Shigeto Koizumi, Kengo Onochi, Shin Tawaraya, Noboru Watanabe, Hiroshi Uchinami, Yuzo Yamamoto, Hirohide Ohnishi, Hirosato Mashima

Author information

Masayuki Sawaguchi
Department of Gastroenterology, Akita University Graduate School of Medicine, Japan
Mario Jin
Department of Gastroenterology, Akita University Graduate School of Medicine, Japan
Tamotsu Matsuhashi
Department of Gastroenterology, Akita University Graduate School of Medicine, Japan
Reina Ohba
Department of Gastroenterology, Akita University Graduate School of Medicine, Japan
Natsumi Hatakeyama
Department of Gastroenterology, Akita University Graduate School of Medicine, Japan
Shigeto Koizumi
Department of Gastroenterology, Akita University Graduate School of Medicine, Japan
Kengo Onochi
Department of Gastroenterology, Akita University Graduate School of Medicine, Japan
Shin Tawaraya
Department of Gastroenterology, Akita University Graduate School of Medicine, Japan
Noboru Watanabe
Department of Gastroenterology, Akita University Graduate School of Medicine, Japan
Hiroshi Uchinami
Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, Japan
Yuzo Yamamoto
Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, Japan
Hirohide Ohnishi
Department of Gastroenterology, Akita University Graduate School of Medicine, Japan
Hirosato Mashima
Department of Gastroenterology, Akita University Graduate School of Medicine, Japan

Keywords: diarrhea, duodenocolic fistula (DCF), peptic stomal ulcer, endoscopy, contrast imaging

JOURNAL OPEN ACCESS
Supplementary material

2013 Volume 52 Issue 14 Pages 1579-1583

DOI https://doi.org/10.2169/internalmedicine.52.0496

Details

Abstract

We herein describe the case of a 51-year-old man with a duodenocolic fistula (DCF) caused by a stomal ulcer. The patient complained of watery diarrhea, dysgeusia and malnutrition. His medical history included distal gastrectomy with Billroth I reconstruction for duodenal ulcer perforation. A combination study using endoscopy and contrast imaging confirmed the presence of DCF. Laparotomic fistulectomy was performed, which resulted in the patient's recovery from diarrhea and malnutrition. The histological findings suggested that the fistula had originated from a stomal ulcer. In patients with chronic watery diarrhea of obscure origin following gastrectomy, DCF is a possible cause of the diarrhea.

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