Long-term survival from gastrocolic fistula secondary to adenocarcinoma of the transverse colon
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Open Access
Case report
Long-term survival from gastrocolic fistula secondary to adenocarcinoma of the transverse colon Matthew J Forshaw, Jamasp K Dastur, Kothandaraman Murali and Michael C Parker* Address: Department of Surgery, Darent Valley Hospital, Dartford, Kent, DA2 8DA, UK Email: Matthew J Forshaw - [email protected]; Jamasp K Dastur - [email protected]; Kothandaraman Murali - [email protected]; Michael C Parker* - [email protected] * Corresponding author
Published: 10 February 2005 World Journal of Surgical Oncology 2005, 3:9
doi:10.1186/1477-7819-3-9
Received: 29 November 2004 Accepted: 10 February 2005
This article is available from: http://www.wjso.com/content/3/1/9 © 2005 Forshaw et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Gastrocolic fistula is a rare presentation of both benign and malignant diseases of the gastrointestinal tract. Malignant gastrocolic fistula is most commonly associated with adenocarcinoma of the transverse colon in the Western World. Despite radical approaches to treatment, long-term survival is rarely documented. Case presentation: We report a case of a 24-year-old woman who presented with the classic triad of symptoms associated with gastrocolic fistula. Radical en-bloc surgery and adjuvant chemotherapy were performed. She is still alive ten years after treatment. Conclusions: Gastrocolic fistula is an uncommon presentation of adenocarcinoma of the transverse colon. Radical en-bloc surgery with adjuvant chemotherapy may occasionally produce long-term survival.
Background
Case presentation
Gastrocolic fistula is a rare complication of both benign and malignant diseases of the gastrointestinal tract [1-6]. In the Western World, adenocarcinoma of the transverse colon is the commonest cause of a fistulous connection between the stomach and the colon with a reported incidence of 0.3–0.4% in operated cases [3,4]. Despite radical en-bloc surgery, these patients usually have a poor prognosis [5,6]. Long-term survival for these patients is rarely reported [5].
A 24-year-old woman presented to the surgical clinic with epigastric pain, feculent vomiting and post-prandial diarrhoea of three months duration; she had lost over one stone in weight. She was previously healthy and was not taking any regular medications. There was no history of peptic ulcer disease, inflammatory bowel disease, trauma or previous abdominal surgery. She had been investigated two years previously by a gastroenterologist for intermittent left-sided abdominal pain at which time the clinical examination and blood tests were normal. Irritable bowel syndrome had been diagnosed, although no colonic imaging was performed. Both her maternal grandfather and great-grandfather had suffered from colonic cancer.
The
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