GASTRO-JEJUNO-COLIC FISTULA: A LATE COMPLICATION OF GJ +VAGOTOMY

We herein report the case of a 49-year-old man with gastrojejunocolic fistula. It is one of the late severe complications of gastrectomy and gastrojejunostomy and is considered to be induced by a stomal ulcer due to inadequate resection of the stomach and incompleteness of vagotomy. Patients usually present with Diarrhoea, Weight loss and Eructation of faecal smelling gas, Epigastric pain, Fatigue, Nutritional deficiencies and faecal vomiting. The diagnostic workup should include barium enema, gastroscopy and sometimes colonoscopy and abdominal CT scan for excluding and ruling out the possibility of malignant extraluminal disease. The historical approach of the treatment of this rare entity was 2?3-phased operations which included colostomy. However today, medical management has recently been recommended as the first-line therapy, with parenteral and enteral support treatments. The preferred surgical approach is single-stage gastrocolic resection and anastomosis and this has been favoured to minimize mortality.