Multidisciplinary Management of a Gastrocolic Fistula Secondary to Gastric Cancer: A Case Report and Literature Review
George Ede
Limi Hospital, Abuja, Nigeria.
Shiney Ansa James
Department of General Surgery, Barking Havering and Redbridge University Hospitals NHS Trust, England.
Thiyagakarthick Raja
Davao Medical School Foundation, Philippines.
Craig Omoruyi Osawaru
University of Benin, Benin.
Muhammad Subhan *
Department of Internal Medicine, Allama Iqbal Medical College, Lahore, Pakistan.
Ruqiya Bibi
Department of Internal Medicine, Allama Iqbal Medical College, Lahore, Pakistan.
*Author to whom correspondence should be addressed.
Abstract
Gastrocolic fistula, an uncommon complication of gastric cancer, represents a significant clinical challenge due to its rarity and complex management. This report presents a case of a 65-year-old female presenting with epigastric pain, foul-smelling vomiting, weight loss, and abdominal distension. Clinical examination revealed a distended abdomen with positive bowel sounds, and laboratory findings showed anemia, leukocytosis, thrombocytosis, and elevated erythrocyte sedimentation rate (ESR). Imaging studies identified a fistulous tract connecting the distal stomach and mid-transverse colon, alongside liver metastasis, abdominopelvic ascites, and pleural effusion. Endoscopy confirmed gastric adenocarcinoma with a gastrocolic fistula. The patient underwent a multidisciplinary approach, including diagnostic laparoscopy, distal gastrectomy with gastrojejunal anastomosis, and systemic chemotherapy. This case highlights the importance of early detection and collaborative management in treating gastrocolic fistulas associated with gastric cancer, emphasizing the need for further research to optimize therapeutic strategies and improve patient outcomes.
Keywords: Gastrocolic fistula, gastric cancer, clinical challenge