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Gastrojejunocolic fistula after gastrojejunostomy in Ayder referral hospital Northern Ethiopia: A report of two cases.

Araaya GH, Desta KG, Gebremeskel WW, Wasihun AG - Ann Med Surg (Lond) (2015)

Bottom Line: Upper GI series or barium enema studies allowed a conclusive diagnosis to be made.As it is rare phenomenon, high clinical suspicion is very important in the diagnosis of GJCF on patients who manifest with chronic diarrhea, vomiting of fecal matter, abdominal pain and features of malnutrition.Careful preoperative preparation is mandatory before any type of surgical procedure is carried out.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, School of Medicine, College of Health Sciences, Ayder Referral Hospital, Mekelle University, Ethiopia.

ABSTRACT

Background: Gastrojejunocolic fistula (GJCF) is a late and severe complication of a stomal ulcer after gastrojejunostomy, which develops as a result of inadequate resection of stomach or incomplete vagotomy. The occurrence of perforation in a GJCF is even more a rare complication because long evolution time or latent period is required for its appearance. Patients with this condition usually present with diarrhea, weight loss, feculent vomiting, under-nutrition and features of peritonitis that require immediate surgical intervention.

Case presentation: We described two cases of gastrojejunocolic fistula in men aged 60 and 40, first cases of gastrojejunocolic fistula seen in our referral hospital and in the whole region following more than a decade after gastrojejunostomy. Both patients initially presented with watery diarrhea, vomiting of fecal materials, poor appetite and weight loss. Upper GI series or barium enema studies allowed a conclusive diagnosis to be made. Both patients underwent one-stage en bloc resection, and their postoperative course and outcome was one cure and one death.

Conclusion: As it is rare phenomenon, high clinical suspicion is very important in the diagnosis of GJCF on patients who manifest with chronic diarrhea, vomiting of fecal matter, abdominal pain and features of malnutrition. Careful preoperative preparation is mandatory before any type of surgical procedure is carried out. Pre-operative nutritional status should be evaluated in patients undergoing corrective surgery. Adequate resection of the stomach after Gastrojejunostomy and complete vagotomy is important to prevention development of GJCF.

No MeSH data available.


Related in: MedlinePlus

Intraoperative acquired photograph showing gastrojejunostomy and end-to-end transvers colon anastomosis.
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fig2: Intraoperative acquired photograph showing gastrojejunostomy and end-to-end transvers colon anastomosis.

Mentions: In this report, we described two cases of GJCF fistula in patients of 60 and 40 years men and review the literature relevant to their diagnosis and management (Fig. 1, Fig. 2).


Gastrojejunocolic fistula after gastrojejunostomy in Ayder referral hospital Northern Ethiopia: A report of two cases.

Araaya GH, Desta KG, Gebremeskel WW, Wasihun AG - Ann Med Surg (Lond) (2015)

Intraoperative acquired photograph showing gastrojejunostomy and end-to-end transvers colon anastomosis.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4660275&req=5

fig2: Intraoperative acquired photograph showing gastrojejunostomy and end-to-end transvers colon anastomosis.
Mentions: In this report, we described two cases of GJCF fistula in patients of 60 and 40 years men and review the literature relevant to their diagnosis and management (Fig. 1, Fig. 2).

Bottom Line: Upper GI series or barium enema studies allowed a conclusive diagnosis to be made.As it is rare phenomenon, high clinical suspicion is very important in the diagnosis of GJCF on patients who manifest with chronic diarrhea, vomiting of fecal matter, abdominal pain and features of malnutrition.Careful preoperative preparation is mandatory before any type of surgical procedure is carried out.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, School of Medicine, College of Health Sciences, Ayder Referral Hospital, Mekelle University, Ethiopia.

ABSTRACT

Background: Gastrojejunocolic fistula (GJCF) is a late and severe complication of a stomal ulcer after gastrojejunostomy, which develops as a result of inadequate resection of stomach or incomplete vagotomy. The occurrence of perforation in a GJCF is even more a rare complication because long evolution time or latent period is required for its appearance. Patients with this condition usually present with diarrhea, weight loss, feculent vomiting, under-nutrition and features of peritonitis that require immediate surgical intervention.

Case presentation: We described two cases of gastrojejunocolic fistula in men aged 60 and 40, first cases of gastrojejunocolic fistula seen in our referral hospital and in the whole region following more than a decade after gastrojejunostomy. Both patients initially presented with watery diarrhea, vomiting of fecal materials, poor appetite and weight loss. Upper GI series or barium enema studies allowed a conclusive diagnosis to be made. Both patients underwent one-stage en bloc resection, and their postoperative course and outcome was one cure and one death.

Conclusion: As it is rare phenomenon, high clinical suspicion is very important in the diagnosis of GJCF on patients who manifest with chronic diarrhea, vomiting of fecal matter, abdominal pain and features of malnutrition. Careful preoperative preparation is mandatory before any type of surgical procedure is carried out. Pre-operative nutritional status should be evaluated in patients undergoing corrective surgery. Adequate resection of the stomach after Gastrojejunostomy and complete vagotomy is important to prevention development of GJCF.

No MeSH data available.


Related in: MedlinePlus