Gastrocolic fistula secondary to primary gastric lymphoma
1Department of Surgery, Tourabi Boudjemaa Hospital, Bechar, Algeria
Toufik Berri, Department of Surgery, Tourabi Boudjemaa Hospital, Bechar,
Gastrocolic fistula (GCF) is an abnormal communication between a
portion of the stomach and the transverse colon. It is a rare entity
and could be due to benign or malignant disease. The gastric or
is the most common malignant cause, while lymphoma is rarely reported.
The cornerstone for detecting the fistula remains the barium enema.
and computed tomography are alternatives for the diagnosis. Gastroscopy
and colonoscopy are not first-line examinations to bring out the
GCF, but they must be used to obtain cytological and biopsy materials.
for GCF remains surgical. A 36-year-old woman had a non-Hodgkin's
gastric lymphoma for 15 years ago treated by chemotherapy. After
she presented with abdominal pain, fecal halitosis, feculent vomiting,
chronic diarrhea and weight loss of 15 kg. A palpable mass in the
left hypochondriac region was found on abdominal examination. Gastroscopy
tumor on the fundus with fistulous orifice in the great curvature
of the stomach. Barium meal showed early opacification of the colon
and a fistula
between the stomach and transverse colon (A). Abdominal
CT demonstrated a wall thickening of the great curvature of the
stomach with GCF (B). There is neither adjacent nor distant
involvement by the lymphoma. According to Lugano staging system,
the lymphoma was
classified as stage
IIE. The patient was prepared for an en bloc resection of the
involved stomach and colon but she died before undergoing the operation.
: A) Barium meal;
B) Abdominal computed tomography. The arrow shows the gastrocolic fistula