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Menni A, Tzikos G, Rafailidis V, Krokou D, Karlafti E, Michalopoulos A, Paramythiotis D. Gastrocolic fistula in Crohn's disease: A case report and review of the literature. Radiol Case Rep 2022; 17:4756-4760. [PMID: 36212753 PMCID: PMC9535290 DOI: 10.1016/j.radcr.2022.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 08/29/2022] [Accepted: 09/04/2022] [Indexed: 11/25/2022] Open
Abstract
Gastrointestinal fistulas constitute a rare type of abdominal fistula and an uncommon complication in the setting of Crohn's disease. In this case presentation we study the treatment of a gastrointestinal fistula between the transverse colon and the stomach in a patient with Crohn's disease and present a review of the available literature. A 53-year-old female patient with history of Crohn's disease presented to the Emergency Department of our Hospital due to reported abdominal pain and clinical symptoms of incomplete ileus with no other specific symptoms. Imaging investigation included plain radiography and computed tomography of the abdomen and revealed mural thickening of the transverse colon for an approximately 10 cm long segment, with the possible presence of gastrocolic fistula. During the exploratory laparotomy, an inflammatory mass was found in the middle of the transverse colon and the communication with the stomach was confirmed. Excision of the affected part of the transverse colon and cuneiform resection of the stomach in the area of the fistula was performed. The patient presented smooth and uncomplicated postoperative period and was discharged on the 10th postoperative day. Gastrointestinal fistulas are an uncommon complication of Crohn's disease, often with an intense clinical manifestation from the upper and lower digestive tract. Surgical treatment, either open or laparoscopic, of gastrointestinal fistulas due to Crohn's disease is the "gold-standard" method, both to control the disease and avoid further complications.
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Affiliation(s)
- Alexandra Menni
- 1st Propedeutic Department of Surgery, Aristotle's University of Thessaloniki, AHEPA University Hospital, Adamantiou Korai 29, Plagiari, 57500 Thessaloniki, Greece,Corresponding author.
| | - Georgios Tzikos
- 1st Propedeutic Department of Surgery, Aristotle's University of Thessaloniki, AHEPA University Hospital, Adamantiou Korai 29, Plagiari, 57500 Thessaloniki, Greece
| | - Vasileios Rafailidis
- Department of Radiology, AHEPA University Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Despoina Krokou
- 1st Propedeutic Department of Surgery, Aristotle's University of Thessaloniki, AHEPA University Hospital, Adamantiou Korai 29, Plagiari, 57500 Thessaloniki, Greece
| | - Eleni Karlafti
- Emergency Department, Aristotle's University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Antonios Michalopoulos
- 1st Propedeutic Department of Surgery, Aristotle's University of Thessaloniki, AHEPA University Hospital, Adamantiou Korai 29, Plagiari, 57500 Thessaloniki, Greece
| | - Daniel Paramythiotis
- 1st Propedeutic Department of Surgery, Aristotle's University of Thessaloniki, AHEPA University Hospital, Adamantiou Korai 29, Plagiari, 57500 Thessaloniki, Greece
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