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Successful Management of a Colo-Duodenal Fistula in a Patient with Crohn's Disease Using a Double Lumen Gastro-Jejunostomy Tube
A 41-year-old woman was admitted with upper abdominal pain, vomiting and fever. Abdominal CT scan showed a colo-duodenal fistula with inflammatory thickening of the transverse colon. The patient's general health was poor because of hypoalbuminemia and coagulopathy. Endoscopy showed a fistula at...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
S. Karger AG
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4049022/ https://www.ncbi.nlm.nih.gov/pubmed/24932163 http://dx.doi.org/10.1159/000363374 |
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author | Zuiki, Toru Meguro, Yoshiyuki Kumano, Hidetoshi Koinuma, Koji Miyakura, Yasuyuki Horie, Hisanaga Lefor, Alan T. Sata, Naohiro Yasuda, Yoshikazu |
author_facet | Zuiki, Toru Meguro, Yoshiyuki Kumano, Hidetoshi Koinuma, Koji Miyakura, Yasuyuki Horie, Hisanaga Lefor, Alan T. Sata, Naohiro Yasuda, Yoshikazu |
author_sort | Zuiki, Toru |
collection | PubMed |
description | A 41-year-old woman was admitted with upper abdominal pain, vomiting and fever. Abdominal CT scan showed a colo-duodenal fistula with inflammatory thickening of the transverse colon. The patient's general health was poor because of hypoalbuminemia and coagulopathy. Endoscopy showed a fistula at the lower duodenal angle and the stomach was filled with refluxed stool. Ileostomy and percutaneous endoscopic gastrostomy were performed at that time and a double lumen gastro-jejunostomy inserted through the gastrostomy to allow both gastric drainage and distal enteral feeding. Nutrition support was gradually converted from parenteral to enteral feeding. Colonoscopy showed stenosis of the transverse colon with a colo-colonic fistula near the stenosis. Two months later, right hemi-colectomy and closure of the colo-duodenal fistula were performed. The resected specimen showed stenosis and a fistula in the transverse colon due to Crohn's disease. The colo-colonic fistula was present and the colo-duodenal fistula had almost closed due to fibrosis. The postoperative course was uneventful and the patient was discharged after administration of infliximab. Use of a double lumen gastro-jejunostomy tube was effective in improving the patient's general condition. This therapeutic strategy allowed the safe conduct of major resection in a high-risk patient. |
format | Online Article Text |
id | pubmed-4049022 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | S. Karger AG |
record_format | MEDLINE/PubMed |
spelling | pubmed-40490222014-06-13 Successful Management of a Colo-Duodenal Fistula in a Patient with Crohn's Disease Using a Double Lumen Gastro-Jejunostomy Tube Zuiki, Toru Meguro, Yoshiyuki Kumano, Hidetoshi Koinuma, Koji Miyakura, Yasuyuki Horie, Hisanaga Lefor, Alan T. Sata, Naohiro Yasuda, Yoshikazu Case Rep Gastroenterol Published online: May, 2014 A 41-year-old woman was admitted with upper abdominal pain, vomiting and fever. Abdominal CT scan showed a colo-duodenal fistula with inflammatory thickening of the transverse colon. The patient's general health was poor because of hypoalbuminemia and coagulopathy. Endoscopy showed a fistula at the lower duodenal angle and the stomach was filled with refluxed stool. Ileostomy and percutaneous endoscopic gastrostomy were performed at that time and a double lumen gastro-jejunostomy inserted through the gastrostomy to allow both gastric drainage and distal enteral feeding. Nutrition support was gradually converted from parenteral to enteral feeding. Colonoscopy showed stenosis of the transverse colon with a colo-colonic fistula near the stenosis. Two months later, right hemi-colectomy and closure of the colo-duodenal fistula were performed. The resected specimen showed stenosis and a fistula in the transverse colon due to Crohn's disease. The colo-colonic fistula was present and the colo-duodenal fistula had almost closed due to fibrosis. The postoperative course was uneventful and the patient was discharged after administration of infliximab. Use of a double lumen gastro-jejunostomy tube was effective in improving the patient's general condition. This therapeutic strategy allowed the safe conduct of major resection in a high-risk patient. S. Karger AG 2014-05-14 /pmc/articles/PMC4049022/ /pubmed/24932163 http://dx.doi.org/10.1159/000363374 Text en Copyright © 2014 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Users may download, print and share this work on the Internet for noncommercial purposes only, provided the original work is properly cited, and a link to the original work on http://www.karger.com and the terms of this license are included in any shared versions. |
spellingShingle | Published online: May, 2014 Zuiki, Toru Meguro, Yoshiyuki Kumano, Hidetoshi Koinuma, Koji Miyakura, Yasuyuki Horie, Hisanaga Lefor, Alan T. Sata, Naohiro Yasuda, Yoshikazu Successful Management of a Colo-Duodenal Fistula in a Patient with Crohn's Disease Using a Double Lumen Gastro-Jejunostomy Tube |
title | Successful Management of a Colo-Duodenal Fistula in a Patient with Crohn's Disease Using a Double Lumen Gastro-Jejunostomy Tube |
title_full | Successful Management of a Colo-Duodenal Fistula in a Patient with Crohn's Disease Using a Double Lumen Gastro-Jejunostomy Tube |
title_fullStr | Successful Management of a Colo-Duodenal Fistula in a Patient with Crohn's Disease Using a Double Lumen Gastro-Jejunostomy Tube |
title_full_unstemmed | Successful Management of a Colo-Duodenal Fistula in a Patient with Crohn's Disease Using a Double Lumen Gastro-Jejunostomy Tube |
title_short | Successful Management of a Colo-Duodenal Fistula in a Patient with Crohn's Disease Using a Double Lumen Gastro-Jejunostomy Tube |
title_sort | successful management of a colo-duodenal fistula in a patient with crohn's disease using a double lumen gastro-jejunostomy tube |
topic | Published online: May, 2014 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4049022/ https://www.ncbi.nlm.nih.gov/pubmed/24932163 http://dx.doi.org/10.1159/000363374 |
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