Cargando…

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

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 evolut...

Descripción completa

Detalles Bibliográficos
Autores principales: Araaya, Girmay Hagos, Desta, Kibrom Gebresilasie, Gebremeskel, Weldehawaria Weldu, Wasihun, Araya Gebreyesus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4660275/
https://www.ncbi.nlm.nih.gov/pubmed/26693276
http://dx.doi.org/10.1016/j.amsu.2015.10.012
_version_ 1782402766725971968
author Araaya, Girmay Hagos
Desta, Kibrom Gebresilasie
Gebremeskel, Weldehawaria Weldu
Wasihun, Araya Gebreyesus
author_facet Araaya, Girmay Hagos
Desta, Kibrom Gebresilasie
Gebremeskel, Weldehawaria Weldu
Wasihun, Araya Gebreyesus
author_sort Araaya, Girmay Hagos
collection PubMed
description 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.
format Online
Article
Text
id pubmed-4660275
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-46602752015-12-21 Gastrojejunocolic fistula after gastrojejunostomy in Ayder referral hospital Northern Ethiopia: A report of two cases Araaya, Girmay Hagos Desta, Kibrom Gebresilasie Gebremeskel, Weldehawaria Weldu Wasihun, Araya Gebreyesus Ann Med Surg (Lond) Original Research 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. Elsevier 2015-11-10 /pmc/articles/PMC4660275/ /pubmed/26693276 http://dx.doi.org/10.1016/j.amsu.2015.10.012 Text en © 2015 Published by Elsevier Ltd on behalf of IJS Publishing Group Limited. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research
Araaya, Girmay Hagos
Desta, Kibrom Gebresilasie
Gebremeskel, Weldehawaria Weldu
Wasihun, Araya Gebreyesus
Gastrojejunocolic fistula after gastrojejunostomy in Ayder referral hospital Northern Ethiopia: A report of two cases
title Gastrojejunocolic fistula after gastrojejunostomy in Ayder referral hospital Northern Ethiopia: A report of two cases
title_full Gastrojejunocolic fistula after gastrojejunostomy in Ayder referral hospital Northern Ethiopia: A report of two cases
title_fullStr Gastrojejunocolic fistula after gastrojejunostomy in Ayder referral hospital Northern Ethiopia: A report of two cases
title_full_unstemmed Gastrojejunocolic fistula after gastrojejunostomy in Ayder referral hospital Northern Ethiopia: A report of two cases
title_short Gastrojejunocolic fistula after gastrojejunostomy in Ayder referral hospital Northern Ethiopia: A report of two cases
title_sort gastrojejunocolic fistula after gastrojejunostomy in ayder referral hospital northern ethiopia: a report of two cases
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4660275/
https://www.ncbi.nlm.nih.gov/pubmed/26693276
http://dx.doi.org/10.1016/j.amsu.2015.10.012
work_keys_str_mv AT araayagirmayhagos gastrojejunocolicfistulaaftergastrojejunostomyinayderreferralhospitalnorthernethiopiaareportoftwocases
AT destakibromgebresilasie gastrojejunocolicfistulaaftergastrojejunostomyinayderreferralhospitalnorthernethiopiaareportoftwocases
AT gebremeskelweldehawariaweldu gastrojejunocolicfistulaaftergastrojejunostomyinayderreferralhospitalnorthernethiopiaareportoftwocases
AT wasihunarayagebreyesus gastrojejunocolicfistulaaftergastrojejunostomyinayderreferralhospitalnorthernethiopiaareportoftwocases