Recurrent Type 1 Enterocutaneous Fistula and Granulomatous Gastritis: A Case Report

Patient: Female, 34-year-old Final Diagnosis: Enterocutaneous fistula Symptoms: Abdominal pain • fistula Medication: — Clinical Procedure: Distal subtotal gastrectomy Specialty: Surgery OBJECTIVE: Unusual clinical course BACKGROUND: Enterocutaneous fistula is an abnormal communication between the gastrointestinal tract and skin. One-third of enterocutaneous fistulas disappear spontaneously, but the rest of them require surgical treatment. CASE REPORT: We describe the case of a 34-year-old woman with enterocutaneous fistula that she had had for year. She had previously undergone 2 unsuccessful operations, and the fistula recurred twice. Distal subtotal gastrectomy and Billroth 2 reconstruction were performed. In the pathological examination, the distal gastrectomy specimen revealed foci of ulceration. Well-circumscribed non-necrotizing granulomas were occasionally encountered beneath the ulcers. CONCLUSIONS: Failure of treatment in recurrent fistula management has a variety of reasons. Our clinical experience shows that granulomatous gastritis can be a complicating factor in treatment of recurrent enterocutaneous fistula.