Gastrocolic fistula as a cause of persistent diarrhea in a patient with a gastrostomy tube.
A 60-year-old man with a history of recurrent strokes secondary to moyamoya disease underwent insertion of a percutaneous radiologic gastrostomy tube because of severe dysphagia. Feeding was continued for 5 months after the procedure without complications. Persistent diarrhea began 2 weeks after admission for comprehensive rehabilitation. Conservative treatment was not effective. Sigmoidoscopy showed a U-shaped tube suggestive of a gastrocolic fistula in the transverse colon. This was confirmed by means of a tubogram obtained through a gastrostomy tube. The diarrhea resolved after changing the gastrostomy tube. This case report highlights the importance of considering other uncommon conditions, such as a gastrocolic fistula, in the differential diagnosis of persistent diarrhea in a patient with a gastrostomy tube.
Department of Rehabilitation Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Republic of Korea.
Young Jin
YJ
Joo
Jung Hoi
JH
Koo
Sun Hong
SH
Song
D003108:Colonic Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D020878:Device Removal; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D004750:Enteral Nutrition / Q000009:adverse effects* / Q000295:instrumentation; D005500:Follow-Up Studies; D005747:Gastric Fistula / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005774:Gastrostomy / Q000009:adverse effects*; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012812:Sigmoidoscopy; D020521:Stroke / Q000628:therapy; D014057:Tomography, X-Ray Computed