title: Benign gastro-colic fistula in a woman presenting with weight loss and intermittent vomiting: a case report.
abstract: BACKGROUND
  Benign gastro-colic fistula is a rare occurrence in modern surgery due to the progress in medical management of gastric ulcer disease. Here we report the first case of benign gastro-colic fistula occurring whilst on proton-pump inhibitor therapy. This is a case study of benign gastro-colic fistula and review of the available literature in regards to etiology, diagnosis, management and prognosis.
  
  
  METHODS
  An 84-year-old woman of Caucasian background presented with 12 months of worsening abdominal pain, nausea, vomiting, diarrhea and weight loss on a background of known gastric ulcer disease.
  
  
  CONCLUSIONS
  The leading cause of gastro-colic fistulae has changed from benign to malignant due to improved medical management of gastric ulcer disease. The rarity and non-specific symptoms of gastro-colic fistula make the diagnosis difficult and it is best made by barium enema; however, computed tomography has not been formally evaluated. Surgical management with en bloc resection of the fistula tract is the preferred treatment. Benign gastro-colic fistulae are becoming exceedingly rare in the context of modern medical management of gastric ulcer disease. Surgical management is the gold standard for both benign and malignant disease.
authors.affiliation: St Vincent's Hospital Melbourne, PO Box 2900 Fitzroy, Victoria 3065, Australia. kate.barrett@svhm.org.au.
authors.forename: Kate
authors.initials: K
authors.lastname: Barrett
authors.forename: Michael W
authors.initials: MW
authors.lastname: Hii
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Cade