title: Gastrocolic fistula secondary to adenocarcinoma of the transverse colon: a case report.
abstract: BACKGROUND
  Gastrocolic fistula is a rare complication of adenocarcinoma of the colon. Despite radical resections, these patients usually have a poor prognosis with a mean survival of 23 months and long-term survival is rarely reported.
  
  
  METHODS
  A 48-year-old Latino-American man presented with watery diarrhea, diffuse abdominal pain and weight loss for 3 months. A computed tomography scan revealed a mass in the splenic flexure that had infiltrated his stomach and diaphragm. Panendoscopy and colonoscopy confirmed the presence of a fistula between the distal transverse colon and the stomach, which was secondary to a colon cancer. His colon, stomach and left diaphragm were resected en bloc. A histological examination revealed a moderately differentiated adenocarcinoma of the colon that had infiltrated the full width of the gastric wall with 37 negative lymph nodes and clear surgical margins. Adjuvant chemotherapy with capecitabine and oxaliplatin was administered after surgery. Our patient is alive and without any recurrence 5 years after surgery.
  
  
  CONCLUSIONS
  En bloc resection with adjuvant chemotherapy offers the best treatment option for gastrocolic fistulas. This is one of the patients with greater survival reported in the medical literature.
authors.affiliation: Colorectal Surgery, Medica Sur Clinic and Foundation, Puente de Piedra 150, Col. Toriello Guerra, Mexico City, 14050, Mexico. omarvergara74@hotmail.com.
authors.forename: Omar
authors.initials: O
authors.lastname: Vergara-Fernández
authors.affiliation: Liver Research Unit, Medica Sur Clinic and Foundation, Puente de Piedra 150, Col. Toriello Guerra, Mexico City, 14050, Mexico. ylsegrobe@gmail.com.
authors.forename: Ylse
authors.initials: Y
authors.lastname: Gutiérrez-Grobe
authors.affiliation: Liver Research Unit, Medica Sur Clinic and Foundation, Puente de Piedra 150, Col. Toriello Guerra, Mexico City, 14050, Mexico. isabellavenant@hotmail.com.
authors.forename: María
authors.initials: M
authors.lastname: Lavenant-Borja
authors.affiliation: Liver Research Unit, Medica Sur Clinic and Foundation, Puente de Piedra 150, Col. Toriello Guerra, Mexico City, 14050, Mexico. enriquerojasmd@hotmail.com.
authors.forename: Carlos
authors.initials: C
authors.lastname: Rojas
authors.affiliation: Liver Research Unit, Medica Sur Clinic and Foundation, Puente de Piedra 150, Col. Toriello Guerra, Mexico City, 14050, Mexico. nmendez@medicasur.org.mx.
authors.forename: Nahum
authors.initials: N
authors.lastname: Méndez-Sánchez
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000230:Adenocarcinoma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D044684:Colon, Transverse / Q000473:pathology*; D003110:Colonic Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D003113:Colonoscopy; D005747:Gastric Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005773:Gastroscopy; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D015431:Weight Loss