Gastroduodenal fistula – a myth or reality
DOI:
https://doi.org/10.18203/2349-2902.isj20254344Keywords:
GD fistula, Endoscopy, Rare complication, Peptic ulcer disease, Double pylorus, Upper abdominal painAbstract
Gastroduodenal fistulas are uncommon complications of peptic ulcer disease, and those involving the distal duodenum are particularly rare today. We describe an elderly man with a history of alcohol use and prior abdominal surgery who presented with longstanding upper abdominal pain, recurrent bilious vomiting, and significant weight loss. Evaluation revealed a fistulous tract between the posterior stomach and the fourth part of the duodenum, along with duodenojejunal narrowing. Definitive surgical management involved excision of the tract and reconstruction with Roux-en-Y gastrojejunostomy and duodenojejunostomy, leading to a satisfactory outcome.
References
Deshmukh F, Devani K, Francisco P, Merrell N. Gastroduodenal Fistula: A Rare Finding With an Atypical Presentation. Gastroenterol Res. 2020;13(3):121-4.
Lei JJ, Zhou L, Liu Q, Xu CF. Acquired double pylorus: Clinical and endoscopic characteristics and four-year follow-up observations. World J Gastroenterol. 2016;22(6):2153-8.
Fousekis F, Aggeli P, Kotsaftis P, Pappas-Gogos G. Double Pylorus: Report of a Case With Endoscopic Follow-Up and Review of the Literature. Gastroenterol Res. 2018;11(2):154-6.
Deshmukh F, Devani K, Francisco P, Merrell N. Gastroduodenal fistula: A rare finding with an atypical presentation. Gastroenterol Res. 2020;13(3):121-4.
Octaricha H, Miftahussurur M. Double pylorus in upper gastrointestinal bleeding. Case Report. Gastroenterol Res. 2021;15:332-7.
Safatle-Ribeiro AV, Ribeiro Júnior U, Habr-Gama A, Gama-Rodrigues JJ. Double pylorus: case report and review of literature. Rev Hosp Clin Fac Med São Paulo. 1999;54(4):131-4.
Mahmoud S, Soltany A. A rare case report of gastro-duodenal fourth segment fistula secondary to a penetrating benign gastric ulcer. J Surg Case Rep. 2019;2019(4):rjz096.
Leppäniemi A, Tolonen M, Mentula P. Complex duodenal fistulae: a surgical nightmare. World J Emerg Surg. 2023;18(1):35.
Tonolini M, Ierardi AM, Bracchi E, Magistrelli P, Vella A, Carrafiello G. Non-perforated peptic ulcer disease: multidetector CT findings, complications, and differential diagnosis. Insights Imaging. 2017;8(5):455-69.
Hu TH, Tai DI, Changchien CS, Chen TY, Chang WC: Double pylorus: report of a longitudinal follow-up in two refractory cases with underlying diseases. Am J Gastroenterol. 1995;90(5):815-8.
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