Radiology, Vol 187, 359-361, Copyright © 1993 by Radiological Society of North America

ARTICLES

Gastrocolic fistulas: the increasing role of aspirin

MS Levine, MR Kelly, I Laufer, SE Rubesin and H Herlinger
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.

Eight patients had gastrocolic fistulas depicted on barium studies at the authors' hospital during a 10-year period between 1982 and 1992. Seven of those patients (88%) had benign disease, including aspirin- induced gastric ulcers of the greater curvature (n = 4), granulomatous colitis (n = 1), tuberculosis (n = 1), and a penetrating anastomotic ulcer after partial gastrectomy (n = 1). The remaining patient had a malignant gastrocolic fistula caused by carcinoma of the transverse colon. Two patients (25%) experienced classic symptoms of gastrocolic fistulas (ie, feculent vomiting or foul-smelling eructations), but the other six (75%) experienced abdominal pain or other nonspecific clinical findings. In the four patients who were taking aspirin, upper gastrointestinal examinations revealed giant penetrating ulcers of the greater curvature that communicated with the superior border of the transverse colon via a fistula. Three of these patients exhibited marked clinical improvement after conservative medical treatment and did not need surgery. This experience suggests that aspirin-induced gastric ulcers of the greater curvature have become a more common cause of gastrocolic fistulas than is carcinoma of the stomach or transverse colon.

This article has been cited by other articles:

				S. E. Rubesin, M. S. Levine, and I. Laufer Double-Contrast Upper Gastrointestinal Radiography: A Pattern Approach for Diseases of the Stomach Radiology, January 1, 2008; 246(1): 33 - 48. [Abstract] [Full Text] [PDF]

				P. J. Pickhardt, S. Bhalla, and D. M. Balfe Acquired Gastrointestinal Fistulas: Classification, Etiologies, and Imaging Evaluation Radiology, July 1, 2002; 224(1): 9 - 23. [Abstract] [Full Text]