Gastroenterocolic fistula in the patient after previous gastric resection and hepaticoenterostomy due to complicated ulcer disease – case report

The report presents the case of a patient treated surgically for perforated gastroenterocolic fistula with a concomitant abscess in abdominal integuments and symptoms of the digestive tract blockage. Many months before this surgery the patient had undergone gastric resection and hepaticoenterostomy (Roux-Y) due to inflammatory tumor causing pyrolostenosis and including the peripheral part of the common bile duct. After the surgery, the patient suffered from recurrent abdominal pain which resulted in many hospitalizations. After one of the episodes of complaints, the patient with symptoms of the digestive tract blockage was admitted again to our ward, prepared to the surgery and qualified for the surgical intervention. En bloc resection of the stomach, hepaticoenterostomy and partial resection of the transverse colon were performed. The continuity of the digestive tract was restored by gastroenterostomy with the isolated jejunal loop, anastomosis between the hepatic loop and side of the afferent loop and end-to-end anastomosis of the transverse colon. There were no postoperative complications. The authors point out circumstances affected on decision to postpone the surgery by the patient despite frequent recurrent complaints after primary surgery and numerous previous hospitalizations.