A Case of Iatrogenic Duodenocolic Fistula due to Operative Anastomosis in an Infant Detected 32 Years after Operation

Yutaka Kimura, Nobuteru Kikkawa, Yasuto Naoi, Taro Hayashi, Takeshi Kato, Takahiko Tanigawa, Shohei Iijima, Hitoshi Yamamoto and Eiji Kurokawa

Department of Surgery, Minoh City Hospital

Cases of benign duodenocolic fistula are very rare, with only 22 reported in Japan. We report a long-term iatrogenic duodenocolic fistula due to operative anastomosis in an infant detected 32 years after operation due to high serum CEA. A 32-year-old man was admitted with abdominal distension and sense of fullness. He had undergone laparotomy as an infant when diagnosed as hernia of the abdomiinal wall. High serum CEA was pointed out and endoscopic and radiologic examinations showed a duodenocolic fistula, necessitating surgical closure of the duodenocolic fistula and hernia repair. Surgery involved a side-to-side duodenocolostomy between the anterior wall of the bulbs and the transverse colon. The duodenocolic fistula was cut with an auto suture stapler and the transverse colon including the fistulous site was partially resected. Postoperative progress was uneventful and serum CEA decreased to the normal range. The patient was of average build and well-nourished despite the large fistula (anastomosis).

Key words
iatrogenic duodenocolic fistula, side-to-side duodenocolostomy, high serum CEA

Reprint requests
Eiji Kurokawa Department of Surgery, Minoh City Hospital 5-7-1 Kayano, Minoh, 562-8562 JAPAN

Accepted
May 29, 2002

To read the PDF file you will need Abobe Reader installed on your computer.