Successful Management of a Colo-Duodenal Fistula in a Patient with Crohn's Disease Using a Double Lumen Gastro-Jejunostomy Tube
A 41-year-old woman was admitted with upper abdominal pain, vomiting and fever. Abdominal CT scan showed a colo-duodenal fistula with inflammatory thickening of the transverse colon. The patient's general health was poor because of hypoalbuminemia and coagulopathy. Endoscopy showed a fistula at...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Karger Publishers
2014-05-01
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| Series: | Case Reports in Gastroenterology |
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| Online Access: | http://www.karger.com/Article/FullText/363374 |
| _version_ | 1819141827613163520 |
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| author | Toru Zuiki Yoshiyuki Meguro Hidetoshi Kumano Koji Koinuma Yasuyuki Miyakura Hisanaga Horie Alan T. Lefor Naohiro Sata Yoshikazu Yasuda |
| author_facet | Toru Zuiki Yoshiyuki Meguro Hidetoshi Kumano Koji Koinuma Yasuyuki Miyakura Hisanaga Horie Alan T. Lefor Naohiro Sata Yoshikazu Yasuda |
| author_sort | Toru Zuiki |
| collection | DOAJ |
| description | A 41-year-old woman was admitted with upper abdominal pain, vomiting and fever. Abdominal CT scan showed a colo-duodenal fistula with inflammatory thickening of the transverse colon. The patient's general health was poor because of hypoalbuminemia and coagulopathy. Endoscopy showed a fistula at the lower duodenal angle and the stomach was filled with refluxed stool. Ileostomy and percutaneous endoscopic gastrostomy were performed at that time and a double lumen gastro-jejunostomy inserted through the gastrostomy to allow both gastric drainage and distal enteral feeding. Nutrition support was gradually converted from parenteral to enteral feeding. Colonoscopy showed stenosis of the transverse colon with a colo-colonic fistula near the stenosis. Two months later, right hemi-colectomy and closure of the colo-duodenal fistula were performed. The resected specimen showed stenosis and a fistula in the transverse colon due to Crohn's disease. The colo-colonic fistula was present and the colo-duodenal fistula had almost closed due to fibrosis. The postoperative course was uneventful and the patient was discharged after administration of infliximab. Use of a double lumen gastro-jejunostomy tube was effective in improving the patient's general condition. This therapeutic strategy allowed the safe conduct of major resection in a high-risk patient. |
| first_indexed | 2024-12-22T12:00:38Z |
| format | Article |
| id | doaj.art-fedec79631f44cf5893d70e3e66c0213 |
| institution | Directory Open Access Journal |
| issn | 1662-0631 |
| language | English |
| last_indexed | 2024-12-22T12:00:38Z |
| publishDate | 2014-05-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Gastroenterology |
| spelling | doaj.art-fedec79631f44cf5893d70e3e66c02132022-12-21T18:26:38ZengKarger PublishersCase Reports in Gastroenterology1662-06312014-05-018216216810.1159/000363374363374Successful Management of a Colo-Duodenal Fistula in a Patient with Crohn's Disease Using a Double Lumen Gastro-Jejunostomy TubeToru ZuikiYoshiyuki MeguroHidetoshi KumanoKoji KoinumaYasuyuki MiyakuraHisanaga HorieAlan T. LeforNaohiro SataYoshikazu YasudaA 41-year-old woman was admitted with upper abdominal pain, vomiting and fever. Abdominal CT scan showed a colo-duodenal fistula with inflammatory thickening of the transverse colon. The patient's general health was poor because of hypoalbuminemia and coagulopathy. Endoscopy showed a fistula at the lower duodenal angle and the stomach was filled with refluxed stool. Ileostomy and percutaneous endoscopic gastrostomy were performed at that time and a double lumen gastro-jejunostomy inserted through the gastrostomy to allow both gastric drainage and distal enteral feeding. Nutrition support was gradually converted from parenteral to enteral feeding. Colonoscopy showed stenosis of the transverse colon with a colo-colonic fistula near the stenosis. Two months later, right hemi-colectomy and closure of the colo-duodenal fistula were performed. The resected specimen showed stenosis and a fistula in the transverse colon due to Crohn's disease. The colo-colonic fistula was present and the colo-duodenal fistula had almost closed due to fibrosis. The postoperative course was uneventful and the patient was discharged after administration of infliximab. Use of a double lumen gastro-jejunostomy tube was effective in improving the patient's general condition. This therapeutic strategy allowed the safe conduct of major resection in a high-risk patient.http://www.karger.com/Article/FullText/363374Double lumen gastro-jejunostomy tubePercutaneous endoscopic gastrostomyRight hemi-colectomy |
| spellingShingle | Toru Zuiki Yoshiyuki Meguro Hidetoshi Kumano Koji Koinuma Yasuyuki Miyakura Hisanaga Horie Alan T. Lefor Naohiro Sata Yoshikazu Yasuda Successful Management of a Colo-Duodenal Fistula in a Patient with Crohn's Disease Using a Double Lumen Gastro-Jejunostomy Tube Case Reports in Gastroenterology Double lumen gastro-jejunostomy tube Percutaneous endoscopic gastrostomy Right hemi-colectomy |
| title | Successful Management of a Colo-Duodenal Fistula in a Patient with Crohn's Disease Using a Double Lumen Gastro-Jejunostomy Tube |
| title_full | Successful Management of a Colo-Duodenal Fistula in a Patient with Crohn's Disease Using a Double Lumen Gastro-Jejunostomy Tube |
| title_fullStr | Successful Management of a Colo-Duodenal Fistula in a Patient with Crohn's Disease Using a Double Lumen Gastro-Jejunostomy Tube |
| title_full_unstemmed | Successful Management of a Colo-Duodenal Fistula in a Patient with Crohn's Disease Using a Double Lumen Gastro-Jejunostomy Tube |
| title_short | Successful Management of a Colo-Duodenal Fistula in a Patient with Crohn's Disease Using a Double Lumen Gastro-Jejunostomy Tube |
| title_sort | successful management of a colo duodenal fistula in a patient with crohn s disease using a double lumen gastro jejunostomy tube |
| topic | Double lumen gastro-jejunostomy tube Percutaneous endoscopic gastrostomy Right hemi-colectomy |
| url | http://www.karger.com/Article/FullText/363374 |
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