Jurnalul de Chirurgie
 Jurnalul de chirurgie
Aparitie trimestriala in a doua luna a trimestrului
Published quarterly in the second month of the quarter
ISSN: 1584 - 9341 Vol.10 Nr.3 - Iulie-Septembrie 2014 | smbt, 25 mai 2019
ISSN: 1584 - 9341 Vol.10 No.3 - July-September 2014
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DUODENAL – ILEAL FISTULA, RARE VARIANT OF PENETRATING OF DUODENAL ULCER, ASSOCIATED WITH SIGMOID CANCER
O. Vaida (1), M.Gh. Pandrea (1), G.M. Bejenaru (2), A. Andercou (3)
1) Department of General Surgery, Municipal Hospital Dej, Romania
2) Department of Anesthesia and Intensive, Municipal Hospital Dej, Romania
3) University of Medicine and Pharmacy „Iuliu Haţieganu”,
IInd Surgical Unit, Cluj-Napoca, Romania
Jurnalul de chirurgie (Iaşi). 2013; 9(3): 257-260.
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Abstract:

Duodeno-ileal fistula has benign (penetration of the duodenal ulcer) or malignant etiology. We present the case of a 73 years old woman, with history of right colectomy; she was admitted in our surgical unit for abdominal pain, fecaloid vomiting, fetid halitosis, bloody diarrhea, weight loss and impaired general condition. A moderate anemia and several electrolytic disorders have been revealed by the laboratory exams. The upper digestive endoscopy revealed a penetrating duodenal ulcer with duodeno-ileal fistula and colonoscopy a stenosant tumor at 25 cm of the anal edge. After the correction of anemia and electrolytic disorders an exploratory laparotomy was performed The exploration noted a tumor mass which included duodenum and gastric antrum, gallbladder, ileum, sigmoid loop and the great omentum. The careful dissection confirmed the sigmoid cancer invading the antropyloric region and the double duodenal ulcer with pancreatic penetration and duodeno-ileal fistula. Multiple organs resection were performed: anterograde cholecystectomy; segmental enterectomy; ¾ distal gastric resection with precolic gastro-jejunal anastomosis (Leger type); sigmoid resection with end-to-end colo-colic anastomosis. The postoperative course was uneventful. Several data from the literature were discussed. CONCLUSIONS: Duodeno-ileal fistula is an accidental variety of ulcer penetration caused by particular morphopathological conditions. Surgical treatment of gastro-digestive fistulas should be applied early with a correct balancing of the patient. Operation is complex and often atypical and implies multiple organs resections. In this particular case, the sigmoid cancer which invaded the distal part of the stomach complicated much more the surgical procedure.

KEY WORDS: DUODENAL ULCER; PENETRATION; DUODENAL-ILEAL FISTULA; METACHRONOUS COLIC CANCER; SIGMOID RESECTION; DISTAL GASTRECTOMY; GASTROJEJUNOSTOMY

SHORT TITLE: Duodenal-ileal fistula & sigmoid cancer

HOW TO CITE: Vaida O, Pandrea MG, Bejenaru GM, Andercou A. [Duodenal – ileal fistula, rare variant of penetrating of duodenal ulcer, associated with sigmoid cancer]. Jurnalul de chirurgie (Iaşi). 2013; 9(3): 257-260. DOI: 10.7438/1584-9341-9-3-9.


: Creative Commons License
Jurnalul de chirurgie [Journal of Surgery] by Editorial Board, Department of Surgery University of Medicine and Pharmacy Iasi, E. Tarcoveanu, R. Moldovanu is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
Based on a work at www.jurnaluldechirurgie.ro.