Diagnosis and treatment of gastrojejunocolic fistula and nutrition support action

Abstract

AIM: To explain the dignostic standard and therapeutic methods and lay emphasis on the impartance to the treatment of nutrition support during the period of before and after operation through analysis of treatment of seven patients with gastrojejunocolic fistula (GJCF) and in combination of medical references concered.

METHODS: Seven patients, all male averaging 32 years in age (21-45), their primary illness was doudenal bulbar ulcer; suture of perforation and large gastrectomy had been operated. GJCF had been found from 4 mo to 12 years after operation (averaging 52 mo), the chief symptom is abdominal pain, diarrhea, vomiting fecaloid substance and loss of body weight. GJCF had been dignosed by barium enema examination.

RESULTS: Five patients were cured by primary excision of GJCF th rough TPN support before operation (including TPN and TEN after operation). Two patients died, one died of burst hemorrhage of upper digestive tract, the other died of fistula without TPN.

CONCLUSION: The common reason for GJCF is duodenal bubar ulcer and stoma ulcer perforated colon after large gastrectomy. it mainly related to high acid. A diagnosis is based on personal illness and ex-operation history. Barium enema examination is the main method to diagnose. The key to successful operation is to improve the patients nutrition condition before and after operation during the period of treatment.

Key Words: Gastrojejunocolic fistula/diagnosis; Gastrjejunocolic fistula/therapy; Gastrojejunocolic fistula/surgery; Nutritional support