Gastrocolic fistula presented as an early complication of gastric surgery in a 42-year-old man

Currently, surgery is less needed for the treatment of refractory peptic ulcer disease [PUD] or its complications. So, the complications of PUD surgery have been clearly declined. Here in, we present a 42-year-old man with chronic watery diarrhea and significant weight loss during 2 years after gastrojejunostomy for the treatment of obstructive PUD. Small bowel gastrointestinal series showed rapid transit without passage of contrast in the parts of small bowel. The patient was scheduled for exploratory laparotomy. During the surgery a large fistula was detected between the stomach and transverse colon, which was repaired. At the follow-up 6 months after the surgery, the patient did not have any history of recurrence of diarrhea and had 10 kg weight gain. Gastrocolic fistula is a very rare complication of surgical management of PUD. Barium enema is the most helpful imaging procedure for the diagnosis of gastrocolic fistula and surgery after correction of nutritional status is suggested especially for malnourished patients

incidence rate of inflammatory bowel disease in an urban area of Iran: a developing country

The incidence of inflammatory bowel disease [IBD] varies among different societies. The aim of this study is to determine the incidence rate of IBD in Kerman, a city in Southeast Iran. All medical records that indicated a new diagnosis of ulcerative colitis [UC] or Crohn's disease [CD] were retrieved from the gastrointestinal endoscopy and pathology departments of 12 centers from October 2011 to September 2012. The incidence rate of UC in Kerman was estimated at 4.98/100,000 [95% CI: 2.44-6.94]. The mean age of patients was 39.4 years and male to female ratio was 0.89:1.0. UC patients had the following prevalence: cigarette smoking [30%], appendectomy [36%] and oral contraceptive [OCP] use [78.9%]. The incidence rate of CD was 0.8/100,000 [95% CI: 0.6 4-1.14]. The mean age at diagnosis was 33.3 years and male to female ratio was 0.5:1.0. Cigarette smoking was reported in 33.3%, appendectomy in 66.6% and OCP useing in 75% of CD patients. Rectal and distal colitis, left side colitis and extensive colitis was seen in 20 [55.4%], 12 [33.3%] and 4 [11.1%] of patients with UC, respectively. All patients with CD had large intestinal involvement and one case [16.6%] had ileocolonic disease. Our study has shown that the incidence rate of both UC and CD in Kerman is lower than Western populations but it is the same as some Asian countries. Characteristics of disease involvement in this study are similar to other studies that have been conducted in Iran and elsewhere.

Blue Rubber Bleb Nevus Syndrome as a rare cause of iron deficiency anemia: a case report and review of literature

Blue Rubber Bleb Nevus Syndrome is a rare disorder that is characterized by multiple recurrent vascular malformations of skin and gastrointestinal tract. The affected patients may present with diverse manifestations including iron deficiency anemia. We report this syndrome in a 22-year-old man that was referred to our hospital for iron deficiency anemia with unknown cause and vascular malformations in the skin and gastrointestinal tract. Because of stable hemoglobin level, we decided to treatment him by iron supplementation and close follow up. We report this case along with a review of literature