A Caae of Gastrocolie Fistula Secondary to Benign Gastric Ulcer / 대한소화기내시경학회지

Gastrocolic fistula is a rare lesion which is caused most commonly by carcinoma of colon or stomach. The less common causes of gastrocolic fistula are follows: trauma, faulty gastrocolic anastomosis during gastrectomy, benign gastric ulcer, syphilis, carcinoid tumor, tuberculosis, intraperitoneal abscess, lymphoma, perforated diverticulum of colon, and ulcerative colitis. The locations of fistulae are mostly between greater curvature of stomach and distal half of the transverse colon. In the case of penetrating benign gastric ulcer and gastrcolic fistula, it is usually associated either with asipirin or with prolonged steroid administration. A 36-year-old male who had an unusual gastrocolic fistula secondary to non-surgically treated benign gastric ulcer is presented. The exitence of a gastrocolic fistula was dernonstrated by radiological examination of the colon and the stomach. In this patient, the colonoscope passde through the fistula and the stomach could be examined. Careful preparation was carried out preoperatively with intravenous fluids and blood transfusions. Resection of the distal stomch, fistulous tract, and segment of the transverse colon was then accamplished.

Concomitant Risk Factor of Atherosclerosis in Hypertensive Subjects

BACKGROUND: Much of the recent understanding of hypertensive has focused on the importance of concomitant atherosclerotic risk factors in addition to the blood pressure itself and has created new therapeutic challenges. METHODS AND RESULTS: We conducted a prospective study to determine the prevalence rates of hyperlipidemia, smoking, diabetes, obesity and left ventricular hypertrophy(LVH) in 185 hypertensive subjects. Serum levels of total cholesterol, triglyceride and HDL-cholesterol were measured by enzymatic method. 1) Mean values of serum total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol and atherogenic index were not significantly different between sex and resident area. 2) The most frequent risk factor in hypertensive subjects was overweight, followed by M-mode echocardiographic LVH, hypertriglyceridemia, high LDL-cholesterol levels, low HDL-cholesterol levels, hypertriglyceridemia, electrocardiographic LVH, and diabetes. 3) The prevalence rates of both total cholesterol levels over 240mg/dl and LDL-cholesterol over 160mg/dl were about 20%, regardless of sex and resident area. CONCLUSION: These results indicate that hypertensive subjects have many concomitant risk factors of atherosclerosis. Hypercholesterolemia(> or =200 mg/dl), M-mode echocardiographic LVH and overweight among the selected risk factors were observed in more than a half of the hypertensive subjects, regardless of sex and resident area. These findings suggest that for the effective management of hypertensive subjects, physician should not only treat hypertension itself, but also control the concomitant risk factors.

A Case of Gastrocolic Fistula Secondary to Colon Cancer / 대한소화기내시경학회지

Gastrocelic fistula of malignant origin is a rare complication, usually due to gastric or colon cancer. Possible other etiologic factors resulting in gastrocolic fistula are peptic ulcer, trauma, carcinoid tumor, intestinal tuberculosis, Crohn's disease, lymphoma, intraabdominal abscess, diverticulitis and etc. At the present, earlier diagnosis and treatment of gastric and colon cancer may explain the low frequency of malignant gastrocolic fistula than the past but the review of Korean literatures revealed only two reports of gastrocolic fistula secondary to gastric cancer and another from benign gastric ulcer. Yet, there has been no report of fistula due to colon cancer. We experienced a case of colon cancer with postural dizziness, fecal eructation who was diagnosed as gastrocolic fistula by endoscopy, barium enema, UGI series and finally underwent operation. Therefore, we report this case with the review of literatures.