PMC4904662_01
(a) Gastroscopy showing normal gastric rugae with no erythema or ulceration. (b) Gastroscopy showing the opening to the GCF adjacent to the pylorus.
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On gastroscopy, a superfluous lumen was identified proximal to the pylorus (Figure 1(b)), which could not be probed. No surrounding erythema or ulceration was noted (Figure 1(a)).
(a) Colonoscopy showing the colonic opening of the GCF. (b) Colonoscopy showing the lumen of the fistula tract.
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On colonoscopy, a structure with a luminal appearance was identified proximal to the splenic flexure (Figure 2(a)). Upon advancing the colonoscope through this structure inadvertently (Figure 2(b)), gastric rugae were ultimately identified, which suggested the presence of a gastrocolic fistula (GCF).
Barium X-ray confirming the GCF.
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A barium study revealed immediate filling of the fistula tract from the stomach into the transverse colon (Figure 3).