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Preoperative Sagittal and Coronal CT scan revealing gastrocolic fistula demonstrated by contrast in the stomach and ascending colon.
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Total abdominal plain contrast CT scan showed obviously irregular thickness between ascending colon walls and remote border with hepatic flexure of the colon wall, showing colon cancer invading outside the serosa, with omentum, lymph node metastasis, and a gastric antral fistula was formed between colon and stomach (Fig. 1).
Gastrocolic fistula appeared immediately after passage of the barium enema into the gastric lumen.
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Then barium enema revealed a small fistula between the greater curvature and the ascending colon (Fig. 2).
Gastrocopic view of gastrocolic fistula located in the greater curvature.
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Next, gastroscopy showed fistula located at the greater curvature closed to posterior wall of stomach (Fig. 3), after we changed to a thinner fiberscope, which barely passed through the fistula into the colon.
Postoperative biopsy specimen proved that it was colon adenocarcinoma (HE stain x 200).
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Colonoscopic biopsy of the edge of mass showed colorectal adenocarcinoma (Fig. 4).