A 27-year-old comatose patient has been under surveillance for several months due to a traffic accident, with trauma and frontal bone exeresis. He practiced partial feeding through our service and received a catheter for home placement PEG.
Six months later, a gastrostomy tube was replaced, starting 48 hours after the ingestion of enteral nutrition.
The patient persists with these symptoms so he goes to the Emergency Department on two occasions.
Analytical studies were normal as well as negative in coprocultive determinations.
The patient remains afflicted although moderate loss is noted for which he is admitted to hospital to complete the study.
Abdominal CT showed a fistula between the posterior wall of the stomach and colon, colonizing the tip of the gastrostomy tube clearly identified via colonic lumen, which was confirmed by the introduction of material.
It was concluded the existence of gastrocolocutaneous fistula.
A gastroscopy showed the absence of a tube as well as the sequel of the gastric fistula orifice without other pathological findings.
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With the diagnosis of gastrocolocutaneous fistula secondary to PEG and due to the need for a new feeding approach gastrocolic fistula is performed at the Department of Surgery where a midline laparotomy is performed confirming the existence of a gastrocolic defect.
The patient is discharged a few days after checking the proper functioning of the new tube and the absence of possible complications.
