Work

Repairing a remote complication of abdominal penetrating trauma: diagnosis and management of a debilitating gastrocolic fistula

Year: 2025

Type: article

Abstract: A young adult with a body mass index (BMI) of 16.5 was admitted to the hospital with mild abdominal pain and failure to thrive. Four years earlier, the patient sustained a right-to-left abdominal gunshot wound, injuring the first portion of the duodenum, pancreas, jejunum, and colon. Their surgical history was somewhat unclear but, from sparse operative reports, we surmised that they underwent a damage control laparotomy followed by multiple small bowel resections, Roux-en-Y gastrojejunostomy, primary repair of the duodenum, partial colectomy, common bile duct exploration, cholecystectomy, diverting loop ileostomy, and eventual ileostomy takedown. Throughout the year prior to admission, the patient lost over 50 pounds and had emergency room visits for chronic abdominal pain, diarrhea, weakness, and weight loss, despite adequate oral intake. Prior clinicians diagnosed the patient with enteritis and encouraged increased per os intake with nutrient-rich dietary supplements. The patient presented to our hospital for a second opinion given worsening cachexia, weakness, and abdominal symptoms.

Source: Trauma Surgery & Acute Care Open

DOI: 10.1136/tsaco-2024-001620

Authors: Joy Obayemi, Peter Sienko, Aasma Hossain, Ryan Eton, Gary Vercruysse

Institutions: Northwestern University, University of Michigan

Language: English

Topic: Abdominal Trauma and Injuries

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,100