Common causes of gastrocolic fistula

What is known

• The most common cause is colonic adenocarcinoma in Western countries and gastric adenocarcinoma in Japan; benign peptic ulcer, crohn's, and NSAID/steroid use are less frequent. ¹
• Gastrocolic fistula classically complicates inadequate gastric surgery (e.g., marginal ulcer after gastrectomy) or gastric/colonic malignancy. ²
• Rarer reported causes include renal carcinoma, gastric lymphoma, and granulomatous (crohn's) colitis. ³
• Crohn's disease is a rare cause of gastrocolic/duodenocolic fistula, and the vast majority of such fistulas originate from diseased colon rather than gastric/duodenal disease. ⁴

What is unknown / caveats

• Geographic variation: malignancy subtype driving fistula differs by region (colonic vs gastric adenocarcinoma)
• Evidence base is largely case reports, reviews, and small series. No comparative epidemiologic ranking
• Precise relative frequencies vary by era and population and are not quantified in the retrieved sources.

References

1. PMID: 22361308. (metadata not in corpus)

2. PMID: 17438897. (metadata not in corpus)

3. PMID: 615797. (metadata not in corpus)

4. Pichney LS, Fantry GT, Graham SM. Gastrocolic and duodenocolic fistulas in Crohn's disease. J Clin Gastroenterol. 1992;15(3):205-11. PMID: 1479163.

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Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct.