Publication:

Gastroduodenal fistula – a myth or reality

Gastroduodenal fistulas are uncommon complications of peptic ulcer disease, and those involving the distal duodenum are particularly rare today. We describe an elderly man with a history of alcohol use and prior abdominal surgery who presented with longstanding upper abdominal pain, recurrent bilious vomiting, and significant weight loss. Evaluation revealed a fistulous tract between the posterior stomach and the fourth part of the duodenum, along with duodenojejunal narrowing. Definitive surgical management involved excision of the tract and reconstruction with Roux-en-Y gastrojejunostomy and duodenojejunostomy, leading to a satisfactory outcome.