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Recurrent Type 1 Enterocutaneous Fistula and Granulomatous Gastritis: A Case Report

Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment

Dogukan Dogu, Nezih Akkapulu, Sinan Efe Yazici, Altan Kavuncuoglu

Turkey Department of General Surgery, Hacettepe University Hospital, Ankara, Turkey

Am J Case Rep 2021; 22:e928532

DOI: 10.12659/AJCR.928532

Available online: 2020-12-23

Published: 2021-02-06


#928532

BACKGROUND: Enterocutaneous fistula is an abnormal communication between the gastrointestinal tract and skin. One-third of enterocutaneous fistulas disappear spontaneously, but the rest of them require surgical treatment.
CASE REPORT: We describe the case of a 34-year-old woman with enterocutaneous fistula that she had had for year. She had previously undergone 2 unsuccessful operations, and the fistula recurred twice. Distal subtotal gastrectomy and Billroth 2 reconstruction were performed. In the pathological examination, the distal gastrectomy specimen revealed foci of ulceration. Well-circumscribed non-necrotizing granulomas were occasionally encountered beneath the ulcers.
CONCLUSIONS: Failure of treatment in recurrent fistula management has a variety of reasons. Our clinical experience shows that granulomatous gastritis can be a complicating factor in treatment of recurrent enterocutaneous fistula.

Keywords: celiac disease, Gastrectomy, Granuloma, Giant Cell, Intestinal Fistula



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