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

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

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

Am J Case Rep 2021; 22:e928532

DOI: 10.12659/AJCR.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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