Gastrocolic Fistula Presumably Caused by Nasogastric Tube and Treated with Endoscopic Hemoclipping: Report of a Case

鼻胃管造成胃大腸瘻管並使用內視鏡止血夾治療成功：一病例報告

林志郎(Chih-Lang Lin) ； 李宇實(Tsung-Shih Lee) ； 簡榮南(Rong-Nan Ching)

《臺灣消化醫學雜誌》 24卷4期 (2007/12) Pp. 409-412

https://doi.org/10.6557/GJT.200712_24(4).0008

摘要

良性胃大腸瘻管是少見的，只有少數服用類因醇合併良性消化性潰瘍的病歷報告，傳統治療是以外科治療為首選。本文報告一個年紀大且腦血管阻塞的植物人病例，合併有紅斑性狼瘡須長期服用類固醇治療，導致反覆發生的胃潰瘍出血併發症，此病人需要定期的更換鼻胃管已有一年了，造成因鼻胃管插入引起的胃大腸瘻管，而以餐後的水瀉為主要臨床症狀。因此，實施內視鏡止血夾治療及氫離子幫浦阻斷劑藥物治療，此胃大腸瘻管於十日後癒合，之後已追蹤24個月仍是相當良好。

關鍵字

胃大腸瘻管 ； 鼻胃管 ； 內視鏡止血夾治療

並列摘要

Benign gastrocolic fistula is unusual, although it has been demonstrated in patients who took steroids and developed peptic ulcer disease. Surgical management traditionally has been employed. In this report, we present an aged cerebrovascular accident patient in vegetative status who had been treated by long-term corticosteroid for systemic lupus erythematosus, with history of recurrent gastric ulcer bleeding. The patient received periodical nasogastric tube replacement for one year. She was brought to us for evaluation of acute diarrhea. A gastrocolic fistula presumably resulting from nasogastric tube penetration was identified. Endoscopic hemoclipping was applied and proton pump inhibitor was prescribed. The gastrocolic fistula healed ten days later. The patient remained well 24 months following initial diagnosis.

並列關鍵字

gastrocolic fistula ； nasogastric tube ； endoscopic hemoclipping therapy