Gastrocolic fistula. A review of 15 cases and an update of the literature.

Gastrocolic fistulas are not common. We review the 10-year experience in our center of 15 cases that emphasize the changing pattern of this disease. The female-to-male ratio was 2:1, with a mean age of 55. Even though we are affiliated with the regional cancer center, the commonest cause of a fistula was benign gastric ulceration. Sixty percent of those with peptic ulcer and a fistula had not had previous gastric surgery. Barium enema was the most accurate investigation, showing the fistula in 10 of 10. Barium meal showed it in seven of eight, and the fistula was seen in seven of 10 patients who had endoscopy. Eleven patients were operated on, and only one was treated "medically." Three deaths occurred, two from advanced carcinoma and one from myocardial infarction.