Benign gastric ulceration as a cause of gastro-colic fistula

Gastro-colic fistulas as a complication of benign gastric ulcers are relatively uncommon. The authors report a 59 year old caucasian female with a known hiatus hernia and gastro-oesophageal reflux disease presenting with diarrhoea and weight loss. Barium enema is the investigation of choice although it is important to exclude malignancy. Management is by en-bloc resection of the fistula with primary gastro-intestinal reconstruction.