Colo-Gastric Fistula as the Presentation of Primary Colonic Carcinoma

　Benign fistula between the stomach and colon is well recognised as a complication of partial gastrectomy for duodenal ulcer (Lowdon, 1963), or, spontaneously, it may complicate the rare peptic ulcer of the greater curvature (Smith and Clagett, 1965), and even colonic disease such as ulcerative colitis (Bargen and others, 1937). In contrast, malignant fistula is rare and usually arises from the colon rather than the stomach (Marshall and KnudHansen, 1957); McMahon and Lund, 1963.)

　This paper reports two unusual cases of cancer of the transverse colon with gastric fistula to highlight, firstly, the possibility of extrinsic invasion of the stomach when there is a lesion of the greater curvature, secondly, the importance of gastric photography and biopsy in assessment and, thirdly, the clinical differences from the features reported with gastro-jejuno colic fistula.