A rare case of an epigastric fistula

The authors report on a 75-year-old man who had been operated on 50 years before because of a gastric perforation. Since then he had had no symptoms. Two weeks before visiting the doctor he had noticed a 2-mm fistula in the epigastric region. Symptomatic therapy prescribed by the general practitioner had no result. On fistulography a complete gastric fistula was diagnosed. X-ray examination of the stomach showed an area highly suggestive of gastric cancer in the antrum region. Surgical examination revealed a 6-cm-long thread with concomitant, enormously extensive granuloma.