Rationale: Gastrocolic fistulae represent abnormal connections between the stomach and large intestine, often leading to chronic diarrhea and malnutrition. They can arise postoperatively, particularly after complex surgeries such as the Billroth II procedure. Patient concerns: This case report describes the case of a 71-year-old male, with a history of hypertension and gastrointestinal surgery, who experienced significant weight loss and postprandial diarrhea. Initial investigations, including stool cultures and multiple imaging studies, failed to reveal the fistula. Diagnoses: A definitive diagnosis of gastrojejunocolic fistulae was made during the third gastroscopy, when the endoscope passed from the stomach into the colon. Interventions: Surgical intervention involved adhesiolysis and resection of the fistula, followed by reconstruction of gastrointestinal continuity. Outcomes: Postoperative care included nutritional support, and the patient showed a significant improvement at follow-up. Lessons: This case highlights the diagnostic challenges associated with gastrojejunocolic fistulae and emphasizes the need for a high index of suspicion in patients with atypical gastrointestinal symptoms after complex surgery. This illustrates that timely surgical intervention can lead to positive outcomes, and underscores the importance of ongoing research and education regarding the management of such complications. Further studies are needed to understand the long-term effects of gastrojejunocolic fistulae and optimize management strategies.

Background: Colorectal cancer (CRC) is a leading cause of cancer-related deaths worldwide, and is largely preventable through colonoscopy, during which adenomatous polyps can be detected and removed. The adenoma detection rate (ADR) and polyp detection rate (PDR) are key quality indicators of colonoscopy quality and are inversely associated with post-colonoscopy CRC. These indicators may be influenced by patient-, physician-, and procedure-related factors. This study aimed to evaluate the ADR and PDR, identify factors influencing these indicators, and compare them among gastroenterologists at a Lebanese medical center. Methods: This observational, single-center, retrospective cohort study included 257 patients aged 50–75 years who underwent first-time screening colonoscopy over 3 years. Data on patient characteristics and colonoscopy findings were collected. ADR and PDR were calculated according to established guidelines, with ADR additionally estimated using the adenoma-to-polyp detection rate quotient (APDRQ). Descriptive statistics were applied, and chi-square or Fisher’s exact tests were used to assess associations between patient-, physician-, and procedural related factors and adenoma detection. Results: Out of 257 patients, 159 had polyps detected during colonoscopy. The overall ADR was 44.4%, and the PDR was 61.8% over the three-year study period. The ADR was 52.1% in men and 38.0% in women, whereas the PDR was 68.6% in men and 56.3% in women. Although the overall ADR and PDR met or exceeded the recommended benchmarks, disparities were noted in detection rates between males and females. Bowel preparation quality and guarantor type significantly influenced adenoma detection, whereas other factors related to patients and endoscopists had no significant effect. The estimated ADRs derived from the PDRs for five endoscopists were also high, surpassing the 25% benchmark; however, their annual estimated ADRs were relatively below this threshold. Conclusion: This study provides valuable regional data and underscores the need for standardized quality monitoring and further multicentric prospective research to optimize CRC prevention in Lebanon.