Abstract
We herein report a case of a spontaneous fistula that developed from a carcinoma of the sigmoid colon that discharged through the umbilicus. A 72-year-old man was referred to our hospital for an examination of a foul odorous and purulent umbilical discharge. Six months prior to admission he complained of enuresis and ischuria for cystitis at the urological clinic of our hospital. The preoperative computed tomography and colonoscopy findings suggested a colo-umbilical fistula arising from the carcinoma of the sigmoid colon. At laparotomy, a 8-cm diameter mass, involving the anterior abdominal wall and the sigmoid colon, was found and it closely adhered to the upper aspect of the urinary bladder. An en bloc resection was thus performed. Its specimen showed an Borrmann 2-liked carcinoma of the sigmoid colon with an orifice of the colo-umbilical fistula, which was composed of a inflammatory tissue and no neoplastic cells were detected. This is the first case report of a spontaneous colo-umbilical fistula caused by a perforation of colon carcinoma, which demonstrated a pus discharge from the umbilicus. Carcinoma of the colon should thus be considered as a cause of an unexplained umbilical discharge.
