A case of advanced colon cancer with a duodenocolic fistula curatively resected by pancreatico-duodenectomy

Abstract

A 66-year-old woman was admitted to our hospital for anorexia and right abdominal pain. Colonoscopy revealed a circumferential Type 3 lesion. Barium enema showed a fistula from the hepatic flexure to the extra-colon. Gastro-intestinal endoscopy revealed an ulcerative lesion with fur in the duodenum and fistula. Upper gastrointestinal series showed two leaking flows one to the duodenum, and the other to the colon through the fistula. We made a preoperative diagnosis of advanved colon cancer with malignant duodenocolic fistula, and performed a right hemicolectomy and pancreatico-duodenectomy. Advanced colon cancer with malignant duodenocolic fistula was the definitive diagnosis. There has been no clinical signs of recurrence and the patient is alive without disease as of 2 years and 2 months after the operation. We think long-term survival for advanced colon cancer with a duodenocolic fistula may be achieved by the redical excision described above.