Abstract
A 76-year-old man was admitted to our hospital because of abdominal pain. He had undergone subtotal gastrectomy 10 years ago. The operative scar was reddish and swelling, and was now 5 cm in diameter. An abdominal computed tomography (CT) showed an abscess in the abdominal wall under the scar ; therefore, we drained the abscess with a drain. Six days after the drainage, we found stool passing from the drain. Fistulography showed a fistula that communicated with the transverse colon. Colonoscopy showed a type 2 tumor at the transverse colon, which was diagnosed as well to moderately differentiated adenocarcinoma, based on the pathological examinations. We diagnosed it as an abscess in the abdominal wall due to penetration by the transverse colon cancer. We resected the transverse colon with the abdominal wall and the cutaneous fistula. Cancer cells were revealed along the fistula in the microscopic examination, and the tumor had invaded the abdominal wall directly. At the last follow-up examination, 18 months after the operation, the patient was in good health with no evidence of recurrence. It is probably less-invasive and safer to perform a curative operation to treat colon cancer with an abdominal wall abscess after conservative therapy.
