Abstract
We encountered 2 patients of colorectal cancer with formation of an enterocolic fistula. Case 1 : A 52-year-old female visited our hospital with abdominal pain and symptoms of ileus. The tumor marker levels were abnormally high, and the patient was diagnosed as having sigmoid colon cancer with liver metastasis based on the CT findings. Sigmoidectomy and combined jejunectomy were performed. The sigmoid tumor was a moderately differentiated adenocarcinoma, which had formed a fistula with the jejunum. The patient died of the primary disease 6 months after the surgery. Case 2 : An 82-year-old female visited our hospital with symptoms and signs of peritonitis. An ileocecal tumor was noted on CT. The patient was diagnosed as having perforated appendicitis-induced peritonitis, however, extended right hemicolectomy was performed because the ileocecal tumor showed infiltration of the ileum and transverse colon. The tumor was a poorly differentiated adenocarcinoma which was found to infiltrate the transverse colon and to form a fistula with the ileum. The patient was alive without recurrence as of 2 years after the surgery. Formation of a fistula between a colorectal cancer and the small intestine is rare, and only 35 cases, including our 2 patients, have been reported in the literature in Japan. Even when other organs are involved, a favorable outcome can be expected by active combined resection, if distant metastasis is absent.
