1993 Volume 54 Issue 3 Pages 725-729
A 61-year-old man was seen at the hospital because of general fatigue and tarry stool. Barium enema revealed a leakage of medium from the transverse colon to the duodenum and jejunum. A diagnosis of invasion of a transverse cancer into the jejunum and duodenum was made. Right hemicolectomy partial excision of the small intestine, and pancreatoduodenectomy were carried out. Histopathologically it was well differentiated adenocarcinoma of the colon involving poorly differentiated and mucinous components, of sin n(-) P0H0M(-)in Stage III. The operation resulted in curative resection. There has been no sign of recurrence, as of one year and eleven months after the operation.
Two fistulas formed between organs is very rare and this case was the 3rd domestic report following Ogawa and Yasunaga and others. Colon cancers with gastrointestinal fistula are often of low malignancy compared to macroscopic findings. If radical resection is successfully performed, better prognosis than that of colonic cancers invading multiple organs without forming a fistula can be expected. Accordingly, without bewidering by local extension of the lesion, aggresive radical operation would be desired.
