A CASE REPORT OF INTRAMESENTERIC ABSCESS OCCURRED BY PENETRATION OF A CAN CER OF THE SIGMOID COLON

Abstract

A 70-year-old woman was hospitalized with signs admitted to the hospital because of abdominal pain and vomiting. Abdominal radiograph demonstrated giant gas lesion in her pelvic cavity. Barium enema study showed a stenosis of the sigmoid colon, cavity of which consistent with the giant gas lesion in the radiograph in oral side of the stenosis, and a leakage into the abdominal cavity as well. Three hours after admission, an exploratory laparotomy was performed because of peritoneal stimulant sign and shock. Ascites with stool smell was found in the abdominal cavity. An infant head size mass was found in the sigmoid mesentery, and a cancer of the sigmoid colon was pointed out in this anal side. Hartmann's operation was pesformed. Histological findings showed pT3 well differentiated adenocarcinoma in the mesenteric side, and penetration of intramesenteric abscess 5.5cm in diameter from oral side of the tumor at a distance of 2cm. There was nonspecific acute inflammation between the tumor and the hole continuously. About 1, 000ml of pus was found in the intramesenteric abscess. It is rare that intramesenteric abscess occurred by penetration of the colon. We think it is necessary to distinguish this disease from others in case of abdominal pain without peritonitis, and pyrexia with abnomal findings of liver and billary tract.