A CASE OF JEJUNOCOLIC FISTULA DUE TO CANCER OF THE TRANSVERSE COLON

Abstract

Malignant jejunocolic fistula resulting from invasion of colon cancer are rare. This report deals with the jejunocolic fistula due to cancer of the transverse colon. A 50-year-old man was admitted to the hospital because of appetite loss and body weight loss. Barium enema, upper gastrointestinal series and abdominal CT scan showed a malignant fistula between the jejunum and transverse colon. We diagnosed the patient as having colonic cancer with jejunocolic fistula and performed an operation. Intraoperative findings included the childs head-sized mass of the transverse colon involving a part of the jejunum and pancreas tail. Transverse colectomy, patrtial resection of the jejunum, disal pancreatectomy and splenectomy were performed. Cholecyctectomy was added for assosiated gallstone and cholecystitis which were confirmed by preoperative examinations. Pathological examination revealed a well differentiated adenocarcinoma without lymph node metastasis [si, n(-), P₀, H₀, ]. Eighty-seven cases of intestinal fistula due to colon cancer have been reported in the Japanese literature so far, and twenty-three cases of them were jejunocolic fistula. We emphasize that most of these cases can be candidates for radical resection because these colon cancers forming fistula have a low grade of biological malignant potential.