ABSTRACT
Malignant duodenocolic fistula is a rare complication of colon cancer, and this usually develops as the right-side colon cancer that invades the duodenal bulb. The fistula often results in watery diarrhea, weight loss and feculent vomiting. A barium enema or duodenography have been the most useful diagnostic procedures, and the fistula is directly confirmed by an endoscopic examination. Curative resection is not possible in many cases due to metastasis or local invasion, so a palliative operation can be performed to relieve symptoms, but it cannot completely prevent the vomiting or diarrhea. Seven Korean cases of malignant duodenocolic fistula have been previously reported on, and an operation was performed in six cases. We report here on a case of duodenocolic fistula with intestinal obstruction that arouse from a right-side colon cancer, and this was successfully managed by placing covered metallic stents at the duodenum and hepatic flexure.
Subject(s)
Barium , Colonic Neoplasms , Diarrhea , Duodenum , Enema , Fistula , Intestinal Obstruction , Neoplasm Metastasis , Stents , Vomiting , Weight LossABSTRACT
Malignant duodenocolic fistula is a rare complication of colon cancer, and this usually develops as the right-side colon cancer or colonic hepatic flexure cancer infiltrates into the second portion of the duodenum. Six Korean cases of this malignancy have been previously reported on. The patients usually complain of watery diarrhea, feculant vomiting and weight loss that can be attributed to the altered normal flora. Barium enema has been the diagnostic procedure of choice to demonstrate the fistulous tract, but with the technical development of gastroendoscopy, the primary procedure is also changing. Curative resection is not possible in many cases. Palliative ileotransverse colostomy with gastrodjejunostomy is performed to relieve symptoms, but it cannot completely prevent the vomiting or diarrhea. We herein present a case of malignant duodenocolic fistula in a patient who had been suffering from indigestion, loose stool and feculant vomiting for one year. This case was diagnosed by endoscopy and the patient underwent a palliative operation.
Subject(s)
Humans , Barium , Colon , Colonic Neoplasms , Colostomy , Diarrhea , Duodenum , Dyspepsia , Endoscopy , Enema , Fistula , Stress, Psychological , Vomiting , Weight LossABSTRACT
Malignant duodenocolic fistula is a rare complication of advanced right colon cancer. The surgeon becomes involved not only with the cancer lesion, but also with the physiologic complications, such as electrolyte imbalance and malnutrition. We experienced 2 cases of duodenocolic fistulas arising from right side colon cancers. One of the patients was surgically treated by right hemicolectomy and pancreatico-duodenectomy and another case was lost to follow-up. We report these cases with a brief review of the literature.