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Rozhl Chir ; 68(4): 249-52, 1989 Apr.
Article in Czech | MEDLINE | ID: mdl-2749390

ABSTRACT

The authors describe rare complications of advanced colorectal carcinoma--duodenocolic fistulae, which unless removed by surgery, soon kill the patient. The authors draw attention to the clinical picture where rapidly developing dehydration, anaemia and general cachexia predominate. After short-term preoperative preparation (adequate parenteral nutrition, transfusion of blood and blood derivatives, antibiotics etc.), the authors recommend, consistent with data in the literature, radical surgery, i.e. right-sided pancreatectomy with right-sided hemicolectomy or at least right-sided hemicolectomy with excision of the fistula on the duodenum and intense postoperative care. Bypass operations are recommended as palliative operations where radical operation is not possible for some reason. A malignant duodenocolic fistula as a complication of an advanced malignant disease in a very exhausted patient may fail even after a radical, technically perfect operation and intense preoperative and postoperative care.


Subject(s)
Colonic Diseases/etiology , Colorectal Neoplasms/complications , Duodenal Diseases/etiology , Intestinal Fistula/etiology , Aged , Colonic Diseases/surgery , Duodenal Diseases/surgery , Female , Humans , Intestinal Fistula/surgery , Male , Middle Aged
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