MALIGNANT DUODENOCOLIC FISTULA- CASE REPORT OF RARE COMPLICATION OF COLONIC CANCER TREATED BY MULTIVISCERAL RESECTION

Edzevit Kadri; Dane Nedelkovski; Evgenija Lazova; Katarina Panikj

Edzevit Kadri General City Hospital, 8th September Department of Abdominal Surgery in Skopje, North Macedonia
Dane Nedelkovski City General Hospital 8thSeptember, Skopje, North Macedonia
Evgenija Lazova City General Hospital 8thSeptember, Skopje, North Macedonia
Katarina Panikj General Hospital of Kochani, North Macedonia

Abstract

Duodenocolic fistulas created by invasive cancer of the colon are rare complications. They are presented with serious electrolytic and nutritional disturbances due to vomiting, diarrhoea, abdominal pain, GI bleeding, and weight loss. Case report: In this paper we present young male patient with malignant duodenocolic fistula between ascendant colon and D2 portion of duodenum and pancreatic head, treated with right hemicolectomy and pancreaticoduoedenectomy. Postoperative histopathology confirmed poorly differentiated colonic adenocarcinoma without spreading to lymph nodes and major vessels. Patient is still alive after three years of the operation which led as to conclusion that this type of radical operation may represent one of the best treatments for this rare complication, provides good quality of life and is prognostically justifiable.

Keywords: malignant duodenocolic fistula, advanced colorectal carcinoma (CRC), right hemicolectomy, pancreaticoduoedenectomy.

References

1. Calmenson M, Black B. Surgical management of carcinomaof the right portion of the colon with secondary involvement of the duodenum, including duodenocolic fistula; data on eight cases. Surgery. 1947;21(4):476-81.
2. Janes RN, Mills JRF. Malignant duodenocolic fistula-report of a case treated successfully by mass resection. Can J Surg 1959;3:91.
3. NishiharaR, Wu K, Lochhead P, Morikawa T, Liao X, Qian ZR, et al. Long-term colorectal- cancer incidence and mortality after lower endoscopy. New England Journal of Medicine. 2013;369(12): 1095-105.
4. Guraya SY, Eltinay OE. Higher prevalence in young population and rightward shift of colorectal carcinoma. Saudi medical journal.2006;27(9):1391-93.
5. Haldane DR. Case of a cancer of the coecum, accompanied by with caecoduodenal and coecocolic fistulae. Edinbourgh Med J 1862.7:624-629.
6. Hershenson LM, KIrsner JB: Duoedeno-colic fistula. Gastroenterology 1951,19:864-873.
7. Welch JP, Warshaw AL. Malignant duodenocolic fistulas. Am J Surg 1977. 133:658-661.
8. Soulsby R, Leung E, Williams N. Malignant colo-duodenal fisula: case reportand review of the literature. World Journal of surgical oncology. 2006;4(1):86.
9. Xenos ES, HalversonJD: Duodenocolic fistula: case report and review of the literature. J Postgrad Med 1999:45:87-89.
10. Hirsch K. Duodenocolic fistulae due to carcinoma of transverse colon. VA Med Mon 1975;102:729.
11. Majeed TA, Gaurav A, Shilpa D, Preeti J, Sanjay S, Manisha S, et al. Malignant Coloduodenal Fistulas-Review of Literature and Case Report. Indian journal of surgical oncology. 2011;2(3):205â€“09.
12. Gallagher H. Extended right hemicolectomy the treatment of advanced carcinoma of the hepatic flexure and malignant duodenocolic fistula. British journal of surgery. 1960;47(206):616â€“21.
13. Vieta JO, Blanco R, Valentini GR. Malignant duodenocolic fistula. Dis Colon Rectum 1976;19:542-552.
14. Izumi Y, Ueki T, Naritomi G, Akashi Y, Miyoshi A, Fukuda T. Malignant duodenocolic fistula: report of a case and considerations for operative management. Surgery today. 1993;23(10):920â€“25.
15. Misra D, Pati GK, Misra B, Singh A, Kar S, Panigrahi MK et al. Malignant dudeno-colic fistula. Journal of Digestive Endoscopy. 2014;5(2):75.