Localised perforation of locally advanced transverse colon cancer with spontaneous colocutaneous fistula formation: a clinical challenge

BMJ Case Rep. 2018 Apr 19:2018:bcr2018224668. doi: 10.1136/bcr-2018-224668.

Abstract

Colon cancer can present with complications such as obstruction, perforation and bleeding. The clinical presentation has been recognised as an independent prognostic factor for morbidity and mortality. 1 We present a rare case of localised perforation of a locally advanced colon cancer arising from mid-transverse colon in an elderly woman in the absence of widely metastatic disease with eventual cutaneous involvement of the overlying skin by direct extension, resulting in formation of colocutaneous fistula. The management of such cases is complex as usually tailored to the situation encountered. 2 This case was a clinical challenge to choose between initial palliative resection and curative R0 resection following neoadjuvant chemotherapy.

Keywords: colon cancer; gastrointestinal surgery.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma* / complications
  • Adenocarcinoma* / pathology
  • Adenocarcinoma* / physiopathology
  • Adenocarcinoma* / therapy
  • Anti-Bacterial Agents / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Colectomy / methods*
  • Colon, Transverse* / diagnostic imaging
  • Colon, Transverse* / pathology
  • Colon, Transverse* / surgery
  • Colonic Neoplasms* / complications
  • Colonic Neoplasms* / pathology
  • Colonic Neoplasms* / physiopathology
  • Colonic Neoplasms* / therapy
  • Colostomy / methods*
  • Fatal Outcome
  • Female
  • Humans
  • Intestinal Fistula* / diagnosis
  • Intestinal Fistula* / etiology
  • Intestinal Fistula* / surgery
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Pneumonia* / diagnosis
  • Pneumonia* / etiology
  • Pneumonia* / therapy
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / therapy
  • Sepsis* / diagnosis
  • Sepsis* / etiology
  • Sepsis* / therapy
  • Tomography, X-Ray Computed / methods

Substances

  • Anti-Bacterial Agents