Abstract
A 44-year-old man was seen at the hospital because of diarrhea and weight loss. Colonoscopic fiber revealed cancer of the transverse colon. Barium enema study showed a leakage of contrast medium from the transverse colon to the duodenum and jejunum. Upper gastrointestinal series revealed no fistula and an extraluminal displacement of the greater curvature of the stomach was seen. A transverse colon cancer with fistulation to the duodenum and jejunum was diagnosed, and a left hemicolectomy, resection of the jejunum including the fistula, a partial gastrectomy, and associated resection of the body and tail of the pancreas and spleen were performed. Histopathologically, it was moderately differentiated adenocarcinoma in Stage III [si, n (-), H0. P0, M (-)]. There have been no signs of recurrence as of 12 months after the operation.Jejunocolic fistulation due to colon cancer is a rare condition, and only 11 cases including this case have been reported in Japan so far. This disease invades the adjacent organs, but it scarcely causes liver metastasis, peritoneal dissemination, and lymph nodes metastasis. Curative resection can be expected by extended excision including the digestive organs where internal fistula is formed.
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