Abstract
A 56-year-old woman admitted to the hospital because of an enlarging left hypochondral painful mass and fever. There was high grade anemia and inflammatory reaction in her laboratory data. Absces formation in the abdominal wall was revealed by ultrasonography and CT scan. E. coli was detected by the culture from the abscess and X-ray with Urograffin showed the fistula between the abscess cavity and transverse colon accompanied with stomach. The patient was diagnosed as malignant gastrocolic fistula due to cancer of the transverse colon. Curative operation (transverse colectomy, gastrectomy and partial resection of the abdominal wall) was performed. Histopathologically it was well-differentiated adenocarcinoma without lympn node metastasis. The patient was discharged from the hospital 27 days after the operation with an uneventful clinical course. Only 27 cases of gastrocolic fistula due to colonic cancer have been reported in Japan, and colonic cancer with abdominal abscess and gastrocolic fistula is especially rare. Aggressive resection of the invaded organ appears to promise a favorable prognosis for malignant gastrocolic fistura.
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