A Case of Penetration Caused by Transanal Decompression Tube in an Obstructive Transverse Colon Cancer

Masanobu Hyodo¹⁾²⁾, Chuuji Sekiguti¹⁾, Munetoshi Tsukahara²⁾ and Hideo Nagai²⁾

Department of Surgery, Nasu-Minami Hospital¹⁾ Department of Surgery, Jichi Medical School²⁾

We report a case of colonic penetration caused by a transanal decompression tube in a transverse colon cancer patient. A 70-year-old male presented with colonic obstruction due to advanced transverse colon cancer at the site of the splenic flexure. Following failure to alleviate the intestinal obstruction with a long naso-intestinal tube, we introduced a transanal decompression tube via a colonoscope. Despite the insertion of the tube through the colonic stenosis being uneventful, the patient developed fever and abdominal pain 4 days after the insertion of the tube. A plain abdominal X-ray and CT suggested penetration of the transanal decompression tube into the mesentery proximal to the stenosis caused by the tumor. The penetration-related local inflammation subsided with conservative therapy with antibiotics and cessation of continuous suction. A radical operation was performed 19 days after the insertion of the transanal decompression tube. The cause of the perforation was thought to be the rapid decompression and continuous suction. It is true that a transanal decompression tube is very useful in the management of colonic obstruction due to advanced colon cancer, but we should bear in mind the possible injury associated with the insertion of the tube, not only at the time of insertion but also several days after the insertion.

Key words
transanal decompression tube, penetration, obstructive colon cancer

Reprint requests
Masanobu Hyodo Department of Surgery, Jichi Medical School Yakushiji, Minamikawachi-machi, Kawachi-gunn, Tochigi, 329-0498 JAPAN

Accepted
July 25, 2000

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