A Case of Sigmoid Colon Cancer with a Fecal Tumor Produced by Penetration of the Mesenterium at the Oral Tumor Side

Masato Moritani, Toshifumi Wada, Yuuichi Nagakawa, Keiichiro Yamamoto, Akihiko Tsuchida, Tatsuya Aoki and Yasuhisa Koyanagi^*

Depertment of Gastroenterology, Nishi-Tokyo Central General Hospital, Department of Surgery III, Tokyo Medical University^*

A 39-year-old woman admitted due to lower abdominal pain without peritoneal stimulation symptoms was given analgesic drugs to temporarily relieve abdominal pain, but underwent emergency surgery due to peritoneal stimulation symptoms and ascites. Operative findings showed a tumor of sigmoid colon and dark-brown swelling of the mesenterium at the oral sigmoid tumor side, with some purulent ascites but no fecal infection. Based on these findings, we made a diagnosis of penetration of the mesenterium and implemented Hartmann's method including resection of the mesenterium and infectious mesenterium. The resected specimen showed the severe stenosis of the sigmoid colon due to Type II cancer, about 800g of fecal storage in the mesenterium, and perforation of the sigmoid colon about 5cm in diameter at the oral tumor side. Her postoperative course was uneventful and she was discharged after chemotherapy. Colon perforation is usually accompanied by peritonitis and a dismal outcome. Only a few reports have been made of penetration of the mesenterium resulting in a favorable outcome.

Key words
mesenterium penetration, sigmoid colon cancer

Reprint requests
Masato Moritani Department of Gastroenterology, Nishi-Tokyo Central General Hospital
2-4-9 Shibakubo-cho, Nishi Tokyo, 188-0014, JAPAN

Accepted
February 27, 2002

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