A Case of Sigmoid Colon Cancer with Jejunocolic Fistula Preoperatively Diagnosed by Colonofiberscope

Masaya Nomura, Shigeo Souda, Yoshifumi Inoue, Yukinobu Yoshikawa, Yuichi Fumimoto and Hirohiko Yokotani

Department of Surgery, Nissay Hospital, Nippon Life Saiseikai Foundation

A 68-year-old man reporting diarrhea and dyspnea on exertion was found barium enema and colonofiberscopy result to have a type 2 carcinoma of the sigmoid colon and fistula formation in the small intestine, necessitating resection of the sigmoid colon and the jejunum including the fistula. A tumor about 6.5 cm in diameter was found in the sigmoid colon and directly involved the jejunum 75 cm distal from Treitz' ligament. No liver metastasis or peritoneal dissemination was seen. The tumor was diagnosed as well-differentiated adenocarcinoma and the pathological staging as IIIa (si). Surgery resulted in curability A, and no recurrence was found during follow-up 18 months postoperatively.
Malignant jejunocolic fistulas due to colon cancer are rare, and only 18, including ours, have been reported in Japan. Our case is also the first of sigmoid colon cancer with jejunocolic fistula. Despite its invasiveness, this disease often involves low malignancy, as indicated by treatment in the 18 reported cases. Once radical surgery for colon cancer involving partial resection of the jejunum and fistula is successful, prognosis improves.

Key words
colon cancer, jejunocolic fistula, internal fitula

Reprint requests
Masaya Nomura Department of Surgery, Nissay Hospital, Nippon Life Saiseikai Foundation 6-3-8 Itachibori, Nishi-ku, Osaka, 550-0012 JAPAN

Accepted
January 22, 2003

To read the PDF file you will need Abobe Reader installed on your computer.