A Case of Sigmoid Colon Cancer with Colocutaneous Fistula through the Operation Scar of Colostomy Closure

Shozo Sasaki, Toru Kamata, Masaki Takeshita, Masahiro Noto, Katsunobu Oyama, Katsuhiro Yoshimoto and Masahiro Kannno

Department of Gastroenterology, Keiju Medical Center

A 58-year-old man discharging pus through a colostomy closure was found to have a fistula formed on the operation scar and draining liquid stool. The colostomy had constructed for ileum myelitis and closed 40 years ago. Fistulography and barium enema showed colon cancer forming a colocutaneous fistula. Colonoscopy showed type 2 sigmoid colon cancer and the pathological diagnosis of biopsy specimens was adenocarcinoma. Enhanced CT detected sigmoid colon cancer invading to the abdominal wall but no metastatic lesions. We conducted sigmoid colon resection with radical excision of the abdominal wall and lymph node dissection. Microscopic findings showed that cancer had invaded to subcutaneous tissue and formed a colocutaneous fistula through abscess formation. The pathological diagnosis was moderately differentiated adenocarcinoma. Surgery was considered curative. Cancer had easily invaded subcutaneous tissue because the abdominal fascia was partially defective and the scar may have contributed to the colocutaneous fistula.

Key words
colocutaneous fistula, colon cancer, abdominal wall abscess

Reprint requests
Shozo Sasaki Surgery, Asanogawa General Hospital
83 Kosakamachinaka, Kanazawa, 920-8621 JAPAN

Accepted
June 18, 2008

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