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一例罕见的降结肠癌穿孔合并左髂腰肌和同侧闭孔肌瘘及脓肿。

A rare case of perforated descending colon cancer complicated with a fistula and abscess of left iliopsoas and ipsilateral obturator muscle.

作者信息

Cacurri Alban, Cannata Gaspare, Trastulli Stefano, Desiderio Jacopo, Mangia Antongiulio, Adamenko Olga, Pressi Eleonora, Giovannelli Giorgio, Noya Giuseppe, Parisi Amilcare

机构信息

Department of General and Oncologic Surgery, University of Perugia, 06157 Perugia, Italy.

Department of Digestive and Liver Surgery Unit, St. Maria Hospital, 05100 Terni, Italy.

出版信息

Case Rep Surg. 2014;2014:128506. doi: 10.1155/2014/128506. Epub 2014 Mar 16.

Abstract

Perforation of descending colon cancer combined with iliopsoas abscess and fistula formation is a rare condition and has been reported few times. A 67-year-old man came to our first aid for an acute pain in the left iliac fossa, in the flank, and in the ipsilateral thigh. Ultrasonography and computed tomography revealed a left abdominal wall, retroperitoneal, and iliopsoas abscess that also involved the ipsilateral obturator muscle. It proceeded with an exploratory laparotomy that showed a tumor of the descending colon adhered and perforated in the retroperitoneum with abscess of the iliopsoas muscle on the left-hand side, with presence of a fistula and liver metastases. A left hemicolectomy with drainage of the broad abscess was performed. Pathologic report findings determined adenocarcinoma of the resected colon.

摘要

降结肠癌穿孔合并髂腰肌脓肿及瘘管形成是一种罕见的病症,仅有少数病例报道。一名67岁男性因左下腹、侧腹及同侧大腿急性疼痛前来我院急救。超声检查和计算机断层扫描显示左腹壁、腹膜后及髂腰肌脓肿,同侧闭孔肌也受累。随后进行了剖腹探查术,结果显示降结肠肿瘤粘连并穿孔至腹膜后,左侧髂腰肌有脓肿,存在瘘管及肝转移。遂行左半结肠切除术并广泛引流脓肿。病理报告结果确诊为切除结肠的腺癌。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea76/3976818/85731791584e/CRIS2014-128506.001.jpg

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