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起源于结肠憩室的结肠癌:一例报告。

Colon cancer arising from colonic diverticulum: A case report.

作者信息

Kayano Hajime, Ueda Yusuhiko, Machida Takashi, Hiraiwa Shinichiro, Zakoji Hidenori, Tajiri Takuma, Mukai Masaya, Nomura Eiji

机构信息

Department of Gastroenterological and General Surgery, Tokai University Hachioji Hospital, Tokyo, Hachioji 192-0032, Japan.

Departments of Pathology, Tokai University Hachioji Hospital, Tokyo, Hachioji 192-0032, Japan.

出版信息

World J Clin Cases. 2019 Jul 6;7(13):1643-1651. doi: 10.12998/wjcc.v7.i13.1643.

Abstract

BACKGROUND

Colonic diverticulosis is a common disease, and the coexistence of colonic diverticulosis and colorectal cancer is often seen clinically. It is very rare that colon cancer arises from the mucosa of a colonic diverticulum. When colon cancer arises in a diverticulum and then tends to develop outside the wall, without developing within the lumen, the differential diagnosis from complicating lesions due to colonic diverticulitis is difficult.

CASE SUMMARY

A 76-year-old man was admitted to a nearby clinic with a chief complaint of discomfort and urinary frequency. Since a vesicosigmoidal fistula was seen on abdominal computed tomography, he was referred to our hospital. Laparoscopic sigmoidectomy was performed because the various diagnostic findings were diagnosed as a vesicosigmoidal fistula with diverticulitis of the sigmoid colon. However, on histopathological examination, it was diagnosed as a vesicosigmoidal fistula due to colon cancer arising in the diverticulum. Laparoscopic partial resection of the bladder was performed because local recurrence was observed in the bladder wall one and a half years after surgery. It is currently one year after reoperation, but there has been no recurrence or metastasis.

CONCLUSION

Colon cancer arising in a diverticulum of the colon should be considered when diverticulitis with complications is observed.

摘要

背景

结肠憩室病是一种常见疾病,临床上结肠憩室病与结直肠癌并存的情况屡见不鲜。结肠癌起源于结肠憩室黏膜的情况极为罕见。当结肠癌在憩室内发生并倾向于向肠壁外发展,而非在肠腔内发展时,与结肠憩室炎所致并发症的鉴别诊断较为困难。

病例摘要

一名76岁男性因不适和尿频为主诉入住附近诊所。因腹部计算机断层扫描发现膀胱乙状结肠瘘,遂转诊至我院。由于各种诊断结果均诊断为膀胱乙状结肠瘘伴乙状结肠憩室炎,故行腹腔镜乙状结肠切除术。然而,组织病理学检查显示,该病例诊断为憩室内发生的结肠癌导致的膀胱乙状结肠瘘。术后一年半,因膀胱壁出现局部复发,遂行腹腔镜膀胱部分切除术。目前再次手术已过去一年,但未出现复发或转移。

结论

当观察到伴有并发症的憩室炎时,应考虑结肠癌起源于结肠憩室的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cea/6658384/9f3140e7deb5/WJCC-7-1643-g001.jpg

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