Haruki Yuji, Fujinaga Kazuhisa, Nakahashi Hiroki
Dept. of Surgery, Matsusaka Municipal Hospital.
Gan To Kagaku Ryoho. 2022 Dec;49(13):1980-1982.
The patient was a 61-year-old man who visited the emergency department of our hospital for the exacerbation of left lower abdominal pain. CT scan revealed a tumor in the descending colon and fluid accumulation and extensive foamy gas in the retroperitoneal space, suggesting that the tumor in the descending colon penetrated the parietal peritoneum and formed an abscess. After percutaneous drainage for the retroperitoneal abscess, a transverse colostomy was performed. After the improvement of the general conditions, the patient underwent an endoscopic biopsy and was diagnosed with well-differentiated adenocarcinoma. After 4 courses of FOLFOX plus panitumumab(PANI), with the drainage and wound care continued, he was discharged and underwent 2 additional courses of chemotherapy. PET-CT revealed marked shrinkage of the descending colon tumor without distant metastasis. Therefore, left colectomy and transverse colostomy closure were performed as curative surgeries. After discharge, the patient underwent 6 courses of chemotherapy and has been followed up without recurrence for 13 months after the curative surgeries.
患者为一名61岁男性,因左下腹疼痛加重前来我院急诊科就诊。CT扫描显示降结肠有肿瘤,腹膜后间隙有积液及广泛的泡沫状气体,提示降结肠肿瘤穿透壁腹膜并形成脓肿。在对腹膜后脓肿进行经皮引流后,行横结肠造口术。在一般情况改善后,患者接受了内镜活检,被诊断为高分化腺癌。在接受4个疗程的FOLFOX加帕尼单抗(PANI)治疗后,继续进行引流和伤口护理,患者出院并又接受了2个疗程的化疗。PET-CT显示降结肠肿瘤明显缩小,无远处转移。因此,行左半结肠切除术及横结肠造口关闭术作为根治性手术。出院后,患者接受了6个疗程的化疗,根治性手术后已随访13个月无复发。