General Surgery, Nepean Blue Mountains Local Health District, Kingswood, New South Wales, Australia
General Surgery, St Vincent's Health Australia Ltd, Darlinghurst, New South Wales, Australia.
BMJ Case Rep. 2024 Apr 19;17(4):e258764. doi: 10.1136/bcr-2023-258764.
We describe a case of bowel perforation secondary to a recurrence of primary fallopian tube carcinoma treated more than a decade ago. A woman in her 70s presented to a rural centre with an acute abdomen. An abdominal CT showed a perforated ileum secondary to a pelvic mass. Emergency laparotomy identified the pelvic mass that was adherent to the side wall and invading the ileum at the site of perforation. Its adherence to the external iliac vessels posed a challenge to achieve en-bloc resection; therefore, a defunctioning loop ileostomy was created. Final histopathology and immunopathology were consistent with the recurrence of her primary fallopian tube carcinoma. The patient was further discussed in a multidisciplinary team meeting at a tertiary referral hospital. This case highlighted the importance of having a high index of suspicion for cancer recurrence, the utility of rapid source control laparotomy and multidisciplinary team patient management.
我们描述了一例继发于十多年前治疗的原发性输卵管癌复发的肠穿孔病例。一位 70 多岁的女性因急性腹痛到农村中心就诊。腹部 CT 显示回肠穿孔继发于盆腔肿块。急诊剖腹术发现盆腔肿块与侧腹壁粘连，并在穿孔部位侵犯回肠。其与髂外血管的粘连给整块切除带来了挑战；因此，进行了保护性回肠造口术。最终的组织病理学和免疫病理学与原发性输卵管癌的复发一致。该病例在三级转诊医院的多学科团队会议上进行了进一步讨论。该病例强调了对癌症复发保持高度怀疑的重要性，快速源头控制剖腹术和多学科团队患者管理的实用性。
