Abstract：
UNASSIGNED: Colon cancer presenting as spontaneous enterocutaneous fistula are rare with only few cases reported in the literature. Such presentation signifies locally advanced disease with poorer outcomes. Enterocutaneous fistula increases morbidity and mortality in cancer and may potentially delay the definitive care. It poses a difficulty in management in terms of patient optimization, determining the type of resection (palliative or curative) and the operative timeline.
METHODS: A 47 years old female presented with complaints of foul smelling discharge from a fistulous opening in right iliac fossa with occasional per rectal bleeding for the past six months. Imaging showed ascending colon mass breaching the peritoneum with fistulous tract opening into subcutaneous plane. Exploratory laparotomy with right hemicolectomy and en bloc resection was performed.
UNASSIGNED: Cutaneous fistula can be caused by traumatic, postoperative etiologies and about 20 % are of spontaneous etiologies. Colon cancer has the ability to mimic any abdominal disease with a wide spectrum of presentations. The locoregional extension from the bowel creates a passage of colonic contents to evacuate from the external opening. The fistulous tract of colon cancer is less likely to close spontaneously and may require surgical intervention following appropriate resuscitation. Due to features suggestive of bowel obstruction an early single stage surgery was performed in our case.
CONCLUSIONS: There are no existing guidelines for colon cancer with colocutaneous fistula because they are the same for benign fistulas (resuscitation, control of output, eradication of the infection, nutritional optimization, surgery) along with a multidisciplinary oncology team approach.
METHODS: A 47 years old female presented with complaints of foul smelling discharge from a fistulous opening in right iliac fossa with occasional per rectal bleeding for the past six months. Imaging showed ascending colon mass breaching the peritoneum with fistulous tract opening into subcutaneous plane. Exploratory laparotomy with right hemicolectomy and en bloc resection was performed.
UNASSIGNED: Cutaneous fistula can be caused by traumatic, postoperative etiologies and about 20 % are of spontaneous etiologies. Colon cancer has the ability to mimic any abdominal disease with a wide spectrum of presentations. The locoregional extension from the bowel creates a passage of colonic contents to evacuate from the external opening. The fistulous tract of colon cancer is less likely to close spontaneously and may require surgical intervention following appropriate resuscitation. Due to features suggestive of bowel obstruction an early single stage surgery was performed in our case.
CONCLUSIONS: There are no existing guidelines for colon cancer with colocutaneous fistula because they are the same for benign fistulas (resuscitation, control of output, eradication of the infection, nutritional optimization, surgery) along with a multidisciplinary oncology team approach.
摘要：
未经证实：结肠癌表现为自发性肠外瘘是罕见的，文献报道的病例很少。这种表现表示局部晚期疾病，结果较差。肠皮瘘可增加癌症的发病率和死亡率，并可能延迟最终治疗。它在病人优化方面给管理带来了困难，确定切除类型（姑息性或治愈性）和手术时间表。
方法：一名47岁的女性在过去的六个月中，抱怨右髂窝的瘘管开口有恶臭的分泌物，偶尔有直肠出血。影像学显示升结肠肿块突破腹膜，瘘管通向皮下平面。行剖腹探查术，右半结肠切除术和整块切除术。
UNASSIGNED：皮肤瘘可由创伤性引起，术后病因约20%为自发性病因.结肠癌具有模拟任何腹部疾病的能力，具有广泛的表现。从肠的局部延伸产生结肠内容物的通道以从外部开口排出。结肠癌的瘘管不太可能自发关闭，并且在适当的复苏后可能需要手术干预。由于提示肠梗阻的特征，在我们的病例中进行了早期的单阶段手术。
结论：目前尚无针对结肠癌合并皮肤瘘的指南，因为它们与良性瘘相同（复苏，控制输出，根除感染，营养优化，手术）以及多学科肿瘤学团队的方法。
方法：一名47岁的女性在过去的六个月中，抱怨右髂窝的瘘管开口有恶臭的分泌物，偶尔有直肠出血。影像学显示升结肠肿块突破腹膜，瘘管通向皮下平面。行剖腹探查术，右半结肠切除术和整块切除术。
UNASSIGNED：皮肤瘘可由创伤性引起，术后病因约20%为自发性病因.结肠癌具有模拟任何腹部疾病的能力，具有广泛的表现。从肠的局部延伸产生结肠内容物的通道以从外部开口排出。结肠癌的瘘管不太可能自发关闭，并且在适当的复苏后可能需要手术干预。由于提示肠梗阻的特征，在我们的病例中进行了早期的单阶段手术。
结论：目前尚无针对结肠癌合并皮肤瘘的指南，因为它们与良性瘘相同（复苏，控制输出，根除感染，营养优化，手术）以及多学科肿瘤学团队的方法。
