COLON CANCER COMPLICATED BY COLO-DUODENAL FISTULA (a case report and literature review)

Abstract

Colo-duodenal fistula is a rare complication of malignant bowel disease. The article presents a brief review of the literature and a case report of radical surgery of the cancer of the hepatic flexure of the colon, complicated by colo-duodenal fistula, chronic intestinal obstruction, duodenal stenosis, severe anemia, malnutrition and gross weight loss with a positive immediate result. At the first stage of the surgery, bypassed loops were applied to restore the passage of the intestinal content and to reduce infection of the small intestine. A month later a curative operation was performed and included right-side hemicolectomy, gastropancreaticoduodenectomy, resection of paranephrium and the right kidney capsule, marginal excision of the IV liver segment and cholecystectomy with lymph node dissection along the hepatic artery and superior mesenteric, portal and inferior cava veins. The postoperative period was difficult with symptoms of severe hypoproteinemia. On the sixth day after surgery due to the outflow of bile from the liver defect, relaparotomy and drainage of the subhepatic cavity were performed. The patient was discharged 25 days after surgery resulted in convalescence.