Advertisement

World Journal of Surgery

, Volume 4, Issue 1, pp 131–134 | Cite as

Palliative treatment of malignant duodenoenteric fistulas

  • Michael Zer
  • Ya’acov Wolloch
  • Rafael Lombrozo
  • Moshe Dintsman
Article

Abstract

Malignant duodenocolic fistula, a rare complication of carcinoma of the hepatic flexure of the colon, may present with bilious diarrhea and feculent vomiting, and is usually associated with severe electrolyte and nutritional depletion. In 2 cases of duodenoenteric fistula caused by recurrence of colonic cancer after right hemicolectomy, the tumor was unresectable. Isolation of the affected intestinal loop, without any attempt at disconnecting it from the duodenum, and diversion of that loop back into the jejunum provided a solution, achieving satisfactory palliation and an improvement in nutritional state.

Keywords

Public Health Carcinoma Colonic Cancer Diarrhea Nutritional State 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

La fistule duodéno-colique, complication rare des cancers de l’angle hépatique du colon, donne comme symptomes une diarrhée biliaire et des vomissements fécaloïdes; elle entraîne en général des pertes importantes d’électrolytes et un état de malnutrition grave. Dans deux cas de fistule duodénointestinale par récidive de cancer colique après hémicolectomie droite, la masse tumorale n’était pas résécable. L’anse intestinale fistulisée a été simplement exclue du transit digestif, sans toucher à la fistule, et réanastomosée au jéjunum. L’opération a en un effet palliatif satisfaisant et a amélioré l’état de nutrition des 2 malades.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Ellis, H., Morgan, N., Wastell, C.: “Curative” surgery in carcinoma of the colon involving duodenum. Br. J. Surg.59:932, 1972PubMedGoogle Scholar
  2. 2.
    Welch, J.P., Warshaw, A.L.: Malignant duodenocolic fistula. Am. J. Surg.133:658, 1977CrossRefPubMedGoogle Scholar
  3. 3.
    Calmenson, M., Black, B.M.: Surgical management of carcinoma of the right portion of the colon with secondary involvement of the duodenum including duodeno-colic fistula. Surgery21:476, 1947Google Scholar
  4. 4.
    Hershenson, L.M., Kirsner, J.B.: Duodeno-colic fistula. Gastroenterology19:864, 1951PubMedGoogle Scholar
  5. 5.
    Zer, M., Mukamel, E., Dintsman, M.: Use of an external bypass technique in gastrointestinal and biliary surgery. World J. Surg.1:535, 1977CrossRefPubMedGoogle Scholar
  6. 6.
    Smith, T.R., Goldin, R.R.: Radiographic and clinical sequelae of the duodenocolic anatomic relationship. Dis. Colon Rectum20:257, 1977PubMedGoogle Scholar
  7. 7.
    Gallagher, H.W.: Extended right hemicolectomy: the treatment of advanced carcinoma of the hepatic flexure and malignant duodeno-colic fistula. Br. J. Surg.47:616, 1960PubMedGoogle Scholar
  8. 8.
    Vieta, J.O., Blanco, R., Valentini, G.R.: Malignant duodenocolic fistula. Dis. Colon Rectum19:542, 1976PubMedGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 1980

Authors and Affiliations

  • Michael Zer
    • 1
  • Ya’acov Wolloch
    • 1
  • Rafael Lombrozo
    • 1
  • Moshe Dintsman
    • 1
  1. 1.Department of Surgery A, Beilinson Medical CenterTel-Aviv University Medical SchoolPetah TikvaIsrael

Personalised recommendations