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Malignant duodenocolic fistula: Report of a case and considerations for operative management

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Abstract

Malignant duodenocolic fistula is a rare complication of gastrointestinal malignancy. We present herein the case of a 34-year-old female in whom a large duodenocolic fistula was caused by advanced transverse colonic carcinoma. Right hemicolectomy combined with pancreaticoduodenectomy enabled en bloc resection of the tumor, and the patient has been free of disease for 1 year and 8 months postoperatively. A review of the international literature, including 33 cases reported in Japan, indicates that if the disease is curable, the treatment of choice is right hemicolectomy with pancreaticoduodenectomy, whereas if it is not curable but locally resectable, the best palliation appears to be right hemicolectomy with partial duodenectomy to include the fistulous tract. Dehiscence of the duodenal wound closure associated with partial duodenectomy can be prevented by using the mucosal or serosal patch techniques with intestinal loops. These therapeutic principles are also applicable for colonic carcinoma which massively involves the duodenum without fistula formation.

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References

  1. Abcarian H, Udezue N (1978) Coloenteric fistulas. Dis Colon Rectum 21:281–286

    Google Scholar 

  2. Haldane DR (1862) Case of cancer of the caecum accompanied with cecoduodenal and cecocolic fistulae. Med J Edinburgh 7:624–629

    Google Scholar 

  3. Calmenson M, Black BM (1947) Surgical management of carcinoma of the right portion of the colon with secondary involvement of the duodenum, including duodenocolic fistula: Data of eight cases. Surgery 21:476–481

    Google Scholar 

  4. Hershenson LM, Kirsner JB (1951) Duodenocolic fistula. Gastroenterology 19:864–873

    Google Scholar 

  5. Chang AE, Rhoads JE (1982) Malignant duodenocolic fistulas: a case report and review of the literature. J Surg Oncol 21:33–36

    Google Scholar 

  6. Schuurman AH, Van den Broek THAA, Meyer S, Hoitsma HFW (1986) Malignant duodenocolic fistula (letter). Neth J Surg 38:188–189

    Google Scholar 

  7. Cogbill TH, Moore EE, Newman MM, Halgrimson CG (1984) Pyloric exclusion in the management of complicated duodenal disease and pancreatic disease. Am Surg 50:244–247

    Google Scholar 

  8. Cawthorn SJ, Bett NJ, Rutter KR (1985) Malignant duodenocolic fistula: Long-term survival following an extended right hemicolectomy with wide local excision of the duodenum. Br J Surg 72:211

    Google Scholar 

  9. Giusto F, Arzillo G, Lodo N, Falchero F, Gramegna A (1986) Malignant duodenocolic fistula. A case report. Ital J Surg Sic 16:47–49

    Google Scholar 

  10. Doberneck RC, Gogel H (1988) Malignant duodenocolic fistula; Diagnosis by colonoscopy and treatment by use of the exclusion-bypass principle. Contemp Surg 33:51–64

    Google Scholar 

  11. Bastiaens MT, Wittens CH, van Deursen CTBM, Lens J, Lustermans FAT (1989) A patient with a duodenocolic fistula. Neth J Surg 41:74–76

    Google Scholar 

  12. Roberts PL, Coller JA, Corriveau S, Nielsen-Whitcomb FF (1989) Malignant duodenocolic fistula diagnosed by endoscopy. Surg Endosc 3:112–114

    Google Scholar 

  13. Welch JP, Warshaw AL (1977) Malignant duodenocolic fistulas. Am J Surg 133:658–661

    Google Scholar 

  14. Ellis H, Morgan MN, Wastell C (1972) “Curative” surgery in carcinoma of the colon involving duodenum: A report of 6 cases. Br J Surg 59:932–935

    Google Scholar 

  15. Japanese Research Society for Cancer of the Colon and Rectum (1983) General rules for clinical and pathological studies on cancer of colon, rectum, and anus. Part I. Clinical classification. Jpn J Surg 13:557–573

    Google Scholar 

  16. Linton RR (1944) Two-stage operation for carcinoma of the transverse colon producing duodenocolic fistula. Arch Surg 48:197–207

    Google Scholar 

  17. Janes RM, Mills JF (1959) Malignant duodenocolic fistula-report of a case treated successfully by mass resection. Can J Surg 3:91–92

    Google Scholar 

  18. Peters JH, Carey LC (1991) Historical review of pancreaticoduodenectomy. Am J Surg 161:219–225

    Google Scholar 

  19. Gallagher HW (1960) Extended right hemicolectomy. The treatment of advanced carcinoma of the hepatic flexure and malignant duodenocolic fistula. Br J Surg 47:616–621

    Google Scholar 

  20. Zer M, Wolloch Y, Lombrozo R, Dintsman M (1980) Palliative treatment of malignant duodenocolic fistulas. World J Surg 4:131–135

    Google Scholar 

  21. Sone K, Sato F, Toyoshima J (1961) A case of duodenocolic fistula caused by ascending colon cancer (in Japanese). Iwate Kenritsu Byoin Igakukai Zasshi (Med J Iwate Prefec Hosp) 1:39–40

    Google Scholar 

  22. Eriguchi K, Tanaka T, Higuchi M (1961) A case report of duodenocolic fistula caused by transverse colon cancer (abstract, in Japanese). Nippon Geka Gakkai Zasshi (J Jpn Surg Soc) 62:519

    Google Scholar 

  23. Matsuzaki M, Matsui T, Tokunaga S, Sakuma O, Horio S (1972) Two case reports of duodenocolic fistula caused by malignant colonic tumor (abstract, in Japanese). Chubu Geka Gakkai Sokai Kiroku (Rec Annual Meeting Chubu Surg Soc) 7:33–34

    Google Scholar 

  24. Suzuki S, Togo Y, Kawai T, Hojo Y, Sato T, Ozawa M, Ikeya T, Nagai I, Miyamoto Y, Nunokawa F, Ito S (1975) A treatment of the wide infiltrated colon cancer with colon-duodenal fistula (in Japanese with English abstract). Gan no Rinsho (Jpn J Cancer Clin) 21:56–59

    Google Scholar 

  25. Suzuki O, Takamura Y, Kasaoka C, Kono T, Yamagishi T, Seki H, Ito S, Ono T (1975) A case of duodenocolic fistula complicating carcinoma coli (in Japanese). Naika (Int Med) 35:311–314

    Google Scholar 

  26. Kotoura Y, Yamamura T, Kusunoki T, Miura J, Ishikawa Y, Ito N (1977) A case of duodeno-colic fistula due to colon cancer (in Japanese with English abstract). Hyogo Ikadaigaku Zasshi (Acta Med Hyogo) 2:291–297

    Google Scholar 

  27. Abe K, Ariumi S, Takahashi H, Ito N (1977) A case report of colon cancer with multiple internal fistulae (abstract, in Japanese). Nippon Geka Gakkai Zasshi (J Jpn Surg Soc) 78:534

    Google Scholar 

  28. Yasui K, Ohara S, Tukaguchi I, Sato K, Nishimura T, Ono N, Sato M (1977) Two cases of duodenocolic fistula (abstract, in Japanese). Nippon Igaku Hoshasen Gakkai Zasshi (Nippon Acta Radiol) 37:736

    Google Scholar 

  29. Kato H, Hajiro H, Kimura T, Nakamoto K, Hitoo Y, Suzuki T, Kawano M (1978) A case report of duodenocolic fistula (abstract, in Japanese). Nippon Shokakibyo Gakkai Zasshi (Jpn J Gastroenterol) 75:1505–1506

    Google Scholar 

  30. Kobayashi Y, Yamada E, Hosota S, Mizuno H (1978) A case report of a transverse colon cancer with duodenocolic fistula and colonic tuberculosis (in Japanese). Nippon Daicho-Koumonbyo Gakkai Zasshi (J Jpn Soc Colo-proctol) 31:97–99

    Google Scholar 

  31. Ogawa M, Oh S, Mizumoto S, Monden M, Okamura J, Kosaki G (1980) Malignant gastroduodenocolic fistula: A case report (in Japanese). Geka Chiryo (Surg Ther) 42:735–740

    Google Scholar 

  32. Mori F, Miyamoto M, Torieda M, Morita N, Mohri H (1981) Malignant duodenocolic fistula: A case report. Jpn J Surg 11:50–53

    Google Scholar 

  33. Nakamoto K, Nitta N, Tanaka A, Kikuchi S, Nio Y, Murasawa K, Katoh H, Henmi K (1982) Malignant duodenocolic fistulae: A report of three cases. Arch Jpn Chir 51:176–185

    Google Scholar 

  34. Togo Y, Izuo M, Miyamoto Y, Sato Y, Ikeya T, Umegai I, Otake Y, Uchida K, Roppongi T, Arai T, Kobori T, Kawai T (1983) A study of colonic cancer which involves other organs (in Japanese). Geka (Surgery) 45:935–940

    Google Scholar 

  35. Nakamura S, Koyama W, Izumi N, Irie T, Kaku H, Sugiura K, Hasumura H, Takeuchi J, Yoshida T (1983) Carcinoma of the colon with duodenocolic fistula and pneumobilia. Report of a case. Naika (Int Med) 51:594–597

    Google Scholar 

  36. Tanaka A, Yoshida H, Masuda T, Minoda S, Hayakawa A, Ibayashi H, Saito S, Konomi K (1983) Duodenocolic fistula due to colonic cancer: A case report (in Japanese). Rinsho to Kenkyu (Jpn J Clin Exp Med) 60:1580–1584

    Google Scholar 

  37. Terashima S, Sanpei M, Satokawa H, Hata A, Suzuki S, Kawarada Y, Yoshida N, Motoki R (1984) Malignant duodenocolic fistula: A case report (in Japanese). Nippon Shokaki Geka Gakkai Zasshi (Jpn J Gastroenterol Surg) 17:2238–2241

    Google Scholar 

  38. Mine T, Harada S, Yoshida S, Akimoto K, Ohsawa H, Hasegawa Y, Ogata E, Furuya S (1984) A case of carcinoma of colon associated with a fistula to the duodenum (in Japanese with English abstract). Schokaki Naishikyo no Shinpo (Prog Digestive Endoscop) 25:325–328

    Google Scholar 

  39. Suzuki K, Wakabayashi Y, Kojima T, Ajikata M, Watanabe H, Murayama H, Tachikawa S (1984) An autopsy case of duodenocolic fistula due to colonic cancer (abstract, in Japanese). Niigata Igakukai Zasshi (Niigata Med J) 98:300

    Google Scholar 

  40. Tanaka S, Arima S, Kinashi M, Uchida H, Mitsuishi K, Futami Y, Tamesue N, Shimura H (1985) A case report of a transverse colon cancer forming a duodenocolic fistula (abstract, in Japanese). Nippon Daicho-Koumonbyo Gakkai Zasshi (J Jpn Soc Colo-proctol) 37:224

    Google Scholar 

  41. Sasamato M, Tanaka M, Kimura Y, Kako N, Koie H, Soejima S (1985) Duodenocolic fistula due to a transverse colon cancer: A case report (abstract, in Japanese). Hirosaki Igaku (Hirosaki Med J) 37:1068

    Google Scholar 

  42. Sewake H, Uemura K, Aoki H, Nakamitsu A, Nakai H (1985) Duodenocolic fistula due to colonic cancer: A case report (abstract, in Japanese). Hiroshima Igaku (J Hiroshima Med Ass) 38:601

    Google Scholar 

  43. Mizutani G, Utsunomiya T, Onishi H, Shinohara O, Bessho T, Kondo T, Takanami I, Tekenaka H, Sasaki K, Nakamura T, Inoue S, Mukai M (1985) A duodenocolic fistula due to transverse colon cancer: A case report (abstract, in Japanese). Nippon Shokakibyo Gakkai Zasshi (Jpn J Gastroenterol) 83:1270

    Google Scholar 

  44. Masui N, Hara M, Ito K, Shiina Y, Nomiyama S, Harasawa S, Miwa T, Nakajima I, Nakazaki H, Tsutsumi H (1986) A case report of malignant coloduodenal fistula (in Japanese with English abstract). Shokaki Naishikyo no Shinpo (Prog Digestive Endoscop) 28:321–324

    Google Scholar 

  45. Ikeda M, Noto T, Kin D, Yasuda T, Tanaka Y, Nakazaki H, Tajima T, Mitsutomi T, Sato T, Sugita T (1987) Pancreaticoduodenectomy for malignant duodenocolic fistula and duodenal invasion: A report of three cases (abstract, in Japanese). Nippon Daicho-Koumonbyo Gakkai Zasshi (J Jpn Soc Colo-proctol) 40:623

    Google Scholar 

  46. Kobayashi T, Tomiyasu T, Mineo N, Sato A, Ishihara N, Yoshitake S, Aoyagi A, Maeda K, Hiroki F, Fukuda S (1987) An autopsy case of duodenocolic fistula (in Japanese). Saitama-ken Igakukai Zasshi (J Saitama Med Soc) 21:1129–1132

    Google Scholar 

  47. Ogawa H, Kawamura Y, Kaibara N, Sasaki H (1988) A colo-duodenal fistula due to colonic cancer: A case report (in Japanese). Shujutsu (Operation) 42:1631–1634

    Google Scholar 

  48. Matsumaru K, Abe T, Tsuruoka Y, Ohmizo M, Uehigashi Y, Masaoka I, Yakabi K, Nakamura T, Shimizu N, Horanoguchi Y, Kozawa K, Wada N, Sugano I, Matsuzaki O, Nagao K (1989) A case of carcinoma of the colon associated with a coloduodenal fistula, which was confirmed by endoscopy (in Japanese with English abstract). Shoukaki Naishikyou no Shinpo (Prog Digestive Endoscop) 35:359–362

    Google Scholar 

  49. Suzuki S, Maruyama A, Yano T, Kuroda H, Fujimori K, Ito T (1989) Malignant duodenocolic fistula: A case report (abstract, in Japanese). Chubu Geka Gakkai Sokai Kiroku (Rec Annual Meeting Chubu Surg Soc) 25:66

    Google Scholar 

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Authors and Affiliations

  1. The Department of Surgery, Usatakada Ishikai Hospital, Ooaza Minami-usa 635, Usa, 872-01, Oita, Japan

    Yasuharu Izumi

  2. The Department of Surgery, Chihaya Mutual Aid Hospital, 2-30-1 Chihaya, Higashi-ku, 813, Fukuoka, Japan

    Takashi Ueki, Gen Naritomi, Yoshio Akashi, Akira Miyoshi & Tadashi Fukuda

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  1. Yasuharu Izumi
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  2. Takashi Ueki
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  3. Gen Naritomi
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  4. Yoshio Akashi
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  5. Akira Miyoshi
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  6. Tadashi Fukuda
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Izumi, Y., Ueki, T., Naritomi, G. et al. Malignant duodenocolic fistula: Report of a case and considerations for operative management. Surg Today 23, 920–925 (1993). https://doi.org/10.1007/BF00311373

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  • DOI: https://doi.org/10.1007/BF00311373

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