A hemophagocytic syndrome-like condition after emergency colectomy for perforated colon cancer: report of a case.
Hemophagocytic syndrome is a rare but often fatal condition, and little is known about why this disorder can occur following surgery. We report herein the case of a patient successfully treated for a hemophagocytic syndrome-like condition that developed after emergency right hemicolectomy for a retroperitoneal abscess secondary to perforated colon cancer. The 62-year-old man initially presented after the sudden development of severe right back pain, and computerized tomography scans revealed a retroperitoneal abscess continuous with a tumor in the ascending colon. An emergency right hemicolectomy was subsequently performed. On postoperative day (POD) 2, his blood platelet count suddenly dropped to 1 x 10(4)/microl and histological examination of a bone marrow specimen taken on POD 5 showed abnormal histiocytes that had phagocytosed not only megakaryocytes, but also erythrocytes and leukocytes, and a normocellular marrow with a normal number of megakaryocytes. Hemophagocytic syndrome was suspected, and predonine was administered. The patient's condition improved remarkably and he was discharged on POD 51.
Yamada
Takayuki
T
Department of Surgery, Maebashi Red Cross Hospital, Gunma, Japan.
Ikeya
Toshiro
T
Ogawa
Tetsushi
T
Nakano
Minoru
M
Ogura
Hidemi
H
Itoh
Hideaki
H
Koyama
Toru
T
Ohwada
Susumu
S
Yokoe
Takao
T
Morishita
Yasuo
Y
D000038:Abscess / Q000382:microbiology; D001853:Bone Marrow / Q000473:pathology; D003082:Colectomy; D003110:Colonic Neoplasms / Q000150:complications / Q000601:surgery*; D015616:Histiocytosis, Non-Langerhans-Cell / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007414:Intestinal Neoplasms / Q000150:complications / Q000601:surgery*; D007710:Klebsiella Infections / Q000150:complications; D007711:Klebsiella pneumoniae; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D012187:Retroperitoneal Space