[A case of subphrenic abscess with ileal fistula caused by metastatic adenocarcinoma of unknown origin].
Usual sources of subphrenic abscess with intestinal fistula are previous abdominal operation, inflammatory bowel disease and malignancy. Reported cases of intestinal fistula caused by adenocarcinoma were complicated by direct invasion. In this report, a 70-year-old male had a subphrenic abscess with intestinal fistula and the cause was a metastatic adenocarcinoma of unknown origin. As far as we know, this has not been reported previously in the literatures. The abscess went on chronic course for six months because intermittent administration of antibiotics modified its clinical presentation. The fistulous tract between the abscess and ileum was demonstrated by tubogram via the drainage catheter in abscess. The patient underwent surgical treatment because the cause of fistula was obscure. Invasion of the ileum by metastatic adenocarcinoma was diagnosed by the histologic examination of surgical specimen. Therefore, when a fistula develops without any apparent cause, there is a possibility of malignancy, and surgical approach must be considered. An early surgical approach will prevent the delay in treatment and reduce the mortality.
Choi
Gi Young
GY
Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.
Kim
Anna
A
Kim
Chang Nam
CN
Yoon
Sang Jeong
SJ
Jung
Sung Hee
SH
Ko
Byeong Seong
BS
Yang
Hyeon Yoong
HY
John
Byung Min
BM
Kim
Seok Hyun
SH
Nam
Hyo Jung
HJ
Go
Hoon
H
D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis / Q000556:secondary*; D000368:Aged; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis / Q000209:etiology*; D007078:Ileal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary*; D007412:Intestinal Fistula / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D009382:Neoplasms, Unknown Primary; D013369:Subphrenic Abscess / Q000175:diagnosis / Q000209:etiology*