title: Closure of duodenocutaneous fistula due to recurrent colon cancer with a pedicled jejunal seromuscular flap.
abstract: A new approach to closing a malignant enterocutaneous fistula is reported. Transverse colon cancer recurred around the superior mesenteric vein along with a duodenocutaneous fistula, thus causing severe dermatitis. The tumor was partially resected at the fascia level and the fistula measured 2.5 cm in diameter. A left rectus abdominis musculocutaneous flap failed to close the fistula because of graft necrosis. A jejunal flap measuring 8 cm in length was prepared by sacrificing about 15 cm of adjacent jejunum to create the pedicle. The mucosal layer of the flap was removed and the fistula was closed, then the tumor surface was covered. Two weeks later, the skin defect was covered with free skin grafting. The patient died of cancer 6 months after surgery, but there was no recurrence of the fistula.
authors.affiliation: Department of Surgery, Yachiyo Hospital, Anjo, Aichi 446-8510, Japan.
authors.forename: Taihei
authors.initials: T
authors.lastname: Oshiro
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Moriura
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yoshioka
authors.forename: Mari
authors.initials: M
authors.lastname: Kawahara
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kobayashi
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Matsumoto
mesh_terms: D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000150:complications*; D017577:Cutaneous Fistula / Q000209:etiology / Q000601:surgery*; D004378:Duodenal Diseases / Q000209:etiology / Q000601:surgery*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology / Q000601:surgery*; D007413:Intestinal Mucosa / Q000637:transplantation; D007583:Jejunum / Q000166:cytology / Q000637:transplantation*; D009364:Neoplasm Recurrence, Local / Q000150:complications*; D013524:Surgical Flaps