[Colopleural fistula caused by recurrence of gastric cancer; report of a case].
Perforation of colon into the pleural space without diaphragmatic hernia is extremely rare. This report illustrates a case of pneumo-pyothorax caused by perforation of metastatic tumor of the transverse colon of a 67-year-old woman with a history of total gastrectomy and splenectomy for advanced gastric carcinoma 4 years before. The patient was admitted to our hospital presenting with fever and dyspnea, which subsided after a thoracic drainage. Cultures of drained effusion revealed Escherichia coli, Klebsiella and Bacteroides. An emergent laparotomy for treatment of mechanical ileus 2 weeks after her admission disclosed a tumor obstructing the splenic flexure of the transverse colon, and a double-barreled colostomy was made. Pathologic examination of the tumors obtained from colon, mesocolon and the parietal peritoneum revealed poorly differentiated adenocarcinoma that was the same as her primary gastric cancer.
Kitagawa
T
T
Department of Surgery, Southern Tohoku General Hospital, Kooriyama, Japan.
Endo
H
H
Suzuki
N
N
Satou
A
A
Kanno
T
T
Takano
Y
Y
Fujiu
K
K
Mori
M
M
Teranishi
Y
Y
D000230:Adenocarcinoma / Q000150:complications* / Q000473:pathology; D000368:Aged; D003108:Colonic Diseases / Q000209:etiology*; D003110:Colonic Neoplasms / Q000150:complications* / Q000556:secondary*; D005260:Female; D005402:Fistula / Q000209:etiology*; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology*; D009364:Neoplasm Recurrence, Local; D010995:Pleural Diseases / Q000209:etiology*; D013274:Stomach Neoplasms / Q000473:pathology*