[The case of a patient who experienced perforation related to sigmoid colon cancer, was bearing a hepatic metastasis, and who underwent radical resection for advanced colon cancer after a salvage operation for pan-peritonitis and chemotherapy].
Colorectal cancer associated perforation initially develops as pan-peritonitis but easily progresses to septic shock, which can be fatal. As such, it can be hard for patients to recover from this pathological condition. A 79-year-old man who was suffering from pan-peritonitis due to sigmoid colon cancer-associated perforation and also had a metastatic hepatic lesion was admitted to our hospital. He underwent an emergency operation in October 2012. Due to hemodynamic instability, peritoneal lavage and drainage, and stomal formation were performed during the operation. Polymyxin-B direct hemoperfusion (PMXDHP) and continuous hemodiafiltration (CHDF) were performed for septic shock and acute renal failure, respectively. The patient was administered 5 courses of chemotherapy consisting of capecitabine, oxaliplatin, and bevacizumab (Cape+L-OHP +Beva) with no severe adverse reactions; the primary colonic and metastatic hepatic lesions showed a good response to the chemotherapy. A radical resection for the sigmoid colon cancer, including a partial hepatic resection for the metastatic lesion, was performed in May 2013. Surveillance examinations have indicated that the patient is recurrence-free 13 months after radical resection.
Dept. of Surgery, Tokyo Women 's Medical University Medical Center East.
Minoru
M
Murayama
Osamu
O
Nakashima
Katsuo
K
Yamazaki
Kazuo
K
Koizumi
Tatsuomi
T
Miyauchi
Akira
A
Miyaki
Atsuko
A
Usuda
Kentarou
K
Yamaguchi
Hajime
H
Yokomizo
Shunichi
S
Shiozawa
Kazuhiko
K
Yoshimatsu
Takeshi
T
Shimakawa
Takao
T
Katsube
Yoshihiko
Y
Naritaka
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology / Q000601:surgery*; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary / Q000601:surgery*; D008297:Male; D010538:Peritonitis / Q000209:etiology / Q000601:surgery*; D016879:Salvage Therapy; D012811:Sigmoid Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*