腹壁膿瘍で発症した下行結腸癌の1例

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  • A CASE OF CARCINOMA OF THE DESCENDING COLON PRESENTING WITH AN ABSCESS OF THE ABDOMINAL WALL

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Invasion into the abdominal wall of a carcinoma of the colon may produce an abscess of the abdominal wall and on rare occasions this may be the presenting sign of the carcinoma. A 48-year-old man was admitted to the hospital because of a tumor in the left upper quadrant of the abdomen. Colonoscopy showed a type 3 tumor and a whole-circumferential stenosis in the desescending colon. Abdominal ultrasonogram revealed an echogenic mass about 5 cm in size in the left upper quadrant. Computed tomogram demonstrated a low density area about 5 cm in size with air in the mass. Lower gastrointestinal fluoroscopy revealed apple core sign in the descending colon, and defluxion and collection of barium from the anal side of the tumor to the left lateral wall. From these findings, the case was diagnosed as abscess formation due to invasion into the abdominal wall of cancer of the descending colon, and a transverse colostomy and drainage of the abscess cavity were performed. After 26 days after the operation when his general condition improved, a left hemicolectomy was performed. The resected tumor was 70×60mm in size and perforated portion was obscure. Histological diagnosis was mucinous adenocarcinoma.

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