부산대학교 도서관

A 73-year-old woman was admitted to our hospital with a CC of general fatigue and vomit with fecal smell. On admission a hens' egg-sized tumor was palpable in the right hypochondrial region. Hb was 8.4 g/dl and TP 5.1 g/dl. Barium enema and colonoscopy revealed a cancer in the hepatic bending region that was completely obstructed. Endoscopy on the upper digestive tract demonstrated a fistula in the descending duodenum, from which watery feces flowed out. Contrastradiography under endoscopy depicted a fistula and the ascending colon. A diagnosis of colon cancer accompanied with duodenocolic fistula was made and operation was performed. The cancer was directly infiltrating into the duodenum. However, as the intraoperative staging was POHON1 (+) the right hemicolectomy and duodenectomy involving the pancreatic head were performed. The resected specimens demonstrated type 2 moderately differentiated adenocarcinoma showing n(-) stage III. There has been no relaptic sign for 2 years and 9 months postoperatic sign for 2 years and 9 months postoperativly.Although this type of colon cancer is high in direct infiltration, favorable prognosis can be expected in resected cases and therefore surgical operation should actively be performed