부산대학교 도서관

A 14-year-old boy diagnosed as having ileus with appendicitis and medicated antibiotics at elsewhere was referred to the hospital. There was tenderness on the right lower quadrant of abdomen. Abdominal CTscan did not show swelling of the appendix, but we thougt it was caused by preceded care, and performed an appendectomy. During operation, we could not find obstructive portion. After the operation we reviewed CT and confirmed the wall thickning of the splenic flexure of transverse colon. Barium enema studies and colonic fiberscopy demonstrated obstructed colon and a tumor with irregular surface. A biopsy reported that the tumor was poorly differentiated adenocarcinoma. At the second operation, a whole-circumferential tumor was present at the splenic flexure and peritoneal dissemination was observed. A left-sided colectomy and intraabdominal administration of 100 mg CDDP were conducted. Pathologic stage was stage IV (ss, n1(+), H0, P3, M(-), por, sci, ly2, v1, infγ). 3rd operation was performed 62days after the 2nd operation, because of multiple small intestinal obstrucion due to dissemination. We consider that colon cancer should not be excluded in children only on the basis of age.