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Case Report
A rare presentation of colonic malignancy: Enterocutaneous fistula secondary to locally advanced cancer
1 Unaccredited Surgical Registrar, Department of Surgery, Gladstone Hospital, Gladstone, QLD, Australia
2 Director of Surgery, Department of Surgery, Gladstone Hospital, Gladstone, QLD, Australia
3 Pathology Registrar, Institute of Clinical Pathology and Medical Research, Westmead, NSW, Australia
Address correspondence to:
Neesa Fadaee
58 Wiare Circuit Orange, NSW 2800,
Australia
Message to Corresponding Author
Article ID: 100059Z12NF2019
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How to cite this article
Fadaee N, De Clercq S, Fadaee S. A rare presentation of colonic malignancy: Enterocutaneous fistula secondary to locally advanced cancer. J Case Rep Images Surg 2019;5:100059Z12NF2019.ABSTRACT
Introduction: Colorectal cancer is the third most common cancer in the world. It is usually identified during screening programs, however some patients present to emergency departments with symptoms such as hemorrhage, perforation, or bowel obstruction. Locally advanced presentations of colorectal cancer are rare.
Case Report: A 69-year-old male presented to our hospital with a large left lumbar wound with active feculent discharge and associated cellulitis. He did not report any other symptoms. Radiological investigations suggested an enterocutaneous fistula with an associated anterior abdominal wall collection. A flexible sigmoidoscopy was performed revealing a fungating tumor in the sigmoid colon. Unfortunately, the patient developed significant per rectal bleeding and blood transfusion dependency. He was palliated on the ward following a multidisciplinary family meeting.
Conclusion: Enterocutaneous fistula formation secondary to locally advanced colorectal cancer is quite rare. There have only been five previously published case reports. The management of such cases is quite complex as it requires a multidisciplinary approach and there are no treatment or prognosis guidelines currently. Our case is of particular interest as it is the first reported case in a developed country.
Keywords: Colorectal cancer, Emergency presentation, Enterocutaneous fistula
SUPPORTING INFORMATION
Author Contributions
Neesa Fadaee - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Stefaan De Clercq - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Shannon Fadaee - Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2019 Neesa Fadaee et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
