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CASE REPORT
Year : 2013  |  Volume : 3  |  Issue : 2  |  Page : 147-149

Spontaneous enterocutaneous fistula due to colonic malignancy: A rare case report


Department of General Surgery, Vardhman Mahavir Medical College and Safdarjang Hospital, New Delhi, India

Correspondence Address:
Umesh Jethwani
Ward No. 26, Department Of General Surgery, Vardhman Mahaveer Medical College and Safdarjung Hospital, New Delhi -110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-9596.122940

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Spontaneous colocutaneous fistula is a rare clinical entity usually associated with diseases like diverticulitis, crohn's disease and post radiotherapy treated malignancy. This case illustrates the challenges of diagnosis and management of such patients. We present a 60-year old lady who had a lump in left lumbar region which started discharging feculent material ten day prior to presentation. There was history of progressively worsening constipation and weight loss but no rectal bleeding or jaundice. There was a necrotic patch with feculent discharge from left lumbar region with underlying lump that was 5 Χ 4 cm, firm, non-tender and immobile. Following complete evaluation including abdomino-pelvic ultrasound that revealed an ill-defined mass arising from sigmoid colon, a diagnosis of colocutaneous fistula secondary to colonic malignancy was made. After resuscitation, the patient had exploration and Hartmann's procedure. Histopathology confirmed growth as adenocarcinoma and patient was placed on chemotherapy. We present this case to illustrate the challenges of diagnosis and management of such patients.


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