Malignant duodenocolic fistulas: A case report and review of the literature

Abstract

A case of primary malignant duodenocolic fistula is presented. Colonic carcinoma is the most common etiology of this entity. clinical features include diarrhea, weight loss, anemia, and feculent vomiting. Review of the literature indicates that the treatment of choice is a right hemicolectomy with a pancreaticoduodenectomy or segmental duodenectomy if the disease is localized. Forty-six percent of patients undergoing this procedure have been reported to be alive more than 2.5 years later. If the disease is disseminated, the best palliative procedure appears to be a right hemicolectomy with a partial duodenectomy. The early morbidity and mortality associated with this latter procedure have been attributed most often to dehiscense of the duodenal closure.

Malignant Coloduodenal Fistulas-Review of Literature and Case Report

“…Izumi reviewed a series of 34 cases of malignant colo-duodenal fistulae in Japan, and their survival with en bloc pancreatico duodenectomy ranged from 7 days to 4 years (median=10 months) [28]. Chang treated 20 of his patients with right hemicolectomy with partial duodenectomy and primary closure of the duodenal wall defect [29]. Ellis used a jejunal loop to close the duodenal wall defect.…”

Management and Outcomes of Primary Coloduodenal Fistulas

“…The literature on primary coloduodenal fistulae is limited to case series. [1][2][3][4][5][6][8][9][10][12][13][14][15]17,[19][20][21][23][24][25][26] Consequently, the clinical presentations, optimal diagnostic and management strategies, and outcomes of CDF are poorly described. The effectiveness of current treatment strategies for fistula treatment and patient survival outcomes are unknown for both benign and malignant CDF.…”

Malignant colo-duodenal fistula; case report and review of the literature

“…There are various curative operations reported, all of which include a right hemicolectomy. Chang treated 20 of his patients with right hemicolectomy with partial duodenectomy and primary closure of the duodenal wall defect [33]. His mortality was 28%, mainly attributed to leakage from the duodenal defect and local recurrence.…”