結腸癌による結腸十二指腸瘻の1例-下膵頭後部リンパ節転移陽性例-

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A 61-year-old man was admitted to our hospital with a history of general malaise and diarrhea. Clinical examination demonstrated ascending colon cancer involving the descending duodenum. Right hemicolectomy and pancreatoduodenectomy were performed. At surgery, a tumor measuring 10cm in diameter was found in the ascending colon and the tumor invaded the descending duodenum resulting in duodenocolic fistula. There was no liver metastasis nor peritoneal metastasis and absolute curative operation was performed. The resected tumor was a mucinous adenocarcinoma involving the duodenum. Only two lymphnodes were positive for metastatic carcinoma ; one was a paracolic lymphnode and another was a posterior side of pancreas head lymphnode. The patient is still living 1 year and 5 months after operation without a recurrence.<BR>W e emphasized that in case of duodenal invasion of colon cancer, a pancreatoduodenectomy is necessary for complete lymphnode dissection of duodenum because of potential lymphnode mtetasasis like this case.
日本大腸肛門病学会の論文