Korean Journal of Gastrointestinal Endoscopy 2009;38(1): 38-42.
악성 십이지장-대장루 1예
김세원ㆍ채현석ㆍ민정요ㆍ손혜숙ㆍ김진수ㆍ김형근ㆍ조영석ㆍ안창혁*
가톨릭대학교 의과대학 내과학교실, *외과학교실
A Case of Malignant Duodenocolic Fistula
Sei Won Kim, M.D., Hiun Suk Chae, M.D., Jeong Yo Min, M.D., Hye Suk Son, M.D., Jin Su Kim, M.D., Hyung Keun Kim, M.D., Young Seok Cho, M.D. and Chang Hyuk Ahn, M.D.*
Departments of Internal Medicine and *Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
Abstract
Malignant duodenocolic fistula is a rare complication of colon cancer, and this usually develops as the right-side colon cancer or colonic hepatic flexure cancer infiltrates into the second portion of the duodenum. Six Korean cases of this malignancy have been previously reported on. The patients usually complain of watery diarrhea, feculant vomiting and weight loss that can be attributed to the altered normal flora. Barium enema has been the diagnostic procedure of choice to demonstrate the fistulous tract, but with the technical development of gastroendoscopy, the primary procedure is also changing. Curative resection is not possible in many cases. Palliative ileotransverse colostomy with gastrodjejunostomy is performed to relieve symptoms, but it cannot completely prevent the vomiting or diarrhea. We herein present a case of malignant duodenocolic fistula in a patient who had been suffering from indigestion, loose stool and feculant vomiting for one year. This case was diagnosed by endoscopy and the patient underwent a palliative operation. (Korean J Gastrointest Endosc 2009;38:38-42)