AUTHOR

Yueh-Tsung Lee et al. [8]

Monisha G et al. [9]

PUBLICATION YEAR

2005

2020

AGE AT PRESENTATION

60 years

29 years

GENDER

Female

Male

PRESENTATION

Generalized weakness, anorexia with fever and chills for 2 weeks. She got two fistulous openings with intermittent fecal discharge on her left flank scar.

Long standing intermittent pus and feculent discharge from fistulous tract opening over left flank at the drain site scar.

PREVIOUS SURGERY AND ITS INDICATION

Left nephrectomy for left renal stones at 30 years age

Left nephrectomy for unknown reasons at 10 years age

SITE OF FISTULA AND INTRAOPERATIVE FINDING

Colo-cutaneous fistula at splenic flexure with lower pole of the spleen adhered and irregular soft tissue beside the region. Partial wall of the jejunum, 10 cm distal to Treitz’s ligament was also adhered.

Colo-cutaneous fistula

OPERATIVE PROCEDURE

En bloc resection with splenectomy, segmental resection of colon with primary anastomosis and wedge resection of jejunum were performed.

Excision of fistulous tract, with primary closure of descending colon site of fistula.

OUTCOME

Postoperative course was grossly smooth and was being followed up at the outpatient department.

Postoperative period was uneventful. Colonoscopy done 2 weeks later was normal. Patient remained asymptomatic and was in regular follow-up till 6 months post surgery. Then he died due to sepsis.

HISTOPATHOLOGICAL ANALYSIS

The pathologist reported moderately differentiated squamous cell carcinoma with the tumor cells arising from the fistulas accompanied by spleen and colon invasion.

Histopathology revealed a moderately differentiated squamous cell carcinoma.