Necrotizing fasciitis of the thigh due to penetrated descending colon cancer: a case report

被引:0
|
作者
Sato, Kentaro [1 ]
Yamamura, Hitoshi [2 ]
Sakamoto, Yoshiyuki [1 ]
Morohashi, Hajime [1 ]
Miura, Takuya [1 ]
Yoshikawa, Toru [1 ]
Suto, Akiko [1 ]
Tsuruta, Satoru [1 ]
Hakamada, Kenichi [1 ]
机构
[1] Hirosaki Univ, Grad Sch Med, Dept Gastroenterol Surg, 5 Zaifu Cho, Hirosaki, Aomori 0368562, Japan
[2] Hirosaki Univ, Grad Sch Med, Dept Disaster & Crit Care Med, 5 Zaifu Cho, Hirosaki, Aomori 0368562, Japan
来源
SURGICAL CASE REPORTS | 2018年 / 4卷
关键词
Necrotizing fasciitis; Colon cancer; Descending colon cancer; One-stage resection; Radical resection;
D O I
10.1186/s40792-018-0544-y
中图分类号
R61 [外科手术学];
学科分类号
摘要
BackgroundNecrotizing fasciitis (NF) caused by colorectal cancer is rare, and very few cases associated with colon cancer have been reported. We describe the case of a patient with NF in the left thigh due to penetration of descending colon cancer who was treated with one-stage surgical resection without creating a stoma.Case presentationAn 80-year-old woman was brought to our hospital complaining of fever and difficulty with body movement. A physical examination showed subcutaneous emphysema from the left lower abdomen to the left femoral region. CT showed abscess formation with emphysema around the descending colon, and the wall of the descending colon was thickened, which led to suspicion of colon cancer. The patient was subsequently diagnosed with NF due to penetration of descending colon cancer. Left hemicolectomy and open drainage of the left femoral region was performed. The histopathological findings were well-differentiated adenocarcinoma, with the tumor grown through the serosa (T4a) and with no metastasis to lymph nodes (N0). After surgery, the patient received intensive care for septic shock and lavage of the open drainage site, and sepsis was controlled progressively. After closure of the drainage site, the patient was transferred to a different hospital at 26days after surgery, and she has had 6-month relapse-free survival.ConclusionsIn NF caused by colon cancer, early one-stage resection may improve the oncological outcome. Physical status should be assessed carefully, and one-stage resection should be considered if the patient has the capacity to undergo this procedure.
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页数:5
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