Limits...
Inferior vena cava enteric fistula due to unresected colorectal metastasis.

Gilshtein H, Ben-Ishay O, Nascovica K, Kluger Y - World J Emerg Surg (2015)

Bottom Line: A year prior to his recent hospitalization he underwent cytoreductive surgery followed by HIPEC due to peritoneal metastases in another hospital.Gross pathology revealed a fistula between the vena cava and the duodenum with bile stained clot within the resected part of the vena cava.The patient recovered well with resolutions of his presenting symptoms.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Rambam Health Care Campus, 8 Ha'Aliyah St, Haifa, 35254 Israel.

ABSTRACT
A 57 year old male presented to our department with recurrent attacks of sepsis and upper gastrointestinal bleeding due to colorectal cancer metastasis that resulted in a fistula involving the inferior vena cava and the third part of the duodenum. Four and a half years ago he underwent laparoscopic right hemicolectomy due to colonic adenocarcinoma. A year prior to his recent hospitalization he underwent cytoreductive surgery followed by HIPEC due to peritoneal metastases in another hospital. During the operation a metastasis adherent to the inferior vena cava and the III part of the duodenum was revealed. The surgeon decided to mark the area with hemo- clips and after the patient recovered from surgery he was sent for radiotherapy aimed at controlling the left over metastases. In his current hospitalization he underwent an en bloc resection of the III part of the duodenum, the adherent vena cava and the right kidney. Gross pathology revealed a fistula between the vena cava and the duodenum with bile stained clot within the resected part of the vena cava. The patient recovered well with resolutions of his presenting symptoms.

No MeSH data available.


Related in: MedlinePlus

Abdominal CT. The mass shown with arrows indicating its connection to the IVC and clips from previous surgery
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4493832&req=5

Fig1: Abdominal CT. The mass shown with arrows indicating its connection to the IVC and clips from previous surgery

Mentions: The patient was transferred to the department of general surgery for further observation and treatment. A revision of all the pertinent imaging modalities (Fig. 1) was performed and a multidisciplinary meeting was held to discuss the treatment options. A consensus was reached that the patient suffers from IVC-enteric fistula due to colon metastasis with an immediate life threatening potential and with a surgical salvage procedure being the only remaining viable option of treatment for palliation of his symptoms. The patient was informed and received a meticulous explanation of the planned procedure with its pure palliative intent. An informed consent was obtained.Fig. 1


Inferior vena cava enteric fistula due to unresected colorectal metastasis.

Gilshtein H, Ben-Ishay O, Nascovica K, Kluger Y - World J Emerg Surg (2015)

Abdominal CT. The mass shown with arrows indicating its connection to the IVC and clips from previous surgery
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4493832&req=5

Fig1: Abdominal CT. The mass shown with arrows indicating its connection to the IVC and clips from previous surgery
Mentions: The patient was transferred to the department of general surgery for further observation and treatment. A revision of all the pertinent imaging modalities (Fig. 1) was performed and a multidisciplinary meeting was held to discuss the treatment options. A consensus was reached that the patient suffers from IVC-enteric fistula due to colon metastasis with an immediate life threatening potential and with a surgical salvage procedure being the only remaining viable option of treatment for palliation of his symptoms. The patient was informed and received a meticulous explanation of the planned procedure with its pure palliative intent. An informed consent was obtained.Fig. 1

Bottom Line: A year prior to his recent hospitalization he underwent cytoreductive surgery followed by HIPEC due to peritoneal metastases in another hospital.Gross pathology revealed a fistula between the vena cava and the duodenum with bile stained clot within the resected part of the vena cava.The patient recovered well with resolutions of his presenting symptoms.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Rambam Health Care Campus, 8 Ha'Aliyah St, Haifa, 35254 Israel.

ABSTRACT
A 57 year old male presented to our department with recurrent attacks of sepsis and upper gastrointestinal bleeding due to colorectal cancer metastasis that resulted in a fistula involving the inferior vena cava and the third part of the duodenum. Four and a half years ago he underwent laparoscopic right hemicolectomy due to colonic adenocarcinoma. A year prior to his recent hospitalization he underwent cytoreductive surgery followed by HIPEC due to peritoneal metastases in another hospital. During the operation a metastasis adherent to the inferior vena cava and the III part of the duodenum was revealed. The surgeon decided to mark the area with hemo- clips and after the patient recovered from surgery he was sent for radiotherapy aimed at controlling the left over metastases. In his current hospitalization he underwent an en bloc resection of the III part of the duodenum, the adherent vena cava and the right kidney. Gross pathology revealed a fistula between the vena cava and the duodenum with bile stained clot within the resected part of the vena cava. The patient recovered well with resolutions of his presenting symptoms.

No MeSH data available.


Related in: MedlinePlus