Malignant duodenocolic fistula

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Abstract
Two patients had duodenocolic fistulas, each following a carcinoma of the colon in the area of the hepatic flexure that perforated into the duodenum. The 1st patient was treated by a radical pancreatoduodenectomy with right colectomy; the 2nd by subtotal colectomy with excision of the duodenal wall and suture. Both patients are alive and without evidence of recurrent disease. The 1st patient had 2 other primary carcinomas, in the cecum and stomach, and the 2nd patient had another primary in the sigmoid. The definitive procedure had to be adjusted to encompass all lesions. The radical operation in 1 stage seems to be the preferred procedure and is most satisfactory as a cancer operation. The patient treated by this procedure has survived more than 11 yr. An intestinal fistula related to colonic carcinoma, even though rare, should not be considered as a separate entity. Treatment of the cancer with an en-bloc resection of the communicating organs should be employed, if possible.