Malignant sigmoid-duodenal fistula: case report and review of the literature

Malignant sigmoidoduodenal fistula

“…Dolichocolon is an abnormally large and long intestine but does not have luminal distension as seen in megacolon. This is the fourth case of sigmoido-dudodenal fistula secondary to a malignant sigmoid tumour [1,2] . Fistulation between the dudodenum and sigmoid has also occurred following oral ingestion of a metallic wire [3] .…”

“…Duodenocolic fistula is a rare complication of malignant colonic disease especially when involving and originating from the sigmoid colon. This is the fourth case of sigmoido-duodenal fistula secondary to a malignant sigmoid tumour [1,2] . We aim to discuss the unusual clinical presentation of this case as well as the investigation and management of duodenocolic fistulas.…”

“…In this case, the sigmoid colon, a mobile intra-peritoneal structure, was elevated by a large ovarian tumour and thus lay in immediate proximity to the duodenum. In other cases, the proximity of the sigmoid colon to the duodenum is explained by dolichocolon [1] . Dolichocolon is an abnormally large and long intestine but does not have luminal distension as seen in megacolon.…”

“…Duodenoscopy may be a challenging procedure due to the common location of the fistula in the distal duodenum. Moreover, intraluminal colonic pressure proximal to the tumour may encourage the passage of stool into the duodenum and make satisfactory antegrade visualisation difficult [1] .…”