Adenocarcinoma of colon with entero-colic fistula
Weight loss recently, now referred with fecal vomiting
CT abdomen and pelvis
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CT shows ill-defined hypodense image in the liver (segment VIII). Not observed dilatation of the bile duct. Metallic suture in the gallbladder bed. Pancreas, adrenal gland and kidney in shape, size, and densitometric unaltered. At the right iliac fossa, there is an eccentric thickening of the cecal wall, which enhances heterogeneous with increased density of peripheral fat and connected with the small bowel at the level of the D2 / D3 junction.
Biopsy conclusion: fragments of large bowel mucosa infiltrated by poorly differentiated malignant tumor consistent with adenocarcinoma.
This case shows a colon adenocarcinoma with an enteric-colic fistula. Fistulas connecting the small bowel and colon are uncommon in clinical practice, although those due to malignancy are usually due to colonic carcinomas.