ABSTRACT

Colorectal cancer is one of the most frequent in Mexico and the world, with a high mortality despite therapeutic advances. Extracolonic manifestations of the disease are rare. This is the case of a 52-year-old patient with no significant history and without a specific clinical picture of digestive tract pathology. That it presented as an empyema secondary to a colo-pleural fistula, with a long evolution. She underwent a chest surgical procedure with no evidence of a fistula at that time. He was admitted to the Institute with empyema and residual cavity, washing and decortication were performed, in the postoperative period the colo-pleural fistula was evidenced, which was dismantled together with the resection of a tumor of the splenic flexure of the colon, which was a moderate adenocarcinoma differentiated ulcerated and perforated. Presents after the procedure, sepsis without improvement. Colon cancer complications like this have a very high mortality despite treatment and in many cases the initial suspicion of the problem is not had.

KEYWORDS

Colo-pleural fistula, colon cancer, empyema.

REFERENCES

1. Calva AM, Acevedo TM. Revisión y actualización general del cáncer colo-rectal. An Rad Mex. 2009;1:99-115.

2. Guía de Práctica Clínica. Detección oportuna y diagnóstico de cáncer de colon y recto no hereditario en adultos en primero, segundo y tercer nivel de atención. México: Secretaría de Salud; 2009. Disponible en: http://www.cenetec-difusion.com/CMGPC/IMSS-145-08/ER.pdf

3. Guía de Práctica Clínica. Detección oportuna y detección de cáncer de colon y reto no hereditario en adultos en primero, segundo y tercer nivel de atención. México: Instituto Mexicano del Seguro Social; actualización junio 2010. Disponible en: http://www.imss.gob.mx/sites/all/statics/guiasclinicas/145GER.pdf

4. Le Chevalier T, Cvitkovic E, Caille P, Harvey J, Contesso G, Spielmann M, et al. Early metastatic cancer of unknown primary origin at presentation a clinical study of 302 consecutive autopsied patients. Arch Intern Med. 1988;148(9):2035-2039.

5. El Hiday AH, Khan FY, Almuzrakhshi AM, El Zeer H, Rasul FA. Colopleural fistula: case report and review of the literature. Ann Thoracic Med. 2008;3(3):108-109. Available in: https://doi.org/10.4103/1817-1737.41917

6. Hinojosa AC, Plata MJ, Medina H, Takahshi T. Manifestación extracolónica como primera manifestación del cáncer colorrectal. Informe de dos casos. Rev Gastroenterol Mex. 2002;67(4):267-270.

7. Lian R, Zhang G, Zhang G. Empyema caused by a colopleural fistula. A case report. Medicine (Baltimore). 2017;96(39):e8165. Available in: https://doi.org/10.1097/md.0000000000008165

8. Pickhardt PJ, Bhalla S, Balfe DM. Acquired gastrointestinal fistulas: classification, etiologies, and imaging evaluation. Radiology. 2002;224(1):9-23. Available in: https://doi.org/10.1148/radiol.2241011185

9. Domingo-Morera JA, Zabala-López S, Remírez-Molina A. A colopleural fistula as the clinical presentation of colonic adenocarcinoma. Arch Bronconeumol. 1999;35(1):52-53.

10. Ruiz TJ, Morales CV, Lobo ME. Complicaciones posquirúrgicas de la cirugía de colónica. Cir Cir. 2010;78:283-291.

11. Domingo MJ, Zabala LS, Remirez MA. Fistula colopleural como presentación clínica de adenocarcinoma de colon. Arch Bronconeumol. 1999;35(1):52-53.