穿孔性虫垂炎にて発症した盲腸癌の2例

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  • TWO CASES OF CECAL CANCER PRESENTED WITH PERFORATED APPENDICITIS

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We report two cases of cecal cancer presented with perforated appendicitid, one of which was diagnosed postoperatively and another preoperatively. Patient 1, a 61-year-old man, was referred to our hospital because of high fever, diarrhea, and abdominal pain. Abdominal CT scan showed ascites in the entire abdominal cavity, and purulent fluid was aspirated by test puncture. Emergency laparotomy was performed with a diagnosis of panperitonitis. Because the appendix with severe inflammation perforated and formed abscess, and the ileocecal region turned out to be inflammatory masses, ilocecal resection was performed. The histopathological diagnosis was moderately differentiated adenocarcinoma. Patient 2, a 68-year-old man, was admitted to our hospital because of high fever and abdominal pain. Abdominal abscess associated with perforated panperitonotis was diagnosed but a cecal tumor was found and conservative therapy was started. Colonoscopy revealed the tumor that obsturucted the appendical lumen, and the hisopathological diagnosis was moderately differentiated adenocarcinoma. During surgery, swelling of the appendix, abscess formation and an ileocecal tumor were found, and then we perfomed right hemicolectomy and D3 lymph node dissection.

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