Misdiagnosis Analysis of One Case of Abdominal Abscess Formation Associated with Colonic Cancer and Literature Review of 22 Cases

SONG Ping; LI Shi-kuan

doi:10.3969/j.issn.1002-3429.2016.04.010

Abstract：Objective To investigate the cause of abdominal abscess formation associated with colonic cancer and the treatment strategies in order to reduce the misdiagnosis and mistreatment rates. Methods We retrospectively analyzed the clinical data of a patient with abdominal abscess formation associated with colonic cancer, and reviewed the relevant articles. Results The patient was admitted to hospital with a 10-day history of pain in the right lower abdominal, and on the 5thd, the symptom became worse with chills and fever. The patient was diagnosed with abdominal abscess formation and underwent drainage. The patient was given sensitive antibiotics after surgery and was discharged after remission. Six months later, he was readmitted for abdominal abscess formation. The original diagnosis was maintained, and after the anti-biotic treatment and drainage, the patient was discharged again. The patient was admitted to hospital for the third time due to suspected intestinal contents flowing out after starching sinus in a local hospital. He was finally diagnosed as having the ascending colon cancer by electronic colonoscopy and pathological examination. The abdominal sinus was found to interlink with the tumor during opera-tion. Then the patient underwent the right hemicolectomy, and the abscess linked sinus was cut off. The pathology was poorly differentiated adenocarcinoma (T4bN0M0). After the full-course chemotherapy, the 6-month follow-up quality of life was ac-ceptable. Conclusion Clinicians should pay attention to colonic cancer in patients with abdominal abscess formation for no definite reason. CT scans combined with colonoscopy can help to confirm the diagnosis. The preferred treatment is elective hemicolectomy after drainage.